Despite the fact that cognitive impairment is frequently seen in heart failure (HF), little is known about the relationship between cognitive function and self-care (SC) in this group. To determine if cognitive function in patients with HF is associated with ability to perform SC. n this cross sectional study, 70 participants with a ≥ 6 month history of HF were recruited from an urban university-based HF clinic and from a suburban private HF practice. Oral and written tests and self-report questionnaires were used to assess cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status, Anosognosia Questionnaire-Dementia, Controlled Oral Word Association Test) and SC ability (Self Care in Heart Failure Index). Hierarchical regression analysis was used to assess the relationship between immediate memory, delayed memory, attention, language, visuospatial/construction, executive function, insight and SC ability. Participants were young (mean 55 years), mostly minority (57%) and well educated (mean 14 years). Cognitive impairment was noted in 44% of participants in the visuospatial/constructional domain, 20% in global cognition, 11% in immediate memory, attention and delayed memory, 9% in language and 3% in executive function. Being Caucasian and having worse immediate memory predicted better confidence in SC after controlling for age, gender and educational level (R2=22%, p=.001). Minorities reported less confidence in their HF self-care, perhaps related to cultural sensitivity of tools or quality of interactions with health care providers. Interestingly, patients with poorer memory reported better self confidence in their HF self-care, which could be attributed to their inability to recall the challenges in managing their health. Implications for practice include the need to address health disparities issues in self-care behaviors of HF patients as well as the contribution of immediate memory on the practice of these behaviors.