Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Neuroscience

Supervisor

Owen, Adrian M.

2nd Supervisor

Debicki, Derek

Co-Supervisor

Abstract

Sex differences exist in the predisposition, exposure, treatment, and recovery of adults who have experienced adverse cardiac events. Women tend to experience cardiac events at older ages, receive fewer evidence-based treatments, and report poorer global outcomes. To date, however, scarce research has examined the impact of sex and gender on cognitive and psychological outcomes. With this is mind, the present study aimed to determine whether men and women hospitalized for out-of-hospital cardiac arrest and ST segment elevation myocardial infarction differed on web-based cognitive tests and psychological screening. In contrast with general trends, women had better resuscitation circumstances and neurological prognosis. Findings revealed mild impairment on the Creyos battery but showed no sex differences in cognitive function in the acute and long-term stages of recovery. Women reported worse psychological outcomes at hospital discharge and 3-months. These findings provide justification for cognitive and psychological screening prior to hospital discharge for women who suffer cardiac incidents.

Summary for Lay Audience

Out-of-hospital cardiac arrest (OHCA) occurs when the heart stops pumping and circulating blood. Myocardial infarction (MI) is a blockage in the heart which leads to the death of cardiac muscle. These ischemic events are medical emergencies and require immediate action. However, even with prompt interventions, death and disability remain common outcomes. Recent evidence paints a bleak outlook for survivors of OHCA and MI, with many reporting cognitive complaints and distressing mental health symptoms. Further, sex and gender may play a more integral role in recovery than once thought. Women tend to suffer disproportionately during treatment for and recovery from cardiac illnesses, evidenced by a greater proportion of deaths and fewer medical treatments compared to men. Additionally, women may experience worse cognitive outcomes compared to men, although the research remains inconclusive. Clearly, there is a critical need for research that determines the extent of cognitive impairment and mental distress after cardiac illness, and whether sex and gender affect such outcomes. The present study aimed to determine how men and women differed in cognitive abilities and psychological wellbeing after two ischemic cardiac events: OHCA and ST-segment elevation myocardial infarction (STEMI). Patients were tested in-hospital, and at 3-, 6-, and 12-months after discharge. No clear differences were detected between men and women on cognitive tests at any time point although women exhibited better recovery than is typically reported, which may have eliminated any cognitive disadvantages. Women had greater mental distress during recovery compared to men exceeding 3-months after hospital discharge. All patients identified as cis-gender, so the role of gender could be interpreted. Altogether, these findings underscore the need for cognitive testing after cardiac illness and highlight the potential for better patient follow-up by including mental health resources.

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Available for download on Saturday, March 01, 2025

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