Asthma associated with memory, executive function difficulty in children

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Findings from a study published in JAMA Network Open suggested that an association exists between asthma onset and memory and executive function difficulties in children.

Seeking to determine this association of lower memory and cognitive function in a pediatric population, investigators developed a cohort study that used observational data from the Adolescent Brain Cognitive Development Study (ABCD). The study is a multisite, longitudinal investigation that began enrollment in 2015 and enrolled approximately 11,800 children aged 9 to 10 years at baseline, with follow-up occurring at 1 and 2 years.

"Participants were selected based on exposures described subsequently to determine longitudinal and cross-sectional associations between asthma and memory," wrote the study authors, who noted data were analyzed from month year to month year.

In the longitudinal analysis, children were selected if they had asthma at baseline and at the 2-year follow-up—defined as earlier childhood onset—2-year follow-up only (later childhood onset), or no history of asthma.

In the cross-section analysis, children were selected if they had asthma at any time point, or no history of asthma. A comparison group of children with asthma history was matched based on demographic and health covariates for each analysis.

In the study, indicators of asthma were derived from parent reports of their child's experienced asthma attacks and medical treatment for the chronic respiratory disease, one that affects approximately 6.5% of children in the United States, per the publication.

"We selected a set of cognitive measures administered in the ABCD Study from the NIH Toolbox based on hypothesized associations with asthma," wrote the study investigators.

The authors noted that a picture sequencing measuring test was the primary outcome measure of episodic memory as it assessed the hippocampus-dependent episodic memory, necessitating retention of arbitrary sequences of objects and activities.

Pattern comparison speed testing with pairs of pictures measured processing speed. Participants were asked to make a same or different judgement, with standardized scores reflecting the timed number of correct responses.

To measure executive function, the investigators used a flanker inhibitory control and attention test that evaluated inhibition and attention.

"Participants view arrays of arrows (5) pointing to either the left or the right," wrote the authors. "Participants sought to select the correct direction of the central arrow (the target), under conditions in which the center arrow points in the same or opposite direction as the 4 other flanking arrows. Standardized scores are computed based on both accuracy and response time."

In all, 474 children were included in the longitudinal analysis, of which 135 were in the earlier childhood onset group. They had a mean age of 9.9 years and 76% were male. There were 102 children in the later childhood onset group, of which the mean age was 9.88 years and 53% were female. The comparison group featured 237 children.

Among those in the longitudinal analysis, children with earlier onset "exhibited lower rates of longitudinal memory improvements relative to the comparison group (β = −0.17; 95% CI, −0.28 to −0.05; P = .01)," stated the authors.

The cross-sectional analysis featured 2062 children, of which 1031 had asthma, with a mean age of 11.99 years and of which 57% were male. According to results, children with asthma (n = 1031) showed lower scores on episodic memory (β = −0.09; 95% CI, −0.18 to −0.01; P = .04), processing speed (β = −0.13; 95% CI, −0.22 to −0.03; P = .01), and inhibition and attention (β = −0.11; 95% CI, −0.21 to −0.02; P = .02), the study investigators found.

"In this cohort study, asthma was associated with memory difficulties in children, which may be more severe if asthma onset is earlier in childhood and may extend to executive function abilities," the authors concluded.

Reference:

Christopher-Hayes NJ, Haynes SC, Kenyon NJ, Merchant VD, Schweitzer JB, Ghetti S. Asthma and Memory Function in Children. JAMA Netw Open. 2024;7(11):e2442803. doi:10.1001/jamanetworkopen.2024.42803