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Title: Three estimates of the association between linear growth failure and cognitive ability
Authors: Cheung, Y.B. 
Lam, K.F.
Keywords: Body height
Child development
Statistical models
Issue Date: Sep-2009
Citation: Cheung, Y.B., Lam, K.F. (2009-09). Three estimates of the association between linear growth failure and cognitive ability. Tropical Medicine and International Health 14 (9) : 1020-1024. ScholarBank@NUS Repository.
Abstract: Objectives To compare three estimators of association between growth stunting as measured by height-for-age Z-score and cognitive ability in children, and to examine the extent statistical adjustment for covariates is useful for removing confounding due to socio-economic status. Methods Three estimators, namely random-effects, within- and between-cluster estimators, for panel data were used to estimate the association in a survey of 1105 pairs of siblings who were assessed for anthropometry and cognition. Furthermore, a 'combined' model was formulated to simultaneously provide the within- and between-cluster estimates. Results Random-effects and between-cluster estimators showed strong association between linear growth and cognitive ability, even after adjustment for a range of socio-economic variables. In contrast, the within-cluster estimator showed a much more modest association: For every increase of one Z-score in linear growth, cognitive ability increased by about 0.08 standard deviation (P < 0.001). The combined model verified that the between-cluster estimate was significantly larger than the within-cluster estimate (P = 0.004). Conclusion Residual confounding by socio-economic situations may explain a substantial proportion of the observed association between linear growth and cognition in studies that attempt to control the confounding by means of multivariable regression analysis. The within-cluster estimator provides more convincing and modest results about the strength of association. © 2009 Blackwell Publishing Ltd.
Source Title: Tropical Medicine and International Health
ISSN: 13602276
DOI: 10.1111/j.1365-3156.2009.02321.x
Appears in Collections:Staff Publications

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