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Modifiable factors associated with cognitive performance in Chinese adolescents: a national environment-wide association study

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Abstract

Growing evidence exists about the candidate factors of childhood cognitive performance, but mainly limited to single-exposure studies. We sought to systematically and simultaneously identify and validate a wide range of potential modifiable factors for childhood cognitive performance. We used data from five waves of data from the China Family Panel Studies (CFPS-2010, 2012, 2014, 2016 and 2018). Our analytical sample was restricted to those children aged 2–5 at baseline with valid exposure information. A total of 80 modifiable factors were identified. Childhood cognitive performance was assessed using vocabulary and mathematics test at wave 5. We used an environment-wide association study (EnWAS) to screen all exposure-outcome associations independently and used the least absolute shrinkage and selection operator (LASSO) variable selection algorithm to identify factors associated with cognitive performance. Multivariable linear model was then used to evaluate causal relationships between identified factors and cognitive performance. Of the 1305 participants included in the study (mean ± SD, 3.5 ± 1.1 years age at baseline, 45.1% girls). Eight factors were retained in the LASSO regression analysis. Six factors across community characteristics (percentage of poverty in the community; percentage of children in the community), household characteristics (family size), child health and behaviors (mobile internet access), parenting behaviors and cognitive enrichment (parental involvement in child’ s education), and parental wellbeing (paternal happiness) domains were significantly associated with childhood cognition. Using a three-stage approach, this study validates several actionable targets for improving childhood cognitive performance.

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Data availability

The data that support the findings of this study are available from https://opendata.pku.edu.cn/dataset.xhtml?persistentId=doi:10.18170/DVN/45LCSO with application.

Abbreviations

SES:

Socioeconomic status

EnWAS:

Environment-wide association studies

GWAS:

Genome wide association study

CFPS:

China family panel studies

LASSO:

Least absolute shrinkage and selection operator

ISEI:

International socio-economic index of occupational status

PIAT:

Peabody individual achievement test

AFQT:

Armed forces qualifying test

SD:

Standard deviation

CI:

Confidence interval

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Acknowledgements

The authors are grateful to the principal investigators and staff, as well as all the study participants in the China Family Panel Study.

Funding

This work was supported by grant 82173537 & 81872638 from the National Natural Science Foundation of China and grant 1908085J26 from the Natural Science Foundation of Anhui Province for Distinguished Young Scholars (Dr Sun).

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Author notes

  1. Shanshan Wang and Ya Wang Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Maternal, Child and Adolescent Health, Anhui Medical University School of Public Health, 81 Meishan Road, Hefei, Anhui, China

    Shanshan Wang, Yuhui Wan, Puyu Su, Fangbiao Tao & Ying Sun

  2. Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China

    Shanshan Wang, Yuhui Wan, Puyu Su, Fangbiao Tao & Ying Sun

  3. Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China

    Yuhui Wan, Puyu Su, Fangbiao Tao & Ying Sun

  4. Section of Child Health, Anhui Provincial Children’s Hospital, Hefei, Anhui, China

    Ya Wang

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  1. Shanshan Wang
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Contributions

Dr Sun had full access to all of the data and takes responsibility for the integrity of the data and the accuracy of the data analysis. W and W: contributed equally to this work. Conceptualization: WS, WY, SY, Data curation: WS, WY, SY, Formal analysis: WS, Funding acquisition: SY, Methodology: WS, WY, SY, Software: WS, WY, Supervision: WY, SP, TF, SY, Validation: SP, TF, Visualization: WS, SY, Writing—original draft: WS, WY, Writing—review & editing: WY, SP, TF, SY.

Corresponding author

Correspondence to Ying Sun.

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Conflict of interest

The authors have no relevant conflicts of interest to disclose.

Ethical approval

The Peking University Biomedical Ethics Review Committee provided ethical approval for the survey (Approval number: IRB00001052-14010). All the participants in CFPS survey were required to subscribe an informed consent form (http://www.isss.pku.edu.cn/cfps/docs/20200615141215123435.pdf, accessed on 12 July 2021) before interview, and all the obtained information from participants was handled voluntarily, confidentially, and anonymously.

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Supplementary Information

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787_2023_2229_MOESM1_ESM.doc

Table S1 Behavioral patterns, anthropometrics, physical and mental health conditions, access to and utilization of health care, and psychosocial factors studied. Table S2 Characteristics of adolescents in follow-up and missing groups from China Family Panel Study (CFPS). Table S3 Multivariate model estimates of associations of 8 modifiable factors identified through LASSO regression analysis with cognitive performance among children and adolescents participating in the China Family Panel Study. Table S4 Associations between each target exposure and the child’s cognitive performance (DOC 287 KB)

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Wang, S., Wang, Y., Wan, Y. et al. Modifiable factors associated with cognitive performance in Chinese adolescents: a national environment-wide association study. Eur Child Adolesc Psychiatry 33, 1047–1056 (2024). https://doi.org/10.1007/s00787-023-02229-1

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