Cold stress impacts cognitive performance in healthy volunteers: results from a randomized, controlled, cross-over study

Falla, Marika; Masè, Michela; Cappello, Tomas Dal; Micarelli, Alessandro; van Veelen, Michiel Jan; Roveri, Giulia; Brugger, Hermann; Hüfner, Katharina; Strapazzon, Giacomo · 2026 · DOAJ

DOI: 10.1038/s41598-026-38048-y

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Summary

This study investigates the impact of acute, short-duration cold exposure on cognitive performance in healthy volunteers, addressing a gap in literature regarding exposures shorter than 15 minutes. While previous research established that prolonged cold impairs attention, processing speed, memory, and executive function, the effects of brief exposures—common in occupational or recreational settings—remain underexplored. The researchers aimed to determine if transient cold stress affects reaction time, processing speed, and risky decision-making before core body temperature changes, and to evaluate whether these effects differ by sex. They specifically tested the "distraction theory," which posits that cold-induced discomfort diverts attentional resources, against the "arousal theory," which suggests slight cooling might enhance performance. The study employed a randomized, controlled, crossover design involving 24 healthy volunteers (12 males, 12 females) aged 18–60. Participants underwent three 15-minute experimental sessions in a climate chamber at ambient temperatures of 20 °C (neutral), 5 °C (cold), and −10 °C (very cold), interspersed with recovery periods. Cognitive performance was assessed using the Psychomotor Vigilance Test (PVT) for attention and reaction time, the Balloon Analogue Risk Task (BART) for risky decision-making, and the Digit Symbol Substitution Test (DSST) for processing speed. Physiological parameters, including core and skin temperature, heart rate, and oxygen saturation, were continuously monitored. Subjective ratings of stress, cold sensation, and thermal comfort were recorded via visual analogue scales. Statistical analyses included repeated measures ANOVA, Friedman tests, and Generalized Estimating Equations (GEE) to account for temperature, sex, age, and education. Results indicated that exposure to −10 °C significantly impaired cognitive performance compared to 5 °C and 20 °C. Specifically, attention was compromised, evidenced by slower mean reaction times on the PVT (277 ms at −10 °C vs. 267 ms at 20 °C) and a higher number of lapses. Risky decision-making was also affected, with participants exhibiting reduced risk-taking behavior (lower mean earnings on BART) at −10 °C. Processing speed, measured by DSST reaction times, was slower at −10 °C compared to 5 °C. However, core and skin temperatures did not differ significantly across conditions, and heart rate was elevated only at −10 °C. Crucially, no significant differences in cognitive performance were observed between males and females. Subjective reports confirmed higher stress and cold sensation at −10 °C. The findings support the distraction theory, suggesting that the sensory discomfort and stress associated with cold exposure divert attentional resources, leading to transient cognitive impairment even before physiological changes in core temperature occur. This implies that individuals performing tasks requiring attention or decision-making in cold environments may experience reduced performance due to psychological stress and distraction rather than hypothermia. The study highlights the need to consider these transient cognitive deficits in safety protocols for occupational and recreational activities in cold climates, particularly for brief exposures where thermal steady state is not reached.

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• stress arousal performance