1. Longitudinal results found that children with earlier asthma onset had slower episodic memory development compared to children without asthma.

2. Cross-sectional results found that children with asthma performed worse on measures of episodic memory, cognitive processing speed, and cognitive inhibition and attention.

Evidence Rating Level: 2 (Good)

Asthma ranks among the most prevalent chronic diseases in children, affecting about 5 million children in the US. While rodent studies have found asthma to result in memory deficits, it is unclear whether asthma impacts memory development in children. This study thus examined whether childhood asthma was associated with lower memory and cognitive function in children. This cohort study analyzed observational data from the Adolescent Brain Cognitive Development (ABCD) Study, a multisite longitudinal study that included 11, 800 children aged 9-10 at baseline from 21 sites in the US. This study analyzed data at the baseline, 1-year follow-up, and 2-year follow-up. Children were included in the longitudinal analysis if they had asthma at both baseline and the 2-year follow-up (earlier childhood onset group), only at the 2-year follow-up (later childhood onset group), or had no history of asthma (comparison group). Children were included in the cross-sectional analysis if they had asthma at any time point or had no history of asthma. The primary outcome was episodic memory, defined as the ability to remember past events with specific details. Secondary outcomes were cognitive processing speed, and cognitive inhibition and attention. The longitudinal analysis included 474 children (earlier childhood onset group: 135 children; mean [SD] age, 9.90 [0.63] years; 76 [56%] male; later childhood onset group: 102 children; mean [SD] age 9.88 [0.59] years; 48 [47%] male; comparison group: 237 children; mean [SD] age, 9.89 [0.59] years; 121 [51%] male). While episodic memory improved over time with increasing age (change in age: β = 0.28; 95% confidence interval (CI), 0.21 to 0.35; p < 0.001), lower rates of improvements were observed in children with earlier childhood onset of asthma (change in age × earlier onset: β = −0.17; 95% CI, −0.28 to −0.05; p = 0.01) compared to the comparison group. Developmental improvements in episodic memory in children with later onset of asthma did not differ from the comparison group and no group differences were observed for processing speed, and inhibition and attention. The cross-sectional analysis included 2062 children (with asthma: 1031 children; mean [SD] age, 11.99 [0.66] years; 588 [57%] male; without asthma: 1031 children; mean [SD] age 12.00 [0.66] years; 554 [46%] male). Children with asthma had lower scores on episodic memory (β = −0.09; 95% CI, −0.18 to −0.01; p = 0.04), processing speed (β = −0.13; 95% CI, −0.22 to −0.03; p = 0.01), and cognitive inhibition and attention (β = −0.11; 95% CI, −0.21 to −0.02; p = 0.02). Overall, this study found asthma in children was linked to memory difficulties, which may be more pronounced with earlier childhood onset. 

Click to read the study in JAMA Network Open

Image: PD

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