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Background: Insomnia is prevalent among patients with heart failure (HF) and is associated with reduced physical and mental functioning, including possible exacerbation of cognitive deficits., Objectives: This study evaluated the effects of Brief Behavioral Treatment for Insomnia (BBTI) on insomnia and related factors among HF patients., Methods: Twenty-three HF patients with insomnia (70% women; 65% white; M age  = 55.7 ± 11.3 years; NYHA Class II = 70%) were randomized to a behavioral intervention (BI; n = 12) or sleep monitoring (SM; n = 11) group. Sleep, cognitive functioning, quality of life, distress, self-care, and functional status were assessed pre- and post-intervention., Results: BI participants experienced reduced insomnia and increased sleep quality and efficiency, with 58% demonstrating clinically meaningful improvements in insomnia and 25% achieving remission of insomnia symptoms. Depression and anxiety also improved in BI participants., Conclusions: BBTI was tolerated well within this symptom-limited patient population and was associated with reduced symptoms of insomnia and distress., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objectives: Cancer survivors often report cognitive problems. Furthermore, decreases in physical activity typically occur over the course of cancer treatment. Although physical activity benefits cognitive function in noncancer populations, evidence linking physical activity to cognitive function in cancer survivors is limited. In our recent randomized controlled trial, breast cancer survivors who received a yoga intervention had lower fatigue and inflammation following the trial compared with a wait list control group. This secondary analysis of the parent trial addressed yoga's impact on cognitive complaints., Methods: Posttreatment stage 0-IIIA breast cancer survivors (n = 200) were randomized to a 12-week, twice-weekly Hatha yoga intervention or a wait list control group. Participants reported cognitive complaints using the Breast Cancer Prevention Trial Cognitive Problems Scale at baseline, immediately postintervention, and 3-month follow-up., Results: Cognitive complaints did not differ significantly between groups immediately postintervention (p = 0.250). However, at 3-month follow-up, yoga participants' Breast Cancer Prevention Trial Cognitive Problems Scale scores were an average of 23% lower than wait list participants' scores (p = 0.003). These group differences in cognitive complaints remained after controlling for psychological distress, fatigue, and sleep quality. Consistent with the primary results, those who practiced yoga more frequently reported significantly fewer cognitive problems at 3-month follow-up than those who practiced less frequently (p < 0.001)., Conclusions: These findings suggest that yoga can effectively reduce breast cancer survivors' cognitive complaints and prompt further research on mind-body and physical activity interventions for improving cancer-related cognitive problems., (Copyright © 2014 John Wiley & Sons, Ltd.)

Purpose: This study compared visuomotor speed and cognitive flexibility in emphysema patients treated with either standard multidisciplinary medical therapy (MT) or lung volume reduction surgery (LVRS), followed over a 2-year period., Methods: MT patients (n = 544) and 542 LVRS patients completed the Trail Making Test (TMT) Parts A and B prior to randomization (baseline). Testing was repeated at 1 and 2 years., Results: There were no differences on scores for TMT Parts A and B between the LVRS and MT groups at baseline or at years 1 and 2. No significant difference between MT and LVRS was noted in terms of overall change in TMT Parts A and B over 2 years. The MT group had a significant improvement on TMT Part A at each followup time compared with baseline (P < .03) but the LVRS group did not. Both the MT and LVRS groups had a significant decline in performance (increase in time to completion) on TMT Part B when comparing year 1 with baseline (P < .0001)., Conclusion: Emphysema patients who received LVRS or MT as treatment performed similarly on measures of visuomotor speed and flexibility at baseline and 1- and 2-year followup. Both groups showed improvement on visuomotor speed during the first year yet overall cognitive flexibility declined. By the second year neither group had any significant change from baseline. These findings suggest that improvement on visuomotor speed and flexibility, observed in a previous 6-month study of LVRS subjects, was not sustained at 1- and 2-year followup.

Purpose: To evaluate the neuropsychological and psychological functioning of emphysema patients following 10 weeks of multidisciplinary medical therapy (MT)., Methods: Patients with moderate to severe emphysema (n = 56) enrolled in the National Emphysema Treatment Trial at 2 sites (National Jewish Health and Ohio State University) completed cognitive, psychological, and quality-of-life (QOL) tests at baseline and 6 to 10 weeks following participation in pulmonary rehabilitation. Healthy control subjects (matched on age, sex, race, and education, n = 54) completed the same tests at baseline and 6 to 10 weeks later., Results: Controlling for practice effects and educational level, emphysema patients in the MT group demonstrated significant improvement compared with controls on a global index of cognition, and in measures of visuomotor sequential skills and visual memory. The MT group showed significant reductions in several measures of depression and anxiety, and the control group showed a significant reduction in total depression, but acute anxiety scores were worse 6 to 10 weeks later. The MT group showed significant improvement on 6 of 9 QOL variables and no change was detected in the control group. Improvement on the cognitive index score in the mt group was related to decline in depression and increased workload., Conclusion: emphysema patients who received MT demonstrated improvement in specific neuropsychological functions, depression, anxiety, and QOL scores compared with control subjects during the same interval (with no treatment). Mechanisms for these neurobehavioral changes include greater exercise endurance and decreased depression.

