Cognitive Functioning and Psychosocial Outcomes in Adults with Complex Congenital Heart Disease: A Cross-sectional Pilot Study.

Verrall, CE; Tran, DL; Kasparian, NA; Williams, T; Oxenham, V; Ayer, J; Celermajer, DS; Cordina, RL

Cognitive Functioning and Psychosocial Outcomes in Adults with Complex Congenital Heart Disease: A Cross-sectional Pilot Study.

Verrall, CE Tran, DL Kasparian, NA Williams, T Oxenham, V Ayer, J Celermajer, DS Cordina, RL

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Publisher:: Springer Nature
Publication Type:: Journal Article
Citation:: Pediatr Cardiol, 2024, 45, (3), pp. 529-543
Issue Date:: 2024-03

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Field	Value	Language
dc.contributor.author	Verrall, CE
dc.contributor.author	Tran, DL
dc.contributor.author	Kasparian, NA
dc.contributor.author	Williams, T
dc.contributor.author	Oxenham, V
dc.contributor.author	Ayer, J
dc.contributor.author	Celermajer, DS
dc.contributor.author	Cordina, RL
dc.date.accessioned	2025-01-28T05:10:41Z
dc.date.available	2023-12-05
dc.date.available	2025-01-28T05:10:41Z
dc.date.issued	2024-03
dc.identifier.citation	Pediatr Cardiol, 2024, 45, (3), pp. 529-543
dc.identifier.issn	0172-0643
dc.identifier.issn	1432-1971
dc.identifier.uri	http://hdl.handle.net/10453/184286
dc.description.abstract	Adults with complex congenital heart disease (CHD) are at risk for cognitive dysfunction. However, associations between cognitive dysfunction and psychosocial outcomes are poorly defined. Between June and November 2022, we prospectively recruited 39 adults with complex CHD who completed a computerized cognitive assessment (Cogstate) and validated psychosocial scales measuring psychological distress, health-related quality of life (HRQOL), and resilience. Participants had a mean age of 36.4 ± 11.2 years. Over half (62%) were women, most (79%) had complex biventricular CHD, and 21% had Fontan physiology. Prevalence of cognitive dysfunction was greatest in the domains of attention (29%), working memory (25%), and psychomotor speed (21%). Adjusting for age and sex, Pearson partial correlations between Cogstate z-scores and self-reported cognitive problems were small. Participants who lived in the most disadvantaged areas and those with a below-average annual household income had lower global cognitive z-scores (p = 0.02 and p = 0.03, respectively). Two-thirds (64%) reported elevated symptoms of depression, anxiety, and/or stress. Small correlations were observed between psychological distress and cognitive performance. Greater resilience was associated with lower psychological distress (r ≥ -0.5, p < 0.001) and higher HRQOL (r = 0.33, p = 0.02). Our findings demonstrate that adults with complex CHD have a high risk of cognitive dysfunction, though may not recognize or report their cognitive challenges. Lower socioeconomic status may be an indicator for those at risk of poorer cognitive functioning. Psychological distress is common though may not be a strong correlate of performance-based cognitive functioning. Formal cognitive evaluation in this patient population is essential. Optimizing resilience may be a protective strategy to minimize psychological distress and bolster HRQOL.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Springer Nature
dc.relation.ispartof	Pediatr Cardiol
dc.relation.isbasedon	10.1007/s00246-023-03376-7
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology
dc.subject.classification	Cardiovascular System & Hematology
dc.subject.classification	3201 Cardiovascular medicine and haematology
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Middle Aged
dc.subject.mesh	Male
dc.subject.mesh	Pilot Projects
dc.subject.mesh	Quality of Life
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Cognition
dc.subject.mesh	Heart Defects, Congenital
dc.subject.mesh	Humans
dc.subject.mesh	Heart Defects, Congenital
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Pilot Projects
dc.subject.mesh	Cognition
dc.subject.mesh	Quality of Life
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Middle Aged
dc.subject.mesh	Male
dc.subject.mesh	Pilot Projects
dc.subject.mesh	Quality of Life
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Cognition
dc.subject.mesh	Heart Defects, Congenital
dc.title	Cognitive Functioning and Psychosocial Outcomes in Adults with Complex Congenital Heart Disease: A Cross-sectional Pilot Study.
dc.type	Journal Article
utslib.citation.volume	45
utslib.location.activity	United States
utslib.for	1102 Cardiorespiratory Medicine and Haematology
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2025-01-28T05:10:40Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	45
utslib.citation.issue	3

Abstract:

Adults with complex congenital heart disease (CHD) are at risk for cognitive dysfunction. However, associations between cognitive dysfunction and psychosocial outcomes are poorly defined. Between June and November 2022, we prospectively recruited 39 adults with complex CHD who completed a computerized cognitive assessment (Cogstate) and validated psychosocial scales measuring psychological distress, health-related quality of life (HRQOL), and resilience. Participants had a mean age of 36.4 ± 11.2 years. Over half (62%) were women, most (79%) had complex biventricular CHD, and 21% had Fontan physiology. Prevalence of cognitive dysfunction was greatest in the domains of attention (29%), working memory (25%), and psychomotor speed (21%). Adjusting for age and sex, Pearson partial correlations between Cogstate z-scores and self-reported cognitive problems were small. Participants who lived in the most disadvantaged areas and those with a below-average annual household income had lower global cognitive z-scores (p = 0.02 and p = 0.03, respectively). Two-thirds (64%) reported elevated symptoms of depression, anxiety, and/or stress. Small correlations were observed between psychological distress and cognitive performance. Greater resilience was associated with lower psychological distress (r ≥ -0.5, p < 0.001) and higher HRQOL (r = 0.33, p = 0.02). Our findings demonstrate that adults with complex CHD have a high risk of cognitive dysfunction, though may not recognize or report their cognitive challenges. Lower socioeconomic status may be an indicator for those at risk of poorer cognitive functioning. Psychological distress is common though may not be a strong correlate of performance-based cognitive functioning. Formal cognitive evaluation in this patient population is essential. Optimizing resilience may be a protective strategy to minimize psychological distress and bolster HRQOL.

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http://hdl.handle.net/10453/184286