Cognitive deficits are common in heart failure, but does that include the ability to recognize and interpret the sometimes subtle cues that underpin social contact (social cognition)?
Social cognition includes emotion recognition, which is the ability to perceive and correctly distinguish emotions, and the ability to make inferences about the mental states of others, known as Theory of Mind (ToM). Researchers from Australian Catholic University say those cognitive skills are important, because patients with chronic heart failure (CHF) have debilitating physical symptoms that cause them to rely on support from others. Moreover, social isolation is a significant predictor of mortality in CHF—whereas social support increases overall quality of life.
Noting that no study has examined this topic, the researchers sought to test their theory that the impact of heart failure on cognition would include social cognition. They compared 31 CHF patients with 38 matched controls, using the Ekman Faces test to assess emotion recognition and the Mind in the Eyes test to measure ToM.
The researchers found no significant difference between the 2 groups in social cognition. People with CHF showed deficits in some, but not all, cognitive functions and had “relatively preserved memory function.” Those who had lower global cognitive ability were more likely to experience difficulty recognizing emotions and inferring mental states, as theorized, but lower scores on emotion cognition and ToM were not significantly correlated with measures of executive function or verbal memory.
The researchers found the differences surprising, because CHF causes diffuse damage to neural structures implicated in the social cognitive processes, such as the frontal and temporal regions. That kind of diffuse damage and widespread cognitive impairment is seen in people with traumatic brain injury, autism spectrum disorders, and multiple sclerosis, all groups that have shown deficits in emotion recognition. Social cognition deficits have also been linked to mood disorders, such as depression and anxiety—both common symptoms in CHF.
The researchers note that their patients were a relatively high-functioning group, both cognitively and symptomatically: Most had no or only mild heart failure symptoms, and the overall rating of depression was normal. Although these findings are preliminary, the researchers suggest that CHF patients with lower cognitive functioning are at risk for social cognitive deficits and might require tailored intervention that focuses on improving psychosocial functioning.
Source:
Stewart MW, Traylor AC, Bratzke LC. J Gerontol Nurs. 2015;41(11):50-59.
doi: 10.3928/00989134-20151015-06.