NIH Public Access
Author Manuscript
J Int Neuropsychol Soc. Author manuscript; available in PMC 2009 August 3.
NIH-PA Author Manuscript
Published in final edited form as:
J Int Neuropsychol Soc. 2009 January ; 15(1): 137–141. doi:10.1017/S1355617708090073.
Sustained attention is associated with left ventricular ejection
fraction in older adults with heart disease
Beth A. Jerskey1, Ronald A. Cohen1, Angela L. Jefferson2, Karin F. Hoth1,3, Andreana P.
Haley1,4, John J. Gunstad5, Daniel E. Forman6, Lawrence H. Sweet1, and Athena Poppas7
1Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University,
NIH-PA Author Manuscript
Providence, Rhode Island 2Alzheimer’s Disease Center, Department of Neurology, Boston
University School of Medicine, Boston, Massachusetts 3Division of Psychosocial Medicine, National
Jewish Health, Department of Psychiatry, University of Colorado Denver, Denver, Colorado
4Department of Psychology, University of Texas at Austin, Austin, Texas 5Department of
Psychology, Kent State University, Kent, Ohio 6Division of Cardiology, Department of Medicine,
Brigham and Women’s Hospital, Geriatric Research, Education, and Clinical Care, VAMC of Boston,
Harvard Medical School, Boston, Massachusetts 7Department of Cardiology, Rhode Island Hospital,
Brown Medical School, Providence, Rhode Island
Abstract
Poor cardiac pumping efficiency has shown to lead to cognitive impairments in patients with
cardiovascular disease (CVD). The current study examined the relationship between left ventricular
ejection fraction and sustained attention and inhibitory processes measured by the Adaptive Rate
Continuous Performance Task and the Go/No-go test. Participants were 67 older outpatients (age
68.5 ± 7.4) with a range of CVD. Associations between cognition and ejection fraction were examined
via linear regression analysis. Results were consistent with the hypothesis that lower ejection fraction
is significantly associated with decrements in sustained attention and vigilance. Overall, the results
provide support for the hypothesis that a change in cardiac pumping leads to decrements in some
aspects of attention; however, inhibitory processes are relatively spared.
Keywords
NIH-PA Author Manuscript
Cardiovascular disease; Ejection fraction; Sustained attention; Vigilance; ARCPT; Go/No-go
INTRODUCTION
With a longer life expectancy, the prevalence and incidence of cardiovascular disease (CVD)
among the elderly have increased substantially (Futterman & Lemberg, 2000). Historically,
clinical research has focused on the effects of chronic CVD on cognition due to either specific
vascular risk factors (e.g., hypertension) or the subsequent effects of cardiac procedures [e.g.,
coronary artery bypass grafting (CABG)]. Although clinicians generally recognize that elderly
patients with chronic CVD often become frail and experience significant functional problems
(Landi et al., 2001), reductions in function may be misattributed to either general aging or
specific risk factors and not related to reductions in overall cardiac performance. There is now
Copyright © 2009 INS. Published by Cambridge University Press.
Correspondence and reprint requests to: Ronald A. Cohen, Miriam Hospital Neuropsychology Clinic, The CORO Building, 3rd Floor,
One Hoppin Street, Providence, RI 02903. E-mail: E-mail: rcohen@lifespan.org; E-mail: beth_jerskey@brown.edu .
Jerskey et al.
Page 2
NIH-PA Author Manuscript
evidence that CVD is associated with cognitive decline even in the absence of clinical stroke
(Paul et al., 2005). Rather, diminished systemic perfusion from cardiac pump function and/or
peripheral vascular dysfunction increases the likelihood of cerebrovascular-associated brain
disturbances (Kalaria, 2003) and circulatory insufficiency, which leads to inadequate cerebral
perfusion and cerebral hypoxia, differentially affects discrete brain regions (i.e., predominant
patterns of white matter lesions in the frontal, occipital lobes and in the periventricular regions
in severe anoxic state; Ammermann et al., 2007).
NIH-PA Author Manuscript
Although the sequelae of hypoxemia or anoxia are complex and diverse in regard to cerebral
functioning (see Caine & Watson, 2000, for review), reduced localized cerebral blood flow
has been found in individuals diagnosed with heart failure (i.e., posterior cortical areas; Alves
et al., 2005) and a history of cardiac arrest (i.e., frontal hypoperfusion; Roine et al., 1991), and
those exhibiting neuropsychological complications related to CABG (i.e., frontal and left
parietal hypoperfusion; Degirmenci et al., 1998). These cortical areas in particular have been
linked to the attention network (Toro et al., 2008). Hypoperfusion to these areas may result in
a variety of cerebral insults from diffuse changes in white matter (O’Sullivan et al., 2002) to
subcortical atrophy (Appelman et al., 2008), either of which could contribute to reductions in
cognitive functioning. Although changes in cognitive functioning are a common part of normal
aging (Brickman et al., 2007), interpretations of results from studies reporting more global
dysfunction are complicated by the demand of underlying attentional processes on other
cognitive domains (e.g., memory). Our prior research with cardiac outpatients supports this
observation by demonstrating that attention and executive deficits adversely impact significant
learning impairment and functional outcome (Jefferson et al., 2006).
The objective of the current study was to focus on various measures of attention since associated
brain regions may be particularly sensitive to reductions in cerebral blood flow. The outpatients
in the current study represent a heterogeneous group with a wide variability in cardiac
functioning. We hypothesized that among older adults with CVD, diminished ejection fraction
would be associated with reductions in various forms of attention.
METHOD
Participants
NIH-PA Author Manuscript
Participants consisted of 76 older adults recruited from the outpatient cardiology offices
affiliated with the Rhode Island Hospital and the Miriam Hospital in Providence, Rhode Island.
The majority of the participants were identified from patients undergoing noninvasive
cardiovascular assessment for coronary heart disease at the Rhode Island Hospital Heart Failure
Clinic. Participants were native English speakers with normal or corrected hearing and vision
at the time of testing. In addition to an extensive medical history interview and medical chart
review, patients were assessed for signs of stroke or other neurological abnormalities by a
cardiologist (AP). Participants were excluded from the study if they had a history of stroke, a
moderate or severe traumatic brain injury (with loss of consciousness), or any other
documented significant neurological disease (e.g., dementia, multiple sclerosis). In addition,
participants were administered a comprehensive neuropsychological battery and were
excluded if they demonstrated any focal determents on formal testing. Any questionable cases
were discussed between one of the primary cardiologists on this study (AP) and a boardcertified neuropsychologist (RAC). Additional exclusion criteria included a diagnosed current
psychiatric illness and history of substance abuse with subsequent hospitalization. Table 1 lists
the clinical characteristics of the sample.
All participants scored below the cutoff for clinically significant depression (<10) on the Beck
Depression Inventory (Beck & Steer, 1993) and were nondemented (Dementia Rating Scale
>124), indicating intact global cognitive functioning according to published norms (Mattis,
J Int Neuropsychol Soc. Author manuscript; available in PMC 2009 August 3.
Jerskey et al.
Page 3
1988). Institutional IRB approval was granted, and informed consent was obtained from all
participants prior to testing. Participants were compensated $50 each.
NIH-PA Author Manuscript
Echocardiogram
Participants were asked to refrain from taking vasoactive medications (e.g., calcium channel
blockers, ACE inhibitors, and beta blockers), drinking caffeinated beverages, exercising, or
smoking for 6 hr before the vascular assessment. Furthermore, all participants fasted for 6 hr
prior to their cardiac assessment. Prior to testing, patients remained supine for 15 min in a quiet
room.
A complete, transthoracic echocardiogram was obtained from each participant according to
the American Society of Echocardiography guidelines. Although many different indices can
be derived from the echocardiogram results, our primary interest for this research was to
examine left ventricular ejection fraction. Ejection fraction is a general measure of how well
the heart is pumping, specifically the performance of the left ventricle (LV). The LV enddiastolic and end-systolic volumes (LVEDV and LVESV, respectively) were calculated, and
ejection fraction is a product of the following formula: (LVEDV – LVESV)/LVEDV.
Reference ranges have been previously published; typically values >0.55 are considered
normal, 0.45–0.55 mildly abnormal, 0.30–0.44 moderately abnormal, and <0.30 severely
abnormal (Lang et al., 2005).
NIH-PA Author Manuscript
Neurocognitive Assessment
All participants completed a standardized neuropsychological assessment by trained research
assistants under the supervision of a licensed clinical neuropsychologist (RAC). Results of
assessments of other cognitive domains have been reported previously (Paul et al., 2005).
NIH-PA Author Manuscript
Adaptive Rate Continuous Performance Test—This computerized test is a
modification of the standardized Continuous Performance Test (Rosvold et al., 1956), which
is used to measure vigilance and sustained attention. The Adaptive Rate Continuous
Performance Test (ARCPT) requires identification of target stimuli in specific combinations
(i.e., the letter “A” followed by the letter “X”). Trials are presented in 10 blocks of 100 trials.
A series of letters is presented on a computer monitor for a 100-ms duration each. A total of
60 targets are presented (A–X), comprising 15% of the total stimuli. Targets are grouped into
10 blocks containing six targets per block for subsequent scoring, though participants are
unaware of these blocks, as stimulus presentation is continuous once the task begins. When
the target appears on the screen, the participant is instructed to press the spacebar on a computer
keyboard. The ARCPT differs from the conventional CPT in that the interstimulus interval
(ISI) varies across blocks of trials as a function of the participant’s performance. A unique
aspect of the ARCPT is this adaptive rate. The ISI, which is initially set at 60 ms, decreases
by 4 ms after each correct response and increases by 4 ms after each error. The ISI settles at a
final ISI, which reflects the minimum ISI at which participants can maintain 80% accuracy.
Sustained attention indices derived from the ARCPT are measures of accuracy of target
detection, including misses and false-positive errors, from which discrimination ability (d′)
and response bias (β) are derived. An additional two indices provide measures of the
consistency of attention over time, an Inconsistency Index, which measures variability over
the 10 blocks of the ARCPT, and Vigilance Decrement, which measures the decline in overall
performance across the duration of the test. Also, a measure of speed of processing is based
on the ISI occurring by the end of the test (Final ISI), which represents the fastest sustained
stimulus presentation rate that the patient was able to achieve. In total, six separate ARCPT
indices were examined in the current study (i.e., Vigilance Decrement, response bias, Final
ISI, discrimination, inconsistency, and false-positive response). The ARCPT has shown to be
J Int Neuropsychol Soc. Author manuscript; available in PMC 2009 August 3.
Jerskey et al.
Page 4
NIH-PA Author Manuscript
a highly reliable and valid measure. Based on the normative data, the group as a whole was
more variable on the Inconsistency Index, although not impaired. Vigilance Decrement was
reflected a normal rate of speed; however, the total ISI was slower. Accuracy was well above
chance (Cohen & Gunstad, 2008).
Go/No-go Test—This test of response competition and inhibition is an adaptation of the
standard Go/No-go paradigm (Lezak, 1995). Briefly, the examiner shows a sequence of finger
extensions on his or her right hand (either index finger only or index and middle fingers
together) with a 1-s interval between stimuli. Participants are instructed to show their index
finger of their dominant hand if they were presented with a two-finger demonstration and not
show any fingers if presented with only one finger from the examiner. This portion of the task
followed a standard contrasting motor paradigm in which participants were instructed to show
one finger if they saw two examiner fingers and two fingers if they saw one examiner finger.
Therefore, a prepotent response was established to respond with a two-finger response in the
subsequent No-go condition. A random sequence of 40 stimuli was presented with half of the
stimuli being the No-go (i.e., showing a two-finger response). The number of commission
errors was recorded (i.e., responding to “No-go” stimuli) as well as total number of errors
including perseveration and failure to respond to “Go” stimuli (Table 2).
NIH-PA Author Manuscript
Echocardiograms were completed between 2 and 4 weeks after the completion of the
neuropsychological battery.
Data Analysis
Descriptive statistics were performed to characterize the sample with respect to demographic
and clinical characteristics, ejection fraction, and neurocognitive performance. Pearson’s
correlations between sex and age were used to investigate the relationship of these a priori
factors to ejection fraction and ARCPT variables, the respective dependent and independent
variables in the primary model. Last, multiple regression analyses were performed using SPSS
13.0 (SPSS Inc., Chicago, IL) to examine the association between ejection fraction and
attention performance, which was entered in one step.
RESULTS
NIH-PA Author Manuscript
Independent t-test analysis was performed on all the clinical characteristics (i.e., CABG,
stenting, angioplasty, CAD, arrhythmia, heart failure) and ejection fraction. Individuals with
heart failure diagnosed by their cardiologist, which by definition is a result of reduced cardiac
output, had significantly lower ejection fractions than participants without heart failure (mean
heart failure group = 0.5182 ± 0.120 vs. non-heart failure = 0.60832 ± 0.110, p = .011). In
addition, bivariate correlations between ejection fraction and sex and age were not significant.
However, significant relationships with neurocognitive measures were observed. Increased age
was related to worse ARCPT discrimination (r = −.316, p = .005) and longer finial ISI (r = .
232, p = .044). Men made more Go/No-go errors than women (r = −.275, p = .016).
Since neither age nor sex was significantly associated with ejection fraction, the final regression
analysis consisted only of the neuropsychological variables. The six ARCPT indices and Go/
No-go errors were independent measures entered in one step with ejection fraction entered as
the dependent measure. Three of the six ARCPT variables were significant predictors of
ejection fraction (vigilance: β = −.32, p = .012; discrimination: β = −.42, p = .039; and falsepositive errors: β = −.51, p = .045). This model accounted for 20.5% of the total variance [F
(7, 60) = 2.21, p = .046, r = .453]. No association emerged for the Go/No-go test.
J Int Neuropsychol Soc. Author manuscript; available in PMC 2009 August 3.
Jerskey et al.
Page 5
DISCUSSION
NIH-PA Author Manuscript
The present study assessed the relationship between ejection fraction and sustained attention
and disinhibition among an older adult cohort with stable cardiovascular insufficiencies.
Consistent with our a priori hypotheses, ejection fraction was associated with impairments
with specific aspects of attention, specifically continuous vigilance and discriminability;
patients with lower cardiac pumping efficiency had difficulty on measures of sustained
attention. Ejection fraction was not associated with one of the measures of disinhibition, the
Go/No-go test, perhaps demonstrating specificity for certain attentional-based processes.
NIH-PA Author Manuscript
Findings from neuroimaging studies provide one possible explanation as to why some, but not
all, attention measures were related to ejection fraction. Research using the Continuous
Performance Test has found widespread neuronal activation patterns in prefrontal and frontal
cortex (Adler et al., 2001). It is possible that discriminability and subsequent false-positive
errors are associated with error monitoring and error processing systems in the brain. These
two systems only partially overlap with brain regions engaged in inhibitory control and
response competition. Gehring and Knight (2000) reported that the lateral prefrontal cortex
interacts directly with the anterior cingulate in monitoring behavior and guiding compensatory
systems. In addition, the neural correlates of vigilance and sustained attention have also been
largely localized to include the right prefrontal as well as the parietal lobe and thalamus (Sarter
et al., 2001). These anterior structures are potentially vulnerable to systemic reductions in blood
flow due to both their overall mass and their contiguous circuits with subcortical structures
(Cummings, 1993), many of which are susceptible to alteration in blood flow (Moody et al.,
1990). An alternative explanation is that these processes, and thus subsequent error monitoring,
are more sensitive to cognitive impairments associated with reduced systemic perfusion.
NIH-PA Author Manuscript
Our findings expand the existing literature by illustrating the association between a direct
measure of cardiac pumping efficiency and different elements of attention in a cohort that
presents unique issues associated with neurovascular aging (Tao et al., 2004). However, there
are several limitations that must be considered. Most participants were well educated and
identified themselves as whites of European descent; therefore, we are unable to determine if
results generalize to other ethnic groups. Although extensive medical background was taken
and participants with a clinical history of stroke were excluded, there remains the possibility
that the participants in this study had experienced underlying silent infarcts that were not
clinically identifiable. Whereas changes in large vessel functioning usually become acutely
obvious, alterations to smaller vessels may occur without detection and lead to substantial
changes in cognitive functioning in apparently neurologically intact older adults (Enzinger et
al., 2007). In addition, this study was aimed at studying ejection fraction as a mechanism of
cardiovascular functioning, and a measure of cerebral perfusion was not included. Ultimately,
it will be important to examine how cardiac function relates to cerebral profusion via other
neuroimaging measures such as Arterial Spin Labeling (Liu & Brown, 2007).
In conclusion, there is considerable value in the study of cognitive function in relationship to
cardiac dysfunction associated with CVD. Consideration of reduced cognitive capacity related
to neuronal changes stemming from CVD is essential as the population of elderly with CVD
increases. Since most CVD patients have a mixture of risk factors, studying patients
encompassing a broad range of cardiovascular dysfunction through the simultaneous
measurement of cardiovascular, peripheral vascular, and cerebrovascular function will likely
facilitate the detection of cognitive effects associated with a poor systemic vasculature.
ACKNOWLEDGMENTS
This work was supported by National Institute of Health grants AG017975 (RAC), AG026850 (KFH), HL074568
(JJG), HD043444 (ALJ), and AG020498 (BAJ, APH).
J Int Neuropsychol Soc. Author manuscript; available in PMC 2009 August 3.
Jerskey et al.
Page 6
REFERENCES
NIH-PA Author Manuscript
NIH-PA Author Manuscript
NIH-PA Author Manuscript
Adler CM, Sax KW, Holland SK, Schmithorst V, Rosenberg L, Strakowski SM. Changes in neuronal
activation with increasing attention demand in healthy volunteers: An fMRI study. Synapse 2001;42
(4):266–272. [PubMed: 11746725]
Alves TC, Rays J, Fráguas R Jr, Wajngarten M, Meneghetti JC, Prando S, Busatto GF. Localized cerebral
blood flow reductions in patients with heart failure: A study using 99mTc-HMPAO SPECT. Journal
of Neuroimaging 2005;15(2):150–156. [PubMed: 15746227]
Ammermann H, Kassubek J, Lotze M, Gut E, Kaps M, Schmidt J, Rodden FA, Grodd W. MRI brain
lesion patterns in patients in anoxia-induced vegetative state. Journal of the Neurological Sciences
2007;60(1–2):65–70. [PubMed: 17490686]
Appelman AP, van der Graaf Y, Vincken KL, Tiehuis AM, Witkamp TD, Mali WP, Geerlings MI.
SMART study Group. Total cerebral blood flow, white matter lesions and brain atrophy: The SMARTMR study. Journal of Cerebral Blood Flow and Metabolism 2008;28(3):633–639. [PubMed:
17912270]
Beck, A.; Steer, R. Manual for the Beck Depression Inventory. San Antonio, TX: Psychological
Corporation; 1993.
Brickman AM, Habeck C, Zarahn E, Flynn J, Stern Y. Structural MRI covariance patterns associated
with normal aging and neuropsychological functioning. Neurobiology of Aging 2007;28(2):284–295.
[PubMed: 16469419]
Caine D, Watson JD. Neuropsychological and neuropathological sequelae of cerebral anoxia: A critical
review. Journal of the International Neuropsychological Society 2000;6(1):86–99. [PubMed:
10761372]
Cohen, RA.; Gunstad, J. Adaptive Rate Continuous Performance Test: Standardization and validation.
Poster presented at the 36th annual meeting of the International Neuropsychological Society;
Waikoloa, Hawaii. 2008 Feb.
Cummings JL. Frontal-subcortical circuits and human behavior. Archives of Neurology 1993;50(8):873–
880. [PubMed: 8352676]
Degirmenci B, Durak H, Hazan E, Karabay O, Derebek E, Yilmaz M, Ozbilek E, Oto O. The effect of
coronary artery bypass surgery on brain perfusion. Journal of Nuclear Medicine 1998;39(4):587–
591. [PubMed: 9544661]
Enzinger C, Fazekas F, Ropele S, Schmidt R. Progression of cerebral white matter lesions—Clinical and
radiological considerations. Journal of Neurological Science 2007;257(1–2):5–10.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive
state of patients for the clinician. Journal of Psychiatric Research 1975;12:189–198. [PubMed:
1202204]
Futterman LG, Lemberg L. The Framingham Heart Study: A pivotal legacy of the last millennium.
American Journal of Critical Care 2000;9(2):147–151. [PubMed: 10705428]
Gehring WJ, Knight RT. Prefrontal-cingulate interactions in action monitoring. Nature Neuroscience
2000;3(5):516–520.
Jefferson AL, Poppas A, Paul RH, Cohen RA. Systemic hypoperfusion is associated with executive
dysfunction in geriatric cardiac patients. Neurobiology of Aging 2006;28(3):477–483. [PubMed:
16469418]
Kalaria RN. Vascular factors in Alzheimer’s disease. International Psychogeriatrics 2003;15:47–52.
[PubMed: 16191216]
Landi F, Onder G, Cattel C, Gambassi G, Lattanzio F, Cesari M, Russo A, Bernabei R. Silvernet-HC
Study Group. Functional status and clinical correlates in cognitively impaired community-living
older people. Journal of Geriatric Psychiatry andNeurology 2001;14(1):21–27.
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ,
Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ. Chamber Quantification
Writing Group, American Society of Echocardiography’s Guidelines and Standards Committee, &
European Association of Echocardiography. Recommendations for chamber quantification: A report
from the American Society of Echocardiography’s Guidelines and Standards Committee and the
Chamber Quantification Writing Group, developed in conjunction with the European Association of
J Int Neuropsychol Soc. Author manuscript; available in PMC 2009 August 3.
Jerskey et al.
Page 7
NIH-PA Author Manuscript
NIH-PA Author Manuscript
Echocardiography, a branch of the European Society of Cardiology. Journal of the Society of
American Echocardiography 2005;18:1440–1463.
