Column by a new PhD


Carina Hjelm (1)I would like to tell you about the day I defended my dissertation, Friday the 13th of September. Yes, I made it despite that fateful date. I am very superstitious, but I was told by many people that this date had been really good for them. Now, Friday the 13th is my lucky day. The whole day was wonderful, the faculty opponent Ingrid Fagerberg was well prepared and we discussed my research for 4 hours. I managed to answer the grading committee’s questions and the evening was spent in the company of good friends, with speeches, singing, comedy, dance performances, presents and flowers. The day was absolutely wonderful and a real ego boost! I congratulate all of you who still have this ahead of you; writing the introductory chapter of the dissertation is hard work, but D-day is totally wonderful and exciting, and marks the end of your time as a doctoral student.

I thought I’d briefly describe the research findings presented in my dissertation:

This thesis is based on four quantitative studies. The data from study I and II were collected in a prospective longitudinal design, including Swedish same-sex twin pairs born in 1913 or earlier in Sweden. The study was conducted 1991-2002 and a total of 702 individuals aged 80 and older were included.

Study III and IV had a cross- sectional design and included stable HF patients, median 72 years of age, living in the community in the south of Sweden. Data were collected between 2009 and 2012. Study III included a total of 137 patients and Study IV included 142 patients.

The overall aim of this thesis was to explore cognitive function in elderly patients with chronic heart failure with focus on prevalence, risk factors, sleep and self-care.

The specific aims of the four studies were:

Aim I To examine the relationship between heart failure and specific cognitive abilities in octogenarians with regard to level and change over time.

Aim II To compare the prevalence of dementia in individuals 80 years or older with CHF and those in the same age group without CHF, and to identify the factors related to dementia in individuals diagnosed with CHF.

Aim III To compare sleep and wake patterns, insomnia, daytime sleepiness and cognitive function in community-dwelling CHF patients, with and without SDB, and to investigate the association between sleep-related factors and cognitive dysfunction.

Aim IV To test the relationship between cognitive function and self-care in patients with heart failure after adjusting for the contribution of age, education, functional status, myocardial stress, sleep and depression. Further, the relationship between cognitive function and self-care was explored with symptoms of depression and sleep as moderators.

I had a lot of interesting results, which you can find in my publications. In this column however, the editor wanted me to jump (!) to the conclusion…
Octogenarians suffering from HF have a decreased performance in spatial and episodic memory and they also have a higher risk for developing dementia. Cognitive dysfunction as well as higher prevalence of dementia can contribute to decreased adherence to prescribed therapy and self-care management, and lead to other socio-behavioural problems. Insomnia was the only sleep-related factor significantly influencing global cognitive function in patients with stable HF with few comorbidities. Self-care was found to be associated with psychomotor speed. This may influence sustained attention negatively and the ability to carry out more than one task at the same time. This may lead to decreased attention for receiving and understanding information on self-care.

If you have any further queries, please do not hesitate to contact me. Thank you for your attention.

Carina Hjelm, PhD