Extreme Heat Exposure is Associated with Lower Learning, General Cognitive Ability, and Memory among US Children.

Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children's cognitive function. Objectives: This study examines the relationship between extreme heat exposure and various domains of cognitive function in children. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Key variables included race/ethnicity, age, gender, family socioeconomic status (SES), heatwave exposure, and multiple cognitive domains: total composite score, fluid composite score, crystallized intelligence, reading ability, picture vocabulary, pattern recognition, card sorting, and list recall. Structural equation modeling (SEM) was used for data analysis. Results: A total of 11,878 children were included in the analysis. Findings revealed significant associations between extreme heat exposure and lower cognitive performance across multiple domains. The strongest adjusted effects were observed in pattern recognition (B = -0.064, p < 0.001) and reading ability (B = -0.050, p < 0.001), both within the learning domain, as well as total composite cognitive ability (B = -0.067, p < 0.001), fluid composite (B = -0.053, p < 0.001), and crystallized intelligence (B = -0.061, p < 0.001), all within general cognitive ability. Weaker but still significant associations were found for list recall (B = -0.025, p = 0.006) and card sorting (B = -0.043, p < 0.001) within the memory domain, as well as picture vocabulary (B = -0.025, p = 0.008) within general cognitive ability. These associations remained significant after controlling for demographic factors, race/ethnicity, family SES, and neighborhood SES. Conclusions: This study underscores the impact of climate change on cognitive function disparities, particularly in learning and general cognitive ability among children exposed to extreme heat. Findings highlight the need for targeted interventions to mitigate the cognitive risks associated with heat exposure in vulnerable populations.