Cognitive development in childhood and drinking behaviour over two decades in adulthood

Background/ aims: Childhood cognition predicts adult morbidity and mortality, potentially working through health behaviours. This study investigates if childhood cognition influences life course ( i) non- drinking and ( ii) binge drinking and pathways through which this might act namely, childhood behaviour problems, adult social position and educational qualifications. Methods: Prospective cohort of British births in March 1958, with information on cognition at 7, 11 and 16 years and alcohol use at 23, 33 and 42 years. Non-drinkers drank "infrequently/ on special occasions'' or "never''. Binge drinkers consumed >= 10 units/ occasion ( men) and >= 7 units/ occasion ( women). Results: Lower cognitive ability increased the odds of non- drinking at each adult survey ( for example, for men at 42 years OR 1.52 ( 95% Cl 1.34 to 1.72) per SD decrease in 7- year maths). Associations remained after adjustment for pathway factors ( i) behaviour problems, ( ii) adult social position and ( iii) educational qualifications. Decreased ability rank across childhood ( 7 - 16 years) also increased odds of non- drinking at 42 years, but the association operated via pathway factors. Lower 7- year ability elevated the odds of 42- year binge drinking, operating via pathway factors. Declining ability rank across childhood also increased the odds of adult binge drinking; associations operated through behavioural problems, adult social position and qualifications. In women, the decline in risk of binge drinking from an age 23- year peak to 42 years was associated with higher 7- year score. Conclusions: Poorer childhood cognition was associated with non- drinking and binge drinking up to the early 40s. Associations between childhood cognition and drinking status may mediate between childhood cognition and adult health.