A Meta-Analysis of Multidimensional Cognitive Functions Changes in Different Intensities of High-Altitude Hypoxia

Purpose

This meta-analysis aims to comprehensively evaluate the impact of high-altitude hypoxia on multidimensional cognitive functions, considering moderating variables such as altitude, exposure time, cognitive domain, and experimental design.

Methods

A three-level meta-analysis was conducted on 59 studies (1966–2024) comprising 739 effect sizes. Studies were screened and coded according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cognitive tasks were categorized into seven domains: executive control, working memory, long-term memory, perceptual ability, psychomotor skill, attention, and others. Hedges’ g was used as the effect size measure, and multilevel modeling was applied to account for dependent effect sizes.

Findings

High-altitude hypoxia significantly impaired overall cognitive function (g = −0.424, p < 0.001). Long-term memory and perceptual functions were most affected, followed by executive control, attention, and psychomotor skills; working memory was least impacted. Cognitive impairment was significant at altitudes above 2500 m. Acute (< 3 days) and chronic (> 30 days) exposure significantly affected cognition, while intermediate exposures (3–30 days) did not. Subgroup analyses revealed varying sensitivity across cognitive domains to altitude and exposure duration.

Conclusion

High-altitude hypoxia adversely affects cognitive function, with severity varying by cognitive domain, altitude, and exposure duration. These findings highlight the need for tailored interventions and further research into acclimatization and de-acclimatization processes.