Nurturing environments and nutrient-rich diets may improve cognitive development: analysis of cognitive trajectories from six to sixty months from the MAL-ED study (OR10-01-19)

Objectives: To identify clusters of cognitive developmental trajectories and associated differentiating factors of children aged 6 to 60 months old in 5 low to middle-income sites.

Methods: We followed 835 children and assessed anthropometry at enrolment (≤ 17 d old); bi-weekly illness data (0–24 and 60 mo); non-diarrheal and diarrheal stools (0–24 mo) analyzed for a panel of enteropathogens; quantitative complementary food intakes (9–24 and 60 mo); micronutrient status (Fe, Zn, Vit A; 7, 15, and 24 mo); quality of the child's home environment (6, 24, and 60 mo) and maternal reasoning ability and depressive symptoms via questionnaire. Child cognitive development was assessed by the Bayley Scales of Infant Development III (6, 15 and 24 mo) and Wechsler Preschool and Primary Scale of Intelligence (60 mo). Clusters of trajectories were identified using a latent class mixed model. Differences between clusters were described using discriminant analysis to rank the contribution of each variable using correlation-adjusted t-scores (CAT).