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Association Between Lung Function and Cognition Among Children in a Prospective Birth Cohort Study

From the Department of Environmental Health (S.F.S., R.O.W., J.S.), Harvard School of Public Health, Boston, Massachusetts; Channing Laboratory (R.O.W., J.S., R.J.W.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts; and the Department of Society, Human Development and Health (R.J.W.), Harvard School of Public Health, Boston, Massachusetts.

Address correspondence and reprint requests to Shakira Franco Suglia, Department of Environmental Health, Harvard School of Public Health, Landmark 415W, 401 Park Drive, Boston, MA 02215. E-mail: sfranco{at}hsph.harvard.edu

Objectives: To examine the relationship between lung function and cognition among children in the Maternal-Infant Smoking Study of East Boston, a prospective cohort of women and children enrolled before 20 weeks of gestation. A number of studies have demonstrated a relationship between lung function and cognition among adults, but this relationship has not been studied among children.

Methods: At 6 years of age, children completed lung function tests. At 9 years of age, the Wide Range Assessment of Memory and Learning (WRAML) and Kaufman Brief Intelligence Test (K-BIT) were administered. Linear regression was used to assess the relationship between cognition and lung function.

Results: The sample of 165 children included 53% girls and 52% Hispanic. Mean (± standard deviation) forced expiratory volume in 1 second (FEV ₁) was 1.26 ± 0.2 L; mean forced vital capacity (FVC) was 1.37 ± 0.2 L. In multivariate regression, a 1% increase from expected FEV₁ was associated with increases in the matrices and composite subscales of the K-BIT (p < .05), and in the verbal and learning subscales of the WRAML (p < .10). FVC was associated with increases in the composite and matrices subscale of the KBIT and in the visual and learning subscales of the WRAML (all p < .05).

Conclusion: Increased lung function was associated with increased cognitive development among children after adjusting for tobacco exposure, birthweight, and peak blood lead. Lung and cognitive function may operate under common regulatory processes and thus have shared vulnerabilities to a host of environmental factors during development.

Key Words: cognitive function • lung function • children

Abbreviations: K-BIT = Kaufman Brief Intelligence Test; WRAML = Wide Range Assessment of Memory and Learning; FEV₁ = forced expiratory volume; FVC = forced vital capacity; FEF_25–75 = forced mid-expiratory flow rate.