Early malnutrition curbs cognition in children with cystic fibrosis

In children with cystic fibrosis, preventing prolonged malnutrition by early diagnosis and nutritional therapy is associated with heightened cognitive function, according to researchers. Minimizing the duration of alpha tocopherol (vitamin E) deficiency appears to be especially important.

"Patients who have cystic fibrosis (CF) and experience delayed diagnosis by traditional methods have greater nutritional insult compared with peers diagnosed via neonatal screening," Dr. Philip M. Farrell, of the University of Wisconsin, Madison, and colleagues observe in the June issue of Pediatrics.

To investigate, the researchers assessed cognitive function in 89 children with CF. In addition, they examined the influence of early diagnosis through neonatal screening and the possible effect of early malnutrition.

Forty-two children were enrolled in the screened diagnosis group and 47 were enrolled in the traditional diagnosis (control) group. The team administered the Test of Cognitive Skills, Second Edition in order to generate a Cognitive Skills Index (CSI) and cognitive factor scores (verbal, non-verbal, and memory).

Cognitive scores in the overall study population were comparable to those in the general population (CSI mean 102.5). The screened group had a mean CSI core of 104.4, compared with 99.8 for the control group.

A correlation was observed between significantly lower cognitive scores and indicators of malnutrition and unfavorable family factors, including single parents, lower socioeconomic status, and less parental education. Patients with low plasma alpha-tocopherol levels at diagnosis were found to have lower cognitive scores.

The researchers also point out that patients in the control group who also had vitamin E deficiency at diagnosis "showed significantly lower CSI scores in comparison with alpha-tocopherol-sufficient control subjects and both deficient and sufficient alpha-tocopherol subsets of screened patients."