Heart Disease is one of the leading causes of death and disability in the United States. Disease processes such as Coronary Artery Disease (CAD) and Chronic Heart Failure (CHF) account for the majority of cases, and are responsible for Myocardial Infarctions (MI), Coronary Artery Bypass Grafting (CABG) surgery, and other common disease sequelae and treatment paradigms. While the fact that heart can negatively impact cognitive functioning is well documented, the factors that drive changes in cognition have not been studied in depth. Additionally, while many heart patients choose to enter cardiac rehabilitation (CR) programs designed to decrease morbidly and mortality, most do not. This study used hierarchical regression models to test these two aims. heart patients entering rehabilitation or electing not to participate were assessed using a chart review, standardized neuropsychological measures, and standard questionnaires, with a final sample size of 52 (11 controls, 41 rehabilitation subjects). For Aim 1, health (hypertension, CHF, surgery history), and cognitive reserve (education, premorbid IQ) variables successfully predicted the cognitive status of heart patients across several functional domains, while affective factors (depression, anxiety, stress) were less predictive. For Aim 2, cognitive variables were not significantly associated with whether or not a patient adheres to cardiac rehabilitation. Results indicate that multiple health and cognitive reserve-related factors impact cognitive functioning. Helping heart patients manage or compensate for identified risk factors could help mediate morbidity and mortality.

LLU Discipline

Clinical Psychology




School of Behavioral Health

First Advisor

Ropacki, Susan A.

Second Advisor

Hartman, Richard E.

Third Advisor

Houston-Feenstra, Linda

Fourth Advisor

Morrell, Holly E. R.

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded

January 2013

Date (Title Page)




Library of Congress/MESH Subject Headings

Heart Failure, Congestive; Cognition disorders; Cardiovascular Diseases - rehabilitation;

Subject - Local

Congestive heart failure; Cardiac rehabilitation; Cognitive impairments; Cognitive status; Cognitive predictors; Coronary artery disease



Page Count

121 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses & Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives