Grant: CIHR REDI Early Career Transition Award - Brain Health and Cognitive Impairment

Cardiovascular disease is the 2nd leading cause of death and major driver of system burden in Canada. Depression and cognitive impairment commonly co-occur in stroke and heart failure, and are estimated to affect 30-40% of individuals with these conditions. These comorbidities have a significant impact on self-care and quality of life. Caregivers, or individuals who provide unpaid care for individuals with these conditions play an important in supporting individuals with these conditions. Occupational engagement, or participation in meaningful activity, is often disrupted and renegotiated after a cardiovascular event for individuals with stroke or heart failure and their caregivers. This is made more complex when individuals with these conditions also have depressive and/or cognitive comorbidity. In stroke and heart failure, evidence suggests that exercise is an important and meaningful activity to promote cardiovascular health and functional mobility. However, little is known about how engaging in exercise may impact on participation in other meaningful activities, yet this is critical because occupational engagement is a significant factor for promoting quality of life. Taking a qualitative approach to obtain perspectives of individuals with these conditions and their caregivers will provide invaluable insight into this. Research suggests sex-specific differences in cardiovascular outcomes and multimorbidity where women are impacted to a greater extent than men. There has been little attention to date focusing on sex differences in occupational engagement yet it is critical for developing tailored intervention approaches and for promoting quality of life. Using an implementation science approach to study how prediction tools for depressive and/or cognitive comorbidity and difficulties with self-care and quality of life can be integrated into standard clinical practice will facilitate their integration into existing systems, scale-up and sustainability.