The 2-minute step test is independently associated with cognitive function in older adults with heart failure

Background and aims: Cognitive impairment is common in persons with heart failure (HF), and measures like the 6-minute walk test (6MWT) are known to correspond to level of impairment. The 2-minute step test (2MST) has been suggested as a more practical alternative to the 6MWT, though no study has examined whether it is associated with cognitive impairment in persons with HF. This study examined whether the 2MST is associated with cognitive function in older adults with HF. Methods: Older adults with HF (n=145; 68.97±9.31 yrs) completed the 2MST and a neuropsychological test battery that assessed function in multiple cognitive domains. Results: Consistent with past work, HF patients exhibited high rates of cognitive impairment. Hierarchical regression analyses adjusting for demographic and medical characteristics found that the 2MST accounted for unique variance in global cognitive function (ΔR ²=0.09, p<0.001), executive function (ΔR²=0.03, p<0.05), and language (ΔR²=0.10, p<0.001). A trend emerged for attention (ΔR²=0.02, p=0.09). Follow-up tests indicated that better 2MST performance was significantly correlated with better global cognitive function, attention, executive, and language test performance. Conclusion: The current results indicate that the 2MST is associated with cognitive function in older adults with HF. Further work is needed to clarify underlying mechanisms for this association and the value of implementing the 2MST during routine visits.