Lezak, MD. Neuropsychological Assessment. Vol. 3rd Edition. New York: Oxford University Press;
1995.
Liu TT, Brown GG. Measurement of cerebral perfusion with arterial spin labeling: Part 1. Methods.
Journal of the International Neuropsychological Society 2007;13:1–9. [PubMed: 17166298]
Mattis, S. Dementia Rating Scale (DRS). Odessa, FL: Psychological Assessment Resources; 1988.
Moody DM, Bell MA, Challa VR. Features of the cerebral vascular pattern that predict vulnerability to
perfusion or oxygenation deficiency: An anatomic study. American Journal of Neuroradiology
1990;11(3):431–139. [PubMed: 2112304]
O’Sullivan M, Lythgoe DJ, Pereira AC, Summers PE, Jarosz JM, Williams SC, Markus HS. Patterns of
cerebral blood flow reduction in patients with ischemic leukoaraiosis. Neurology 2002;59(3):321–
326. [PubMed: 12177363]
Paul RH, Gunstad J, Poppas A, Tate DF, Foreman D, Brickman AM, Jefferson AL, Hoth K, Cohen RA.
Neuroimaging and cardiac correlates of cognitive function among patients with cardiac disease.
Cerebrovascular Disease 2005;20:129–133.
Roine RO, Launes J, Nikkinen P, Lindroth L, Kaste M. Regional cerebral blood flow after human cardiac
arrest. A hexamethylpropyleneamine oxime single photon emission computed tomographic study.
Archives of Neurology 1991;48(6):625–629. [PubMed: 2039385]
Rosvold HE, Mirsky AF, Sarandon I, Bransome ED, Beck LH. A continuous performance test of brain
damage. Journal of Consulting Psychology 1956;20:343–350. [PubMed: 13367264]
Sarter M, Givens B, Bruno JP. The cognitive neuroscience of sustained attention: Where top-down meets
bottom-up. Brain Research Brain Research Reviews 2001;35(2):146–160. [PubMed: 11336780]
Tao J, Jin YF, Yang Z, Wang LC, Gao XR, Lui L, Ma H. Reduced arterial elasticity is associated with
endothelial dysfunction in persons of advancing age: Comparative study of noninvasive pulse wave
analysis and laser Doppler blood flow measurement. American Journal of Hypertension 2004;17(8):
654–659. [PubMed: 15288882]
Toro R, Fox PT, Paus T. Functional coactivation map of the human brain. Cerebral Cortex 2008;18(11):
2553–2559. [PubMed: 18296434]
NIH-PA Author Manuscript
J Int Neuropsychol Soc. Author manuscript; available in PMC 2009 August 3.
Jerskey et al.
Page 8
Table 1
Clinical characteristics of sample
Mean
SD
Range
NIH-PA Author Manuscript
Male
%
55
Female
45
Age
68.5
7.37
56–85
Education
14.26
2.80
8–20
Caucasian
89.8
African American
8.5
Other
1.7
Coronary artery disease
35.6
CABG
30.3
Angioplasty
28.3
Heart failure
24.2
Stenting
19.0
Cardiac arrhythmia
16.7
NIH-PA Author Manuscript
NIH-PA Author Manuscript
J Int Neuropsychol Soc. Author manuscript; available in PMC 2009 August 3.
Jerskey et al.
Page 9
Table 2
Neuropsychological functioning of sample
NIH-PA Author Manuscript
Measure
Mean
SD
Range
MMSE total
28.78
1.318
25–30
137.80
3.78
126–144
Attention
35.91
1.34
31–37
I/P
35.91
1.83
29–37
DRS total
DRS subtests
Construction
5.55
0.89
3–6
Conceptualization
36.50
2.16
31–39
Memory
24.00
1.51
18–25
ARCPT discrimination (d′)
2.43
0.61
0.24–3.66
ARCPT bias (β)
0.63
0.30
−0.13 to 1.0
ARCPT inconsistency
8.71
3.77
3.0–20.0
NIH-PA Author Manuscript
ARCPT vigilance
0.05
0.05
−0.06 to 0.29
ARCPT final ISI
95.91
62.96
28.1–397.6
ARCPT false-positive errors
2.96
3.89
0.0–25.0
Go/No-go errors
1.04
1.29
0.0–1.0
Note. MMSE = Mini-Mental Status Examination; DRS = Mattis Dementia Rating Scale; I/P = initiation/perseveration (Folstein et al., 1975).
NIH-PA Author Manuscript
J Int Neuropsychol Soc. Author manuscript; available in PMC 2009 August 3.