Sex Differences in Psychosocial and Neurocognitive Outcomes in Adults with Moderate to Complex Congenital Heart Disease

患有中度至复杂先天性心脏病的成人心理社会和神经认知结果的性别差异

• 批准号: 10825104
• 负责人: Cristina Cabrera-Mino
• 金额: $ 3.98万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-11-15 至 2025-08-14
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10825104
• 关键词: Abbreviations; Academic achievement; Address; Adolescent; Adult; Affect; Age; Age Years; Aging; Analysis of Variance; Anxiety; Attention; Cardiac Surgery procedures; Caring; Caucasians; Chronic; Classification; Clinic; Clinical; Clinical Data; Cognitive; Communities; Comparative Study; Complex; Computerized Medical Record; Congenital Abnormality; Data; Development; Diagnosis; Dimensions; Disparity population; EFRAC; Early Intervention; Education; Employment; Ethnic Origin; Female; Food; Future; Generalized Anxiety Disorder; Goals; Health; Health Surveys; Heart; Hospitalization; Housing; Income; Intelligence; Intervention; Knowledge; Life; Logistic Regressions; Los Angeles; Measurement; Medical; Memory; Menopausal Status; Mental Depression; Methods; Moods; Morbidity - disease rate; Neurocognition; Neurocognitive; Neurocognitive Deficit; Operative Surgical Procedures; Outcome; Participant; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Physical Function; Population; Quality of life; Questionnaires; Reporting; Sample Size; Sampling; Science; Self Care; Self Management; Severity of illness; Sex Differences; Short-Term Memory; Social support; Testing; Unemployment; United States; Ventricular Ejection Fractions; Vulnerable Populations; age related; aged; analog; anxiety symptoms; cognitive testing; comparative; congenital heart disorder; depressive symptoms; design; disability; executive function; follow-up; gender difference; high risk; improved; improved outcome; innovation; male; mental function; middle age; mortality; processing speed; programs; psychosocial; recruit; sex; social health determinants

PROJECT ABSTRACT Congenital Heart Disease (CHD) is the number one birth defect worldwide, with 2.4 million people (1.4 million adults) in the United States. Those figures are expected to double in the next decade with more than 90% of CHD patients reaching adulthood. Despite medical and surgical advancements, 50% of adults with CHD have neurocognitive deficits, depression and heart-focused anxiety that can affect their daily life. However, there are no studies that examine sex differences in psychosocial and neurocognitive outcomes in adults with moderate to complex CHD. Only a few studies have examined either neurocognitive function or psychosocial outcomes in adults with CHD. Those studies have shown deficits in neurocognitive domains such as attention, executive function, processing speed, working memory and intelligence. These deficits place the patient at higher risk for lower educational attainment, unemployment, disability, poor self-care, increased mortality and morbidity, lower quality of life and potential loss to medical follow-up. Unfortunately, small sample sizes in these few studies limited further analysis based on sex / gender differences. To address this critical gap, we will recruit 180 CHD participants between 18 to 40 years of age with a diagnosis of moderate-to-complex CHD from the Ahmanson/UCLA Adult CHD Center. An additional sample of 40 healthy controls will be recruited from the Los Angeles community for comparison. This cross-sectional, comparative study will include measurements to assess neurocognition, anxiety/depression, social determinants of health, mental and physical functioning, social support, and quality of life. Clinical data include ventricular ejection fraction (EF), number of cardiac surgeries, CHD severity and menopause status in females. Specific Aim 1) Examine sex /gender differences in psychosocial, physical functioning, social determinants of health (SDoH), and neurocognitive scores in adults with moderate to complex CHD compared to age-, sex-, and ethnicity-matched controls. We hypothesize that males will have worse neurocognitive scores compared to females with CHD and matched controls, while females with CHD will have worse psychosocial scores compared to males with CHD and match controls. Specific Aim 2) Determine the relationship between neurocognitive scores and sex, clinical factors, SDoH, psychosocial, and physical functioning in adults with moderate-to-complex CHD. We hypothesize that greater number of surgeries, lower EF, worse physical function, higher levels of anxiety and depressive symptoms, less social support, negative SDoH, and male sex will be associated with worse neurocognitive scores in adults with moderate to complex CHD. This study will contribute to new knowledge on the association of sex / gender differences related to neurocognition and psychosocial outcomes in aging adults with CHD. The clinical implications are substantial as results will support the development of targeted interventions to improve neurocognitive and psychosocial outcomes in this high-risk, growing population.

项目摘要