Atopic dermatitis and executive function across early and middle childhood - A longitudinal cohort study of children in the United Kingdom.

BACKGROUND

Atopic dermatitis (AD; aka eczema), affecting 10-20% of the paediatric population, has been linked to neuropsychological conditions and cognitive functioning, prompting this study to explore executive functions (EF) as a potential mechanism due to its role in high-level thinking, decision making, and behavioural control.

OBJECTIVES

To examine how early childhood AD impacts middle-childhood EF.

METHODS

Our longitudinal study involved 11,373 children from the Avon Longitudinal Study of Parents and Children (ALSPAC), a United Kingdom birth cohort for whom parent-reported AD activity and severity were measured at ≥2 time points between 6 months and 81 months of age. Latent class mixed modelling was used to classify children into 5 distinct early childhood AD trajectories: unaffected/rare (62.90%), early onset resolving AD (1.09%), persistent mild AD (31.35%), persistent moderate-to-severe AD (0.93%), and worsening AD (3.74%). Multivariate regression analysis was conducted to investigate the relationship between the AD trajectories and three components of executive function-attention, inhibition, and working memory-measured between 8 and 11 years old, adjusting for covariates.

RESULTS

Across all EF measures, no statistically significant associations were observed with AD trajectories or cross-sectional AD status at 81 months. Specifically, selective attention at age 8 showed no significant associations for "early onset resolving AD" (-0.04 [-0.38, 0.31], p = 0.83), "worsening AD" (0.05 [-0.14, 0.22], p = 0.60), "persistent mild AD" (-0.03 [-0.10, 0.05], p = 0.49), or "persistent moderate-to-severe AD" (0.02 [-0.31, 0.35], p = 0.69), with similar results for all other executive functions.

CONCLUSIONS

Our null findings suggest early childhood AD does not significantly affect middle-childhood EF in a population mostly consisting of milder AD cases. Future studies focusing on children with severe AD and longitudinal research at other developmental stages are needed to clarify the AD-neurocognitive function relationship.