Study links childhood asthma to memory difficulties

New international research has linked childhood asthma to memory difficulties, finding the earlier a child develops the condition, the more they could be impacted.
 
The United States study tested the memory skills of 2000 children between nine and 12 years old, finding those with asthma had a lower ability to remember specific events, lower mental processing speed and impulse control or attention skills.
 
A separate analysis of around 500 children over two years found the link between asthma and memory difficulties was stronger among those who developed asthma earlier.
 
Dr Kerry Hancock, Chair of RACGP Specific Interests Respiratory Medicine, told newsGP the research highlighted some ‘surprising findings’, and that she was unaware asthma may be associated with chronic neuroinflammation.
 
‘It brings to our attention some issues, such as these cognitive deficits, in children and adults with asthma that many of us may not have considered in the past,’ she said.
 
But Dr Hancock urged GPs caution when speaking to patients about these results.
 
‘However, we do need to be cautious in giving this research too much weight, and possibly causing unnecessary concern to people with asthma, especially parents of children with asthma,’ she said.
 
Specifically, the study’s cross-sectional analysis found earlier age asthma onset is associated with the strongest link between asthma and memory differences with this group showing slower developmental improvement of memory over time.
 
Children with later onset asthma however demonstrated developmental improvement that was not different to the comparison group, or children without asthma.
 
However, the longitudinal component, which included data from 2000 children, showed lower scores for processing speed and inhibition and attention in addition to episodic memory.
 
The research comes at a time when asthma is one of the most common conditions affecting Australians.
 
According to the National Asthma Council of Australia, asthma is one of the nation’s most prevalent chronic diseases, with around 2.8 million people living with the condition in 2022.
 
When asked if this new data may bring additional complexity into the general practice consulting room, Dr Hancock said a ‘well-designed prospective study may assist’ in determining the validity of these associations. 
 
‘What we do not know is what it is that could be influencing this effect on cognition in children,’ she said.
 
‘Is it exposure to beta-agonists, or the inhaled steroids, or the oral steroids, or other medicines, or the asthma flare ups or the disease itself? 
 
‘Until we do know more, then I feel that it supports our current guidance to aim for good asthma control with the lowest effective dose of medication, and to limit excessive use of SABAs and oral corticosteroids by preventing flare ups.’
 
Children and adults with asthma are more likely to experience time away from study and work environments and may require episodic or continuous medications, including inhaled and oral steroids, for prevention and treatment of their condition.
 
This new research brings GPs’ attention to a growing understanding that asthma, traditionally considered a respiratory disease, may in fact be a multisystem condition with inflammatory effects on other systems.
 
Historically prolonged oral steroids for hard-to-treat asthma were associated with a risk of impacting growth and behaviour in children.
 
Newer pharmaceutical approaches have largely allayed these fears and have been welcomed by health professionals and families alike as they allow significant improvements in asthma management.
 
If further research does indeed clarify asthma is a multisystem disease affecting neurocognition in addition to airways, GPs, as specialists of whole-person care and multisystem disease, are particularly well-placed to incorporate this new information into our clinical practice.
 
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