This study evaluated outcomes of self-directed exercise activity on cognitive functioning and psychological well-being among 28 adults with chronic obstructive pulmonary disease (COPD). Participants had completed an intensive 10-week program of exercise training and were given an exercise prescription to follow. One year later, participants completed comprehensive assessments of physical, cognitive, and psychological functioning. At follow-up, 39% (n=11) had continued with a regular program of moderate intensity exercise. Repeated measures analysis of variance indicated that exercise adherent participants maintained gains they had achieved in the initial exercise intervention, but nonexercise participants experienced declines in functional capacity, cognitive performance, and psychological well-being. Continued exercise among patients with COPD is associated with maintenance of physical, cognitive, and psychological functioning.

Objective: Exercise has been associated with improved cognitive performance among patients with coronary artery disease. Music listening has been associated with enhanced cognitive functioning among healthy adults. This study evaluated the combined influence of exercise and music listening on cognitive performance among patients in cardiac rehabilitation (CR)., Design and Setting: Using a within-subjects repeated measures design, this study was conducted in an outpatient University-based CR facility., Sample: Thirty-three men and women (mean age = 62.6 +/- 10.5 years) participated in this study., Methods: Participants completed 1 exercise session accompanied by music and a second exercise session without music. Order of conditions was assigned randomly. Before and after each exercise session, participants completed a brief assessment of depression and anxiety, and a cognitive test of verbal fluency., Results: The music condition was associated with significant improvements in verbal fluency, but the no-music control condition was not associated with cognitive change., Conclusion: The study provides preliminary evidence of the combined benefit of exercise and music listening for cognitive performance among patients in CR.

This study was designed to evaluate the association of age, self-rated health, and walking activity with four measures of cognitive functioning in 6,979 men and women (age range: 18-94 years) randomly selected from British electoral registers. Assessments included a face-to-face interview regarding health and health beliefs as well as cognitive testing (including simple reaction time [SRT] and choice reaction time [CRT]. Hierarchical regression analyses indicated that faster reaction time (RT) speed was associated with both younger age and better self-rated health. There were also significant interactions of Age by Self-Rated Health and of Health Rating by Walking Activity for CRT, as well as an interaction of Age by Walking Activity for both SRT and CRT. Exercise and health may have an interactive effect on RT speed, and both exercise and health may modify age-related changes in RT.

The purpose of this study was to determine the psychological, behavioral, and cognitive changes associated with up to 14 months of aerobic exercise training. For the first 4 months of the study, 101 older (greater than 60 years) men and women were randomly assigned to one of three conditions: Aerobic exercise, Yoga, or a Waiting List control group. Before and following the intervention, all subjects completed a comprehensive assessment battery, including measures of mood and cognitive functioning. A semi-crossover design was employed such that, following completion of the second assessment, all subjects completed 4 months of aerobic exercise and underwent a third assessment. Subjects were given the option of participating in 6 additional months of supervised aerobic exercise (14 months total), and all subjects, regardless of their exercise status, completed a fourth assessment. Results indicated that subjects experienced a 10-15% improvement in aerobic capacity. In general, there were relatively few improvements in cognitive performance associated with aerobic exercise, although subjects who maintained their exercise participation for 14 months experienced improvements in some psychiatric symptoms. However, the healthy subjects in this study were functioning at a relatively high level to begin with, and exercise training may produce greater improvements among elderly with concomitant physical or emotional impairments.

The effects of aerobic exercise training in a sample of 85 older adults were investigated. Ss were assigned randomly to either an aerobic exercise group, a nonaerobic exercise (yoga) group, or a waiting-list control group. Following 16 weeks of the group-specific protocol, all of the older Ss received 16 weeks of aerobic exercise training. The older adults demonstrated a significant increase in aerobic capacity (cardiorespiratory fitness). Performance on reaction-time tests of attention and memory retrieval was slower for the older adults than for a comparison group of 24 young adults, and there was no improvement in the older adults' performance on these tests as a function of aerobic exercise training. Results suggest that exercise-related changes in older adults' cognitive performance are due either to extended periods of training or to cohort differences between physically active and sedentary individuals.