Correlations Between Macular Pigment Levels and Cognitive Performance Metrics in Children

Purpose: Macular pigment optical volume (MPOV) and cognitive function were characterized in children to explore the distributions of these parameters, as well as their consistency and potential associations. Methods: Baseline data from 65 healthy children aged 7–10 years (53.8% male, 78.5% white) enrolled in the Investigating Cognition and Ocular Nutrition in Children intervention study were analyzed. Demographic profiles were recorded, and participants underwent ophthalmic examination. Macular pigment (MP) was quantified using fundus autofluorescence imaging (Heidelberg Spectralis) at radii of 1° and 9°, expressed as central and total MPOVs, respectively. These parameters refer to the region where MP is largely concentrated and to the total of MP across the macula, respectively. Neurocognitive function was evaluated using the Cambridge Neuropsychological Test Automated Battery, which assesses attention, psychomotor speed, visual memory, and executive functions. Dietary intake was assessed using the Lutein and Zeaxanthin Food Frequency Questionnaire (LZQ) screening tool. Statistical correlation and regression analyses were conducted. Results: Mean central and total MPOVs were 333.05 ± 117.69 and 6903.54 ± 2925.81, respectively. Wide variation in MP distribution and concentration was observed across ethnicity, dietary carotenoid intake, and weight-specific differences, consistent with previously reported variability. As with MP, most variation in neurophysiological test performance was also consistent across demographic and ophthalmic characteristics. Across tasks, performance was correlated within the respective domains assessed. Domain-, sex-, and age-specific patterns showed no floor or ceiling effects, supporting the suitability of these measures in this cohort. Central MPOV was negatively associated with total errors in multitasking (r = −0.24, p = 0.04) and positively associated with memory task performance (r = 0.26, p = 0.03). After adjustment for demographic factors and dietary intake, children with higher MPOVs showed better attention (β = −0.026, p = 0.03) and cognitive flexibility (β = 0.007, p = 0.02) during multitasking. Conclusion: Despite the greater variability, our findings are broadly consistent with adult data and suggest that macular carotenoids (i) are likely involved in foundational cognitive processes, attention and cognitive flexibility, in children and (ii) likely support critical learning skills and knowledge acquisition. These insights are expected to guide future analyses and interventional research in children, a group that remains markedly less studied than adults.