Executive Functions And Asthma Self-Management: A Systematic Review

Abstract

Bronchial asthma is a chronic inflammatory disease whose effective management largely depends on the patient's ability to regulate their behavior in accordance with therapeutic demands. Executive functions—including working memory, cognitive flexibility, and inhibitory control—are fundamental cognitive processes involved in goal-directed behavior, adaptive decision-making, and treatment adherence. However, the relationship between asthma and executive functioning has not been systematically examined.

The aim of this systematic review was to examine the empirical evidence regarding the association between executive functions and bronchial asthma. The review was conducted in accordance with the PRISMA 2020 guidelines, through a search of the PubMed, PsycINFO, Web of Science, and Scopus databases including studies published up to February 2026. Empirical studies assessing executive functions in patients with asthma using validated instruments were included.

Of the records identified, 14 studies met the inclusion criteria. The results indicate that individuals with asthma show impairments in working memory, cognitive flexibility, and inhibitory control in both pediatric and adult populations. Executive functioning was also associated with clinically relevant variables such as treatment adherence, appropriate inhaler use, and disease control. Neuroimaging studies further identified alterations in brain networks involved in cognitive control, suggesting possible underlying neurobiological mechanisms.

In conclusion, bronchial asthma appears to be associated with alterations in executive functioning that may affect disease self-management. Cognitive assessment may therefore contribute to improving clinical interventions and optimizing therapeutic outcomes.