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Neurocognition in adults with congenital heart disease post-cardiac surgery: A systematic review
Cristina Cabrera-Mino1, Holli A DeVon2, Jamil Aboulhosn3
1University of California Los Angeles, United States.
Insights
Adults with congenital heart disease (CHD) often experience neurocognitive deficits. Factors like sex and socioeconomic status may influence cognitive outcomes, but more research is needed in diverse populations.
Area of Science:
- Cardiology
- Neuroscience
- Public Health
Background:
- Congenital heart disease (CHD) is the most common birth defect globally.
- Over 50% of adolescents and young adults with moderate to complex CHD experience neurocognitive deficits and psychiatric disorders impacting daily life.
Conclusions:
- Adults with CHD exhibit diverse cognitive deficits, with potential links to sex, clinical history, and SDoH factors.
- The precise impact of these factors on cognition in moderate to complex CHD remains unclear.
- Future longitudinal research should investigate age-related cognitive changes and healthcare disparities in diverse CHD populations.
Background:
Congenital heart disease (CHD) is the most common birth defect worldwide. Neurocognitive deficits and psychiatric disorders, which can impact daily life, have been reported in over 50% of adolescents and young adults with moderate to complex CHD.
Objective:
Conduct a systematic review of sex, clinical, psychological and social determinants of health (SDoH) factors affecting neurocognition in adults with CHD post-cardiac surgery.
Methods:
PubMed, Cumulated Index to Nursing and Allied Health Literature, and Embase were searched for relevant studies over the past 5 years. Thirteen articles met inclusion criteria of: 1) CHD post-cardiac surgery, 2) age ≥ 18 years, and 3) used a validated measure of neurocognition.
Results:
A total of 507 articles were identified. After screening, 30 articles underwent full text review yielding 13 eligible articles. Twelve articles reported deficits in multiple domains including executive function, intellectual functioning, visuospatial ability, and verbal fluency in more complex CHD. Only three studies examined cognition based on sex, with female and lower parental SES associated with worse cognitive outcomes. Most studies were from Europe, predominantly sampled Caucasian participants, had heterogeneous samples of CHD complexity, and lacked standardized cognitive measures which limited generalizability of findings.
Conclusions:
Adults with CHD present with a wide variety of cognitive deficits, with some associations with sex, clinical history, and SDoH factors. It remains unclear to what degree these factors affect cognition in adults with moderate to complex CHD. Future longitudinal studies should focus on age-related effects on cognition and potential health care disparities in diverse CHD samples.
