Neurocognition in Adult Congenital Heart Disease: How to Monitor and Prevent Progressive Decline

Michelle Keir, Patricia Ebert, Adrienne H. Kovacs, Jonathan M.C. Smith, Emily Kwan, Thalia S. Field, Marie Brossard-Racine, Ariane Marelli

Research output: Contribution to journalReview article

Abstract

Children born with congenital heart disease (CHD) are now living to adulthood in unprecedented numbers and many will eventually live to become senior citizens. As care goals shift from surviving to thriving, a new focus on quality of life has emerged. Neurocognition and the ability to participate fully in society, form meaningful relationships, and collaborate effectively with the health care system are important considerations. As adults with CHD age, research regarding their cognitive function becomes prescient. The focus is now shifting from defining neurocognitive deficits in children with CHD to preventing neurocognitive decline in adults living with CHD. In this review, we describe the possible etiologies and predictors of neurocognitive decline in adults with CHD. We performed a comprehensive literature review to identify all of the current data available on neurocognitive function in adults with CHD. We summarize the available evidence by describing common deficits in this patient population and the potential effects of these deficits on adult functioning, health care decision-making, and long-term relationships with care providers. We review potential modifiable etiologies for progressive neurocognitive decline and suggest strategies for surveillance and prevention of the potential decline. We conclude that the current information available regarding the aging brain of adults with CHD and the effect of neurocognitive decline on morbidity and mortality is woefully insufficient. This review, therefore, provides a roadmap for future research endeavours to study neurocognition in older adults with CHD.

Original languageEnglish (US)
JournalCanadian Journal of Cardiology
DOIs
StateAccepted/In press - Jan 1 2019

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Heart Diseases
Delivery of Health Care
Aptitude
Cognition
Decision Making
Quality of Life
Morbidity
Mortality
Brain
Research
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Neurocognition in Adult Congenital Heart Disease : How to Monitor and Prevent Progressive Decline. / Keir, Michelle; Ebert, Patricia; Kovacs, Adrienne H.; Smith, Jonathan M.C.; Kwan, Emily; Field, Thalia S.; Brossard-Racine, Marie; Marelli, Ariane.

In: Canadian Journal of Cardiology, 01.01.2019.

Research output: Contribution to journalReview article

Keir, Michelle ; Ebert, Patricia ; Kovacs, Adrienne H. ; Smith, Jonathan M.C. ; Kwan, Emily ; Field, Thalia S. ; Brossard-Racine, Marie ; Marelli, Ariane. / Neurocognition in Adult Congenital Heart Disease : How to Monitor and Prevent Progressive Decline. In: Canadian Journal of Cardiology. 2019.
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