Abstract
BackgroundFatigue is a common complaint among elementary and junior high school students, and is known to be associated with reduced academic performance. Recently, we demonstrated that fatigue was correlated with decreased cognitive function in these students. However, no studies have identified cognitive predictors of fatigue. Therefore, we attempted to determine independent cognitive predictors of fatigue in these students.MethodsWe performed a prospective cohort study. One hundred and forty-two elementary and junior high school students without fatigue participated. They completed a variety of paper-and-pencil tests, including list learning and list recall tests, kana pick-out test, semantic fluency test, figure copying test, digit span forward test, and symbol digit modalities test. The participants also completed computerized cognitive tests (tasks A to E on the modified advanced trail making test). These cognitive tests were used to evaluate motor- and information-processing speed, immediate and delayed memory function, auditory and visual attention, divided and switching attention, retrieval of learned material, and spatial construction. One year after the tests, a questionnaire about fatigue (Japanese version of the Chalder Fatigue Scale) was administered to all the participants.ResultsAfter the follow-up period, we confirmed 40 cases of fatigue among 118 students. In multivariate logistic regression analyses adjusted for grades and gender, poorer performance on visual information-processing speed and attention tasks was associated with increased risk of fatigue.ConclusionsReduced visual information-processing speed and poor attention are independent predictors of fatigue in elementary and junior high school students.
Highlights
Fatigue is a common complaint among elementary and junior high school students, and is known to be associated with reduced academic performance
In order to identify cognitive predictors associated with fatigue in the elementary and junior high school students, univariate and multivariate logistic regression analyses were performed (Table 3)
In univariate logistic regression analyses, no cognitive tests reached statistical significance, in multivariate logistic regression analyses adjusted for grades and gender, lower scores on the symbol digit modalities test [odds ratio (OR): 1.85, 95% confidence interval (CI): 3.03 to 1.12, p = .016] and longer reaction time on task A of modified advanced trail making test (mATMT) [OR: 1.88, 95% CI: 1.20 to 2.94, p = .006] were associated with a higher risk of fatigue in the elementary and junior high school students
Summary
Fatigue is a common complaint among elementary and junior high school students, and is known to be associated with reduced academic performance. We demonstrated that fatigue was correlated with decreased cognitive function in these students. No studies have identified cognitive predictors of fatigue. We attempted to determine independent cognitive predictors of fatigue in these students. Because fatigue in students is associated with a decrease in academic performance [3], the impact of fatigue on children and adolescents requires additional attention. When students proceed to junior high school from elementary school, a multitude of changes occur in their environment, which have the potential to cause a variety of behavioral and emotional problems [4]. It has been reported that student fatigue markedly increases from elementary school to junior high school [6]. Identifying fatigue-related factors is important for preventing increased levels of fatigue during this transition period
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