Puberty timing and cognitive functioning: insights from the Adolescent Brain Cognitive Development (ABCD) study and Mendelian randomization.

BACKGROUND

Early puberty timing is linked to altered neurodevelopment and adverse mental health outcomes, yet its relationship with cognitive functioning remains unclear. We examined the effects of puberty timing across multiple cognitive domains.

METHODS

In 10,722 participants from the Adolescent Brain and Cognitive Development (ABCD) study, we assessed associations between puberty timing, operationalized using sex specific logistic growth curve models, and performance on six cognitive tasks at baseline, 2-year, and 4-year follow-ups. Linear-mixed regression models were calculated separately by sex, adjusting for age, bodyweight, parental income, race/ethnicity, birthweight, prenatal alcohol/tobacco exposure, and whether the assessment occurred before or after the onset of the COVID-19 pandemic. To