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Review
. 2022 Dec 19;12(12):1736.
doi: 10.3390/brainsci12121736.

Cognition and Neuropsychological Changes at Altitude-A Systematic Review of Literature

Kathrin Bliemsrieder  1 , Elisabeth Margarete Weiss  2 , Rainald Fischer  3 , Hermann Brugger  4 , Barbara Sperner-Unterweger  1 , Katharina Hüfner  1
Affiliations
Review

Cognition and Neuropsychological Changes at Altitude-A Systematic Review of Literature

Kathrin Bliemsrieder et al. Brain Sci. .

Abstract

High-altitude (HA) exposure affects cognitive functions, but studies have found inconsistent results. The aim of this systematic review was to evaluate the effects of HA exposure on cognitive functions in healthy subjects. A structural overview of the applied neuropsychological tests was provided with a classification of superordinate cognitive domains. A literature search was performed using PubMed up to October 2021 according to PRISMA guidelines. Eligibility criteria included a healthy human cohort exposed to altitude in the field (at minimum 2440 m [8000 ft]) or in a hypoxic environment in a laboratory, and an assessment of cognitive domains. The literature search identified 52 studies (29 of these were field studies; altitude range: 2440 m-8848 m [8000-29,029 ft]). Researchers applied 112 different neuropsychological tests. Attentional capacity, concentration, and executive functions were the most frequently studied. In the laboratory, the ratio of altitude-induced impairments (64.7%) was twice as high compared to results showing no change or improved results (35.3%), but altitudes studied were similar in the chamber compared to field studies. In the field, the opposite results were found (66.4 % no change or improvements, 33.6% impairments). Since better acclimatization can be assumed in the field studies, the findings support the hypothesis that sufficient acclimatization has beneficial effects on cognitive functions at HA. However, it also becomes apparent that research in this area would benefit most if a consensus could be reached on a standardized framework of freely available neurocognitive tests.

Keywords: PRISMA; STAR data reporting guidelines; altitude; cognition; cognitive domains; hypoxia; neuropsychological tests.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of article selection (The color coding refers to the classification and is picked up again in Table A1).
Figure 2
Figure 2
(A) Test results in the field studies. (B) Test results in the laboratory studies.
Figure 2
Figure 2
(A) Test results in the field studies. (B) Test results in the laboratory studies.
See this image and copyright information in PMC

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