Lung function and cognitive ability in children: a UK birth cohort study

Jack Grenville*, Raquel Granell, James Dodd

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)


Background: Decreased adult lung function is associated with subsequent impairment in cognition. A similar relationship in early life could be of great policy importance, since childhood cognitive ability determines key adult outcomes, including socioeconomic status and mortality. We aimed to expand the very limited data available on this relationship in children, and hypothesised that reduced lung function would be longitudinally associated with decreased cognitive ability.

Methods: Lung function was measured at age 8 (forced expiratory volume in one second (FEV1), forced vital capacity (FVC); % predicted), and cognitive ability was measured at ages 8 (Wechsler Intelligence Scale for Children, third edition) and 15 (Wechsler Abbreviated Scale of Intelligence), in the Avon Longitudinal Study of Parents and Children. Potential confounders were identified as preterm birth, birth weight, breastfeeding duration, prenatal maternal smoking, childhood environmental tobacco smoke exposure, socioeconomic status and prenatal/childhood air pollution exposure. Univariable and multivariable linear models (n range=2332-6672) were fitted to assess the cross-sectional and longitudinal associations of lung function with cognitive ability, and change in cognitive ability between ages 8 and 15.

Results: In univariate analyses, both FEV1 and FVC at age 8 were associated with cognitive ability at both ages, but after adjustment, only FVC was associated with full-scale IQ (FSIQ) at ages 8 (β=0.09 (95% CI 0.05 to 0.12; p<0.001)) and 15 (β=0.06 (0.03 to 0.10; p=0.001)). We did not find evidence of an association between either lung function parameter and interval change in standardised FSIQ.

Discussion: Reduced FVC, but not FEV1, is independently associated with decreased cognitive ability in children. This low-magnitude association attenuates between ages 8 and 15, while no association is evident with longitudinal change in cognitive ability. Our results support a link between FVC and cognition across the life course, possibly due to shared genetic or environmental risk, rather than causation.
Original languageEnglish
Article numbere001528
JournalBMJ Open Respiratory Research
Issue number1
Publication statusPublished - 2 May 2023

Bibliographical note

Funding Information:
JD contribution is funded by Medical Research Council CARP award Reference: MR/T005114/1. The UK Medical Research Council and Wellcome (Grant reference: 217065/Z/19/Z), and the University of Bristol, provide core support for Avon Longitudinal Study of Parents and Children (ALSPAC). This publication is the work of the authors, and JG, RG and JD will serve as guarantors for the contents of this paper. A comprehensive list of grants funding is available on the ALSPAC website. Wechsler Abbreviated Scale of Intelligence measurement at age 15 was funded by the Medical Research Council (Grant reference: 076467/Z/05/Z).

Publisher Copyright:
© 2023 BMJ Publishing Group. All rights reserved.

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