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Factors Associated with Perceived Cognitive Problems in Children and Adolescents with Congenital Heart Disease

  • Christine A. Limbers
  • Kara Emery
  • Karen Uzark
Article

Abstract

The objective of the present study was to assess demographic and disease-specific factors associated with perceived cognitive problems in children and adolescents with heart disease. 246 children with congenital heart disease ages 8–18 years and their parents completed the Cognitive Problems Scale of the Pediatric Quality of Life Inventory Cardiac Module. The 5-item Cognitive Problems Scale assesses school-related cognitive problems including attention and memory from the perspective of the child and parent. Multiple linear regression analysis was conducted with demographic variables and disease-specific factors entered as independent variables and perceived cognitive problems as the dependent variable. Socioeconomic status (SES) and cardiac disease severity were significantly associated with parent proxy-reported cognitive problems (p < .05). None of the demographic or disease-specific variables were significantly associated with child self-reported cognitive problems. In conclusion, our data suggest that assessment of perceived cognitive problems in children and adolescents with greater disease severity and from lower SES homes may facilitate early identification of children who need formal evaluation and interventions to address cognitive impairments.

Keywords

Cognitive problems Congenital heart disease Pediatric heart disease 

Notes

Conflict of interest

None.

References

  1. Berkes, A., Pataki, I., Kiss, M., Kemény, C., Kardos, L., Varni, J. W., et al. (2010a). Measuring health-related quality of life in Hungarian children with heart disease: Psychometric properties of the Hungarian version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales and the Cardiac Module. Health and Quality of Life Outcomes, 8, 1–12.CrossRefGoogle Scholar
  2. Berkes, A., Varni, J. W., Pataki, I., Kardos, L., Kemény, C., & Mogyorósy, G. (2010b). Measuring health-related quality of life in Hungarian children attending cardiology clinic with the Pediatric Quality of Life Inventory. European Journal of Pediatrics, 169, 333–347.PubMedCrossRefGoogle Scholar
  3. Boeka, A. G., & Lokken, K. L. (2008). Neuropsychological performance of a clinical sample of extremely obese individuals. Archives of Clinical Neuropsychology, 23, 467–474.PubMedCrossRefGoogle Scholar
  4. Brosig, C. L., Mussatto, K. A., Kuhn, E. M., & Tweddell, J. S. (2007). Neurodevelopmental outcome in preschool survivors or complex congenital heart disease: Implications for clinical practice. Journal of Pediatric Health Care, 21, 3–12.PubMedCrossRefGoogle Scholar
  5. DeMaso, D. R., Rao, S., Hirshberg, J., & Ibeziako, P. (2010). Heart disease. Arlington, VA: American Psychiatric Publishing.Google Scholar
  6. Forbess, J. M., Visconti, K. J., Bellinger, D. C., Howe, R. J., & Jonas, R. A. (2002). Neurodevelopmental outcomes after biventricular repair of congenital heart defects. Journal of Thoracic and Cardiovascular Surgery, 123, 631–639.PubMedCrossRefGoogle Scholar
  7. Gonzalez-Gil, T., Mendoza-Soto, A., Alonso-Lloret, F., Castro-Murga, R., Pose-Becerra, C., & Martin-Arribas, M. (2012). The Spanish version of the Health-related Quality of Life Questionnaire for children and adolescents with heart disease (PedsQL). Revista Espanola de Cardiologia, 65, 249–257 (English edition).PubMedGoogle Scholar
  8. Granberg, M., Rydberg, A., & Fisher, A. G. (2008). Activities in daily living and schoolwork task performance in children with complex congenital heart disease. Acta Paediatrica, 97, 1270–1274.PubMedCrossRefGoogle Scholar
  9. Gunstad, J., Paul, R. H., Cohen, R. A., Tate, D. F., Spitznagel, M. B., & Gordon, E. (2007). Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Comprehensive Psychiatry, 48, 57–61.PubMedCrossRefGoogle Scholar
  10. Hagger-Johnson, G. E., Shickle, D. A., Deary, I. J., & Roberts, B. A. (2010). Direct and indirect pathways connecting cognitive ability with cardiovascular disease risk: Socioeconomic status and multiple health behaviors. Psychosomatic Medicine, 72, 777–785.PubMedCrossRefGoogle Scholar
  11. Hemmingsson, T., Essen, J. V., Melin, B., Allebeck, P., & Lundberg, I. (2007). The association between cognitive ability measured at ages 18–20 and coronary heart disease in middle age among men: A prospective study using the Swedish 1969 conscription cohort. Social Science and Medicine, 65, 1410–1419.PubMedCrossRefGoogle Scholar
  12. Hövels-Gürich, H. H., Konrad, K., Skorzenski, D., Nacken, C., Minkenberg, R., Phys, D., … Seghaye, M. C. (2006). Long-term neurodevelopmental outcome and exercise capacity after corrective surgery for tetralogy of fallot or ventricular septal defect in infancy. Annals of Thoracic Surgery, 81, 958–967.Google Scholar
