Abstract
Cognitive function impairment due to high altitude exposure has been reported with some contradictory results regarding the possible selective cognitive domain involvement. We prospectively evaluated in 36 lowlanders, exposed for 3 consecutive days to an altitude of 3,269 m, specific cognitive abilities (attention, processing speed, and decision-making) required to safely explore the mountains, as well as to work at altitude. We simultaneously monitored the physiological parameters. Our study provides evidence of a reduced processing speed in lowlanders when exposed to altitude in the first 24 h. There was a fairly quick recovery since this impairment was no more detectable after 36 h of exposure. There were no clinically relevant effects on decision-making, while psychomotor vigilance was unaffected at altitude except for individuals with poor sleep. Significant changes were seen in physiological parameters (increased heart rate and reduced peripheral oxygen saturation). Our results may have practical implications, suggesting that individuals should practice prudence with higher ascent when performing risky activities in the first 24–36 h, even at altitudes below 3,500 m, due to an impairment of the cognitive performance that could worsen and lead to accidents.
Highlights
There is increasing mountain attendance related to different recreational risky activities, as well as for occupational purposes with increasing accidents (Monasterio, 2005)
There was no effect of altitude on the parameters of the Psychomotor Vigilance Test (PVT) but generalized estimating equations (GEE) showed an effect of Insomnia Severity Index (ISI) on the number of false starts (p = 0.045) as individuals with ISI higher than 7 made more false starts [1.5 vs. 0.9]
Psychomotor vigilance was unaffected at altitude except for individuals with poor sleep, and the Balloon Analogue Risk Task (BART) total time of execution was faster on the last session compared to the first three, but it was not associated with clinically relevant lower performance and likely due to a learning effect
Summary
There is increasing mountain attendance related to different recreational risky activities (e.g., mountaineering, skiing, and climbing), as well as for occupational purposes (e.g., mining, astrophysics) with increasing accidents (Monasterio, 2005) Preserved cognitive functions, such as executive function, attention, and memory, are essential during such activities since a reduced efficiency of those abilities can provoke injury or even death in such environments. The acute exposure to HH induces increased ventilation, an autoregulatory increase in cerebral blood flow and an increased oxygen extraction at the tissue/ cell level Despite these changes, a reduction in the total amount of oxygen available persists, producing a decrease in cognitive performance and different HA illnesses, especially if ascent occurs too rapidly with no acclimatization. A reduction in the total amount of oxygen available persists, producing a decrease in cognitive performance and different HA illnesses, especially if ascent occurs too rapidly with no acclimatization. Hornbein et al (1989) found a slight decline in verbal and visual long-term memory and increased errors in the aphasia screening test in mountaineers exposed to altitude between 5,488 and 8,848 m
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