title: Neuropsychological outcomes at midlife following moderate to severe malnutrition in infancy.
abstract: OBJECTIVE
  To compare neuropsychological profiles of adults who had experienced an episode of moderate to severe protein-energy malnutrition confined to the first year of life with that of a healthy community comparison group.
  
  
  METHODS
  We assessed neuropsychological functioning in a cohort of Barbadian adults, all of whom had birth weight >2268 g. The previously malnourished group (N = 77, mean age = 38 years, 53% male) had been hospitalized during the first year of life for moderate to severe protein energy malnutrition and subsequently enrolled in a program providing nutrition education, home visits and subsidized foods to 12 years of age. They also had documented, adequate nutrition throughout childhood and complete catch-up in growth by the end of adolescence. The healthy comparison group (N = 59, mean age = 38 years, 54% male) were recruited as children from the same classrooms and neighborhoods.
  
  
  RESULTS
  Adjusted for effects of standard of living during childhood and adolescence and current intellectual ability level, there were nutrition group differences on measures of cognitive flexibility and concept formation, as well as initiation, verbal fluency, working memory, processing speed, and visuospatial integration. Behavioral and cognitive regulation were not affected.
  
  
  CONCLUSIONS
  Postnatal malnutrition confined to the first year of life is associated with neurocognitive compromise persisting into midlife. Early malnutrition may have a specific neuropsychological signature, affecting response initiation to a somewhat greater extent than response inhibition.
authors.affiliation: Department of Psychiatry, Boston Children's Hospital.
authors.forename: Deborah P
authors.initials: DP
authors.lastname: Waber
authors.affiliation: Barbados Nutrition Study.
authors.forename: Cyralene P
authors.initials: CP
authors.lastname: Bryce
authors.affiliation: Laboratory for Psychiatric Biostatistics, McLean Hospital.
authors.forename: Garrett M
authors.initials: GM
authors.lastname: Fitzmaurice
authors.affiliation: Judge Baker Children's Center.
authors.forename: Miriam L
authors.initials: ML
authors.lastname: Zichlin
authors.affiliation: Department of Psychology, University of New Hampshire.
authors.forename: Jill
authors.initials: J
authors.lastname: McGaughy
authors.affiliation: Department of Psychiatry, Boston Children's Hospital.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Girard
authors.affiliation: Judge Baker Children's Center.
authors.forename: Janina R
authors.initials: JR
authors.lastname: Galler
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D015331:Cohort Studies; D003210:Concept Formation / Q000502:physiology*; D005260:Female; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000150:complications*; D007266:Inhibition, Psychological; D007361:Intelligence Tests; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011795:Surveys and Questionnaires