  13. Hoznik, M. P., MacFarlane, J. W., & Allen, L. (1948). The stability of mental test performance between two and eighteen years. Journal of Experimental Education, 17, 309–324.Google Scholar
  14. Karsdorp, P. A., Everaerd, W., Kindt, M., & Mulder, B. J. (2007). Psychological and cognitive functioning in children and adolescents with congenital heart disease: A meta-analysis. Journal of Pediatric Psychology, 32, 527–541.PubMedCrossRefGoogle Scholar
  15. Limperopoulos, C., Tworetzky, W., McElhinney, D. B., Newburger, J. W., Brown, D. W., Robertson, R. L., … du Plessis, A. J. (2010). Brain volume and metabolism in fetuses with congenital heart disease: Evaluation with quantitative magnetic resonance imaging and spectroscopy. Circulation, 121, 26–33.Google Scholar
  16. Neyens-Lidwien, G. J., & Aldenkamp, A. P. (1997). Stability of cognitive measures in children of average ability. Child Neuropsychology, 3, 161–170.CrossRefGoogle Scholar
  17. Phillips, J., & Klein, W. (2010). Socioeconomic status and coronary heart disease risk: The role of social cognitive factors. Social and Personality Psychology Compass, 4, 704–727.PubMedCrossRefGoogle Scholar
  18. Schaefer, S. E., Salazar, M., Bruhn, C., Saviano, D., Boushey, C., & Van Loan, M. D. (2009). Influence of race, acculturation, and socioeconomic status on tendency toward overweight in Asian-American and Mexican-American early adolescent females. Immigrant Minority Health, 11, 188–197.CrossRefGoogle Scholar
  19. Schuerger, J. M., & Witt, A. C. (1989). The temporal stability of individually tested intelligence. Journal of Clinical Psychology, 45, 294–302.CrossRefGoogle Scholar
  20. Spijkerboer, A. W., Utens, E. M., Bogers, A. J., Verhulst, F. C., & Helbing, W. A. (2008). Long-term intellectual functioning and school-related behavioural outcomes in children and adolescents after invasive treatment for congenital heart disease. British Journal of Developmental Psychology, 26, 457–470.CrossRefGoogle Scholar
  21. Tahirović, E., Begic, H., Nurkic, M., Tahirović, H., & Varni, J. W. (2010). Does the severity of congenital heart defects affect disease-specific health-related quality of life in children in Bosnia and Herzegovina. European Journal of Pediatrics, 169, 349–353.PubMedCrossRefGoogle Scholar
  22. Tahirović, E., Begić, H., Tahirović, H., & Varni, J. W. (2011). Quality of life in children after cardiac surgery for congenital heart disease. Collegium Antropologicum, 35, 1285–1290.PubMedGoogle Scholar
  23. Uzark, K., Jones, K., Burwinkle, T. M., & Varni, J. W. (2003). The Pediatric Quality of Life Inventory in children with heart disease. Progress in Pediatric Cardiology, 18, 141–148.CrossRefGoogle Scholar
  24. Uzark, K., Jones, K., Slusher, J., Limbers, C. A., Burwinkle, T. M., & Varni, J. W. (2008). Quality of life in children with heart disease as perceived by children and parents. Pediatrics, 121, e1060–e1067.PubMedCrossRefGoogle Scholar
  25. van der Rijken, R., Hulstin, W., Hulstijn-Dirkmaat, G., Daniels, O., & Maassen, B. (2011). Psychomotor slowness in school-age children with congenital heart disease. Developmental Neuropsychology, 36, 388–402.PubMedCrossRefGoogle Scholar
  26. Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQL 4.0: Reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Medical Care, 39, 800–812.PubMedCrossRefGoogle Scholar
  27. Warnes, C. A., Liberthson, R., Danielson, G. K., Dore, A., Harris, L., Hoffman, J. E., … Webb, G. D. (2001). Task force 1: The changing profile of congenital heart disease in adult life. Journal of the American College of Cardiology, 37, 1170–1175.Google Scholar
  28. Watanabe, K., Matsui, M., Matsuzawa, J., Tanaka, C., Noguchi, K., Yoshimura, N., … Gur, R. (2009). Impaired neuroanatomic development in infants with congenital heart disease. The Journal of Thoracic and Cardiovascular Surgery, 137, 146–153.Google Scholar
  29. Woolley, M. E., Bowen, G. L., & Bowen, N. K. (2004). Cognitive pretesting and the developmental validity of child self-report instruments: Theory and applications. Research Social Work and Practice, 14, 191–200.CrossRefGoogle Scholar
  30. Wray, J. (2006). Intellectual development of infants, children, and adolescents with congenital heart disease. Developmental Science, 9, 368–378.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Christine A. Limbers
    • 1
  • Kara Emery
    • 1
  • Karen Uzark
    • 2
  1. 1.Department of Psychology and NeuroscienceBaylor UniversityWacoUSA
  2. 2.Division of Pediatric Cardiology, C.S. Mott Children’s HospitalUniversity of Michigan Medical CenterAnn ArborUSA

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