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Logo of behbrainBioMed CentralBiomed Central Web Sitesearchsubmit a manuscriptregisterthis articleBehavioral and Brain Functions : BBFJournal Front Page
 
Behav Brain Funct. 2008; 4: 31.
Published online Jul 24, 2008. doi:  10.1186/1744-9081-4-31
PMCID: PMC2519065
Cognitive development in children with chronic protein energy malnutrition
Bhoomika R Kar,corresponding author1 Shobini L Rao,2 and B A Chandramouli3
1Centre for Behavioural and Cognitive Sciences, Psychology Building, University of Allahabad, Allahabad, 211001, U.P., India
2Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, PB No.: 2900, Hosur Road, Bangalore, 560029, Karnataka, India
3Department of Neurosurgery, National Institute of Mental Health and Neurosciences, PB No.: 2900, Hosur Road, Bangalore, 560029, Karnataka, India
corresponding authorCorresponding author.
Bhoomika R Kar: bhoomika2000/at/yahoo.com; Shobini L Rao: shobini.rao/at/gmail.com; B A Chandramouli: cmouli/at/nimhans.kar.nic.in
Received October 23, 2007; Accepted July 24, 2008.
Abstract
Background
Malnutrition is associated with both structural and functional pathology of the brain. A wide range of cognitive deficits has been reported in malnourished children. Effect of chronic protein energy malnutrition (PEM) causing stunting and wasting in children could also affect the ongoing development of higher cognitive processes during childhood (>5 years of age). The present study examined the effect of stunted growth on the rate of development of cognitive processes using neuropsychological measures.
Methods
Twenty children identified as malnourished and twenty as adequately nourished in the age groups of 5–7 years and 8–10 years were examined. NIMHANS neuropsychological battery for children sensitive to the effects of brain dysfunction and age related improvement was employed. The battery consisted of tests of motor speed, attention, visuospatial ability, executive functions, comprehension and learning and memory
Results
Development of cognitive processes appeared to be governed by both age and nutritional status. Malnourished children performed poor on tests of attention, working memory, learning and memory and visuospatial ability except on the test of motor speed and coordination. Age related improvement was not observed on tests of design fluency, working memory, visual construction, learning and memory in malnourished children. However, age related improvement was observed on tests of attention, visual perception, and verbal comprehension in malnourished children even though the performance was deficient as compared to the performance level of adequately nourished children.
Conclusion
Chronic protein energy malnutrition (stunting) affects the ongoing development of higher cognitive processes during childhood years rather than merely showing a generalized cognitive impairment. Stunting could result in slowing in the age related improvement in certain and not all higher order cognitive processes and may also result in long lasting cognitive impairments.
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