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Cognitive development in children with chronic protein energy malnutrition
Bhoomika R Kar1, Shobini L Rao, B A Chandramouli
1Centre for Behavioural and Cognitive Sciences, Psychology Building, University of Allahabad, Allahabad, 211001, U,P,, India. bhoomika2000@yahoo.com.
Insights
Chronic protein energy malnutrition (PEM) in children impairs cognitive development, slowing age-related improvements in higher cognitive functions like memory and attention. This can lead to lasting cognitive deficits.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Malnutrition, particularly protein-energy malnutrition (PEM), is linked to brain pathology and cognitive deficits in children.
- Chronic PEM leading to stunting may impede the development of higher cognitive processes in children over 5 years old.
Purpose of the Study:
- To investigate the impact of stunted growth on the developmental trajectory of cognitive processes in children.
- To assess cognitive functions in malnourished versus adequately nourished children using neuropsychological measures.
Main Methods:
- Examined 20 malnourished and 20 adequately nourished children aged 5-10 years.
- Utilized the NIMHANS neuropsychological battery to assess motor speed, attention, visuospatial ability, executive functions, comprehension, learning, and memory.
Main Results:
- Malnourished children showed poorer performance in attention, working memory, learning, memory, and visuospatial ability compared to nourished peers.
- Age-related cognitive improvement was absent in malnourished children for design fluency, working memory, visual construction, and learning/memory.
- Despite deficits, malnourished children showed age-related gains in attention, visual perception, and verbal comprehension.
Conclusions:
- Chronic stunting from PEM selectively affects higher cognitive process development, rather than causing generalized impairment.
- Stunting can decelerate age-related cognitive improvements and potentially lead to long-term cognitive deficits in children.
Background:
Malnutrition is associated with both structural and functional pathology of the brain. A wide range of cognitive deficits has been reported in malnourished children. Effect of chronic protein energy malnutrition (PEM) causing stunting and wasting in children could also affect the ongoing development of higher cognitive processes during childhood (>5 years of age). The present study examined the effect of stunted growth on the rate of development of cognitive processes using neuropsychological measures.
Methods:
Twenty children identified as malnourished and twenty as adequately nourished in the age groups of 5-7 years and 8-10 years were examined. NIMHANS neuropsychological battery for children sensitive to the effects of brain dysfunction and age related improvement was employed. The battery consisted of tests of motor speed, attention, visuospatial ability, executive functions, comprehension and learning and memory
Results:
Development of cognitive processes appeared to be governed by both age and nutritional status. Malnourished children performed poor on tests of attention, working memory, learning and memory and visuospatial ability except on the test of motor speed and coordination. Age related improvement was not observed on tests of design fluency, working memory, visual construction, learning and memory in malnourished children. However, age related improvement was observed on tests of attention, visual perception, and verbal comprehension in malnourished children even though the performance was deficient as compared to the performance level of adequately nourished children.
Conclusion:
Chronic protein energy malnutrition (stunting) affects the ongoing development of higher cognitive processes during childhood years rather than merely showing a generalized cognitive impairment. Stunting could result in slowing in the age related improvement in certain and not all higher order cognitive processes and may also result in long lasting cognitive impairments.
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