Yu Jing, Haynie Denise L, Sundaram Rajeshwari, Gilman Stephen E
Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
JAMA Netw Open. 2025 Sep 2;8(9):e2531283. doi: 10.1001/jamanetworkopen.2025.31283.
Higher intellectual abilities have been associated with lower mortality risk in several longitudinal cohort studies. However, these studies did not fully account for early life contextual factors or test whether the beneficial associations between higher neurocognitive functioning and mortality extend to children exposed to early adversity.
To explore how the associations of child neurocognition with mortality changed according to the patterns of adversity children experienced.
DESIGN, SETTING, AND PARTICIPANTS: The Collaborative Perinatal Project (CPP) is a US pregnancy cohort study conducted at 12 US academic medical centers among children born between 1959 and 1966. Pregnant women at participating centers were invited to enroll in the study, and their offspring were followed up for assessments of neurocognition and mortality risk. The CPP offspring cohort was linked to the National Death Index to ascertain their later vital status. Analyses were conducted in August 2024 and June 2025.
Nine neurocognitive test scores captured children's visual-motor, sensory-motor, auditory-vocal, intelligence quotient (IQ), and academic skills.
All-cause mortality between 1979 and 2016.
Among the 49 853 CPP offspring, about half were male (25 226 offspring [50.6%]). A total of 23 331 (46.8%) mothers were Black, 3739 (7.5%) were other races, and 22 783 (45.7%) were White Eight of the 9 neurocognitive scores were associated with the risk of mortality, with each SD higher score in neurocognition associated with 9% (auditory-vocal association function hazard ratio [HR], 0.91; 95% CI, 0.88-0.95) to 15% (full-scale IQ HR, 0.85; 95% CI, 0.81-0.88) lower mortality risk. Full scale and performance IQ and arithmetic skills were associated with an 11% (IQ HR, 0.91; 95% CI, 0.82-0.96) to 23% (arithmetic skills HR, 0.77; 95% CI, 0.72-0.83) lower mortality risk for children exposed to low adversity, crowded housing and poverty, and/or family instability, but not for those exposed to severe patterns of adversities.
This large US cohort study found that most childhood neurocognitive functions were associated with lower risk of premature mortality through middle adulthood, although the associations of some neurocognitive functions were diminished in the context of exposure to complex patterns of adversity. Thus, developing strong neurocognitive skills may foster long-term health resilience.
在多项纵向队列研究中，较高的智力水平与较低的死亡风险相关。然而，这些研究并未充分考虑早期生活背景因素，也未检验较高的神经认知功能与死亡率之间的有益关联是否适用于经历早期逆境的儿童。
探讨儿童神经认知与死亡率之间的关联如何根据儿童所经历的逆境模式而变化。
设计、背景和参与者：协作围产期项目（CPP）是一项在美国12个学术医疗中心进行的美国孕期队列研究，研究对象为1959年至1966年出生的儿童。参与中心的孕妇被邀请参加该研究，其后代接受神经认知和死亡风险评估的随访。CPP后代队列与国家死亡指数相链接，以确定他们后来的生命状态。分析于2024年8月和2025年6月进行。
九个神经认知测试分数反映了儿童的视觉运动、感觉运动、听觉发声、智商（IQ）和学术技能。
1979年至2016年期间的全因死亡率。
在49853名CPP后代中，约一半为男性（25226名后代[50.6%]）。共有23331名（46.8%）母亲为黑人，3739名（7.5%）为其他种族，22783名（45.7%）为白人。9个神经认知分数中的8个与死亡风险相关，神经认知方面每高一个标准差的分数与低9%（听觉发声关联功能风险比[HR]，0.91；95%CI，0.88-0.95）至低15%（全量表智商HR，0.85；95%CI，0.81-0.88）的死亡风险相关。全量表和操作智商以及算术技能与经历低逆境、居住拥挤和贫困及/或家庭不稳定的儿童的死亡风险降低11%（智商HR，0.91；95%CI，0.82-0.96）至23%（算术技能HR，0.77；95%CI，0.72-0.83）相关，但对于经历严重逆境模式的儿童则不然。
这项大型美国队列研究发现，大多数儿童神经认知功能与中年期之前较低的过早死亡风险相关，尽管在经历复杂逆境模式的情况下，一些神经认知功能的关联有所减弱。因此，培养强大的神经认知技能可能会增强长期的健康恢复力。
