Cognitive dysfunction in adult CHD with different structural complexity

Manavi Tyagi, Theodora Fteropoulli, Catherine S Hurt, Shashivadan P Hirani, Lorna Rixon, Anna Davies, Nathalie Picaut, Fiona Kennedy, John Deanfield, Shay Cullen, Stanton P Newman

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

OBJECTIVE: We carried out a cross-sectional study to assess cognitive function in a sample of adult CHD patients, within the Functioning in Adult Congenital Heart Disease study London. The association between cognitive functioning and disease complexity was examined.

METHODS: A total of 310 patients participated in this study. Patients were classified into four structural complexity groups - tetralogy of Fallot, transposition of the great arteries, single ventricle, and simple conditions. Each patient underwent neuropsychological assessment to evaluate cognitive function, including memory and executive function, and completed questionnaires to assess depression and anxiety.

RESULTS: Among all, 41% of the sample showed impaired performance (>1.5 SD below the normative mean) on at least three tests of cognitive function compared with established normative data. This was higher than the 8% that was expected in a normal population. The sample exhibited significant deficits in divided attention, motor function, and executive functioning. There was a significant group difference in divided attention (F=5.01, p=0.002) and the mean total composite score (F=5.19, p=0.002) between different structural complexity groups, with the simple group displaying better cognitive function.

CONCLUSION: The results indicate that many adult CHD patients display impaired cognitive function relative to a healthy population, which differs in relation to disease complexity. These findings may have implications for clinical decision making in this group of patients during childhood. Possible mechanisms underlying these deficits and how they may be reduced or prevented are discussed; however, further work is needed to draw conclusive judgements.

Original languageEnglish
Pages (from-to)851-859
Number of pages9
JournalCardiology in the Young
Volume27
Issue number5
Early online date18 Oct 2016
DOIs
Publication statusPublished - Jul 2017

Keywords

  • Adolescent
  • Adult
  • Aged
  • Anxiety/psychology
  • Attention
  • Cognition
  • Cognitive Dysfunction/epidemiology
  • Cross-Sectional Studies
  • Depression/psychology
  • Executive Function
  • Female
  • Heart Defects, Congenital/classification
  • Humans
  • London/epidemiology
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Psychiatric Status Rating Scales
  • Self Report
  • Young Adult

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