Changes in cognitive function and latent processes of decision-making during incremental ascent to high altitude

High altitude sojourn is broadly associated with impaired cognitive function, although there are inconsistencies within the literature. Incorporation of mathematical modeling to gain insight into latent aspects of decision-making may strengthen the ability to characterize changes in cognitive function during high altitude sojourn. This study sought to examine the effects of high altitude on cognitive function and underlying constructs of decision-making during an 11-d incremental ascent to 5160 m in 18 healthy adults (26 ± 12 yrs). Participants underwent cognitive testing at 116 m, 3440 m, 4240 m, and 5160 m. Cognitive function was assessed using standard metrics of accuracy and reaction time (RT) during working memory (2-back) and attention (Flanker) tasks. Behavioral data were additionally analyzed using drift-diffusion modeling to interrogate latent neural (strength of evidence, non-decision time) and behavioral (caution, bias) processes of decision-making. Flanker accuracy was unaltered during incremental ascent to high altitude, while 2-back accuracy decreased at 5160 m (p < 0.01). RT was faster at 4240 m for the Flanker, and faster at all altitudes compared to 116 m for the 2-back (p < 0.01). Incremental ascent to high altitude elicited modest reductions in caution and non-decision time, increases in bias and strength of evidence for non-match items during the 2-back (0.04 ≥ p > 0.01). These data indicate that while RT may appear to improve during incremental ascent to high altitude, increases in speed may be driven by participants 1) accumulating less evidence before initiating a response (i.e., less cautious) and 2) preferentially attending to (more biased), and extracting more evidence from, frequent/easier stimuli, rather than improved processing per se. Taken together, changes in cognitive function during incremental ascent to high altitude may reflect subtle changes in neural and behavioral components of decision-making intended to reduce cognitive load and conserve brain resources under challenging environmental conditions.