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|Title:||Three estimates of the association between linear growth failure and cognitive ability||Authors:||Cheung, Y.B.
|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. https://doi.org/10.1111/j.1365-3156.2009.02321.x||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||URI:||http://scholarbank.nus.edu.sg/handle/10635/110324||ISSN:||13602276||DOI:||10.1111/j.1365-3156.2009.02321.x|
|Appears in Collections:||Staff Publications|
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