INTRODUCTION: Paragliding is an emerging discipline of aviation, with recreational pilots flying distances over 100 km. It remains risky. Accidents typically relate to pilot error rather than equipment failure. We measured cognition and physiological responses during simulated flight, to investigate whether errors might be due to pilot impairment, rather than misjudgment.METHODS: There were 10 male paraglider pilots (aged 19-58 yr) who undertook a simulated flight in an environmental chamber from sea level (0.209 FIo₂) to 1524 m (0.174 FIo₂), 2438 m (0.156 FIo₂), and 3658 m (0.133 FIo₂), over approximately 2 h. They experienced normobaric hypoxia, environmental cooling and headwind, completing logical reasoning, mannikin, mathematical processing, Stroop Color-Word and Tower Puzzle tasks; as well as measures of risk-taking (BART), mood (POMS), and subjective experience.RESULTS: Results were compared to ten controls, matched by age, sex, and flying experience. Physiological measures were oxygen consumption, carbon dioxide production, ventilation, heart rate, oxygen saturation, rectal and skin temperatures, blood glucose, blood lactate, and urine production. There were no significant differences between pilots and controls at any altitude. Results were heterogenous within and between individuals. As altitude increased, oxygen consumption and minute volume increased significantly, while oxygen saturations fell (98.3% [baseline] to 88.5% [peak]). Rectal temperatures fell by a statistically (but not clinically) significant amount (37.6°C to 37.3°C), while finger skin temperatures dropped steeply (32.2°C to 13.9°C).DISCUSSION: Results suggest cognitive impairment is unlikely to be a primary cause of pilot error during paragliding flights (of less than 2 h, below 3658 m), though hand protection requires improvement.Wilkes M, Long G, Massey H, Eglin C, Tipton MJ. Cognitive function in simulated paragliding flight. Aerosp Med Hum Perform. 2019; 90(10):851-859.