Early Neurodevelopment Related Variables And Cardiovascular Health: Findings From The Multidimensional Assessment Of Preschoolers Study

Background: Cardiovascular health (CVH) declines with age starting in early childhood. Neurodevelopmental health (NDH) measures, such as executive function, in early childhood have been associated with subsequent behavioral and lifestyle outcomes; however, little is known about the association of NDH measures in early life with CVH during childhood. Objective: To assess the association of preschool NDH with CVH in later childhood/early adolescence. Methods: Among participants from the Multidimensional Assessment of Preschoolers Study (MAPS), we defined 3 neurodevelopment domains at baseline (ages 3-7 years): executive functioning, developmental functioning, and emotion and behavior regulation (each as a z-score of its component surveys and direct assessment). At the tween follow-up wave (ages 9-14 years), MAPS participants completed a CVH examination including assessment of physical activity, diet, blood pressure, and BMI defined as favorable vs unfavorable CVH metrics according to AHA recommendations. Multivariate logistic regression models were used to assess the association of each NDH domain with favorable/unfavorable CVH metrics at follow up. Models were adjusted for age, race, gender, and poverty. Results: We included 229 SES-diverse children (46.2% boys; 52% living in poverty at baseline; mean baseline age 4.7 yr; mean follow-up age: 11.3 yr). At follow-up, there were 179 (78.2%) children with favorable CVH and 50 (21.8%) children with unfavorable CVH. Better performance on all 3 NDH domains at baseline was demonstrated among children with favorable CVH at follow-up compared to those with unfavorable CVH, with mean z-score of 0.04 among those with favorable CVH compared to -0.15 among those with unfavorable CVH for executive functioning (p<0.001), 0.02 compared to -0.07 for developmental functioning (p=0.004), and 0.02 compared to -0.06 for emotion and behavior regulation (p=0.027). After adjustment, associations between executive functioning, developmental functioning, and emotion/behavior regulation and favorable CVH were attenuated to non-significance {OR (95% CI): 1.21 (0.80-1.81), 1.03 (0.64-1.67), 1.08 (0.73-1.59), respectively}. Conclusions: These findings suggest a possible association between neurodevelopmental domains and CVH, although findings were not significant after adjustment. The heterogeneity of the sample may have obscured effects and the moderating role of the environment may elucidate explanatory pathways. More research with larger sample sizes is needed to better understand the impact of early-life NDH with adolescent CVH.