Abstract 4370743: Sex Differences in Cognitive and Psychosocial Outcomes in Adults with Moderate to Complex Congenital Heart Disease Compared to Controls

Background: Adults with moderate-to-complex congenital heart disease (CHD) show psychosocial and neurocognitive deficits, particularly in mood, anxiety, and cognitive domains. However, sex differences in neuropsychological outcomes remain underexplored. Objective: To examine sex-based differences in cognitive and psychosocial outcomes in adults with CHD compared to age- and sex-matched healthy controls. Methods: 80 adults (20 female CHD, 20 male CHD, 20 female controls, 20 males controls) were recruited. Cognitive tests were administered (Montreal Cognitive Assessment [MoCA], Wechsler Abbreviated Scale of Intelligence [WASI-II]) and questionnaires assessing anxiety, depression, and perceived social support were completed. Group comparisons were completed using independent samples t-tests, and the relationships between psychosocial and cognitive variables were examined using Pearson correlations. Results: The CHD group showed significantly worse neurocognitive performance in multiple domains (visuospatial/executive function (VISEXEC), attention, language, WASI-II full-scale IQ, verbal comprehension (VCI), perceptual reasoning (PRI) subscales), and higher anxiety and depression scores compared to controls (all p values < .030). The male CHD group performed significantly worse on the MoCA (p < .001), VISEXEC (p < .001), VCI (p = .05), PRI (p < .001), full-scale IQ (p = .002), and reported greater anxiety, depression, and lower social support (p = .049) compared to male controls. The female CHD group had significantly lower scores on the MoCA (p = .003), executive function (p = .001), attention (p = .002), WASI-II subtasks matrix reasoning (p < .001), vocabulary (p = .006), block design (p = .007), with no differences found in psychosocial measures compared to controls. In correlational analyses, among males with CHD, greater social support was associated with better executive function (r = 0.49, p < .03). Conclusions: Sex differences in adults with CHD are apparent in some cognitive and psychosocial domains compared to controls. Findings highlight the significance of social support and its association with executive function in adult males with CHD.