Early onset of asthma associated with memory and executive function difficulties in children

Asthma is associated with impaired memory and executive function in children, and can be more severe if asthma develops early, according to results from a recent cohort study published in . American Medical Association Journal.1

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Little is known about whether asthma is associated with memory impairment in children. However, the high prevalence of this condition in children in the United States and the inflammatory processes associated with asthma pose a potential concern, especially since inflammation can extend to the brain as neuroinflammation.¹

This issue has been investigated in the context of corticosteroid treatment. Bender et al. demonstrated that children with asthma treated with high doses of corticosteroids had impaired verbal memory compared to children who received low doses of corticosteroids. However, this trial did not have a comparison group, so no conclusions regarding asthma and memory performance can be drawn.²

Other studies, including one conducted by Jiang et al. using functional magnetic resonance imaging, have reported difficulties with executive function, attention, and visual and working memory. However, these trials did not account for the confounding effects of socio-economic factors that may influence the probability of developing asthma and cognitive impairment. This reality makes it difficult to understand the full picture of potential relationships.^1,3

In the current trial, researchers used data from the Adolescent Brain and Cognitive Development Study to assess whether children with asthma showed poorer memory. A battery of cognitive measures was used to measure cognitive abilities, including a picture sequence memory test and a pattern comparison processing speed test.¹

A total of 237 children with asthma were analyzed based on inclusion and exclusion criteria, and 135 children had early onset. Overall, episodic memory improved over time (change with age: β = 0.28; 95% CI, 0.21 to 0.35; P< .001). However, of note, the early childhood onset group showed a lower rate of improvement in episodic memory performance compared to the comparison group (change in age × early onset: β = −0.17 ; 95% CI, −0.28 to −0.05; P = .01).¹

The researchers observed no such difference between the late childhood onset group and the comparison group (change in age x late onset: β = -0.02, 95% CI, -0.15 to 0.10, 95%C. P= .75).¹

Similar results regarding episodic memory ability were found after testing longitudinal models of processing speed and inhibition/attention. Improvements in processing speed were observed over time (annual change: β = 0.39; 95% CI, 0.32-0.45; P< .001) and inhibition and attention (age change: β = 0.29; 95% CI, 0.21-0.36; P< .001), no significant differences were found between groups.¹

Next, the researchers conducted a cross-sectional analysis between children with a history of asthma (n=1,031) and a comparison group of children without asthma (n=1,031). Analyzes showed that children with a history of asthma performed worse 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), inhibition and attention scale (β = −0.11; 95% CI, −0.21 to −0.02; P= .02), the study authors said.¹

This data provides the first evidence that children who experience asthma are likely to perform worse on memory tasks, the study authors argued. This is especially true for children who develop asthma early, as this condition can particularly interfere with neurodevelopment.¹

One possible explanation for this association is that the association between asthma and developmental trajectory may emerge earlier with respect to memory, perhaps due to susceptibility to subtle hippocampal damage, the study authors wrote. . To address this issue, future studies should seek to include data from additional time points.¹

“These results highlight the need to examine this population more closely to understand the extent to which asthma affects neurodevelopment,” the researchers concluded.¹

References

1. Christopher-Hayes NJ, Haynes SC, Kenyon NJ, et al. Asthma and memory function in children. JAMA Net Open. 2024;7(11):e2442803. doi:10.1001/jamanetworkopen.2024.42803

2. Bender BG, Lerner JA, Kollasch PA, et al. Changes in mood and memory in children with asthma receiving corticosteroids. Amer Acad Child and Adolescent Psychiatry.1988;27(6):720-725. doi:10.1097/00004583-198811000-00010

3. Kaihua Jiang, Lin Zhu, Yawen Ge et al. A brain network study of attentional cognitive impairment in children with bronchial asthma. 2021. PREPRINT (version 1) is available at Research Square. doi:10.21203/rs.3.rs-969991/v1]