title: Cognitive dysfunction in adult CHD with different structural complexity.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1Centre for Health Services Research,School of Health Sciences,City University London,London,United Kingdom.
authors.forename: Manavi
authors.initials: M
authors.lastname: Tyagi
authors.affiliation: 1Centre for Health Services Research,School of Health Sciences,City University London,London,United Kingdom.
authors.forename: Theodora
authors.initials: T
authors.lastname: Fteropoulli
authors.affiliation: 1Centre for Health Services Research,School of Health Sciences,City University London,London,United Kingdom.
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Hurt
authors.affiliation: 1Centre for Health Services Research,School of Health Sciences,City University London,London,United Kingdom.
authors.forename: Shashivadan P
authors.initials: SP
authors.lastname: Hirani
authors.affiliation: 1Centre for Health Services Research,School of Health Sciences,City University London,London,United Kingdom.
authors.forename: Lorna
authors.initials: L
authors.lastname: Rixon
authors.affiliation: 1Centre for Health Services Research,School of Health Sciences,City University London,London,United Kingdom.
authors.forename: Anna
authors.initials: A
authors.lastname: Davies
authors.affiliation: 2GUCH Unit,The Heart Hospital,University College of London Hospitals NHS Foundation Trust,London,United Kingdom.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Picaut
authors.affiliation: 2GUCH Unit,The Heart Hospital,University College of London Hospitals NHS Foundation Trust,London,United Kingdom.
authors.forename: Fiona
authors.initials: F
authors.lastname: Kennedy
authors.affiliation: 2GUCH Unit,The Heart Hospital,University College of London Hospitals NHS Foundation Trust,London,United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Deanfield
authors.affiliation: 2GUCH Unit,The Heart Hospital,University College of London Hospitals NHS Foundation Trust,London,United Kingdom.
authors.forename: Shay
authors.initials: S
authors.lastname: Cullen
authors.affiliation: 1Centre for Health Services Research,School of Health Sciences,City University London,London,United Kingdom.
authors.forename: Stanton P
authors.initials: SP
authors.lastname: Newman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D001288:Attention; D003071:Cognition; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D056344:Executive Function; D005260:Female; D006330:Heart Defects, Congenital / Q000145:classification* / Q000150:complications*; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D055815:Young Adult
keywords: Adult CHD; cognition; mood; neuropsychological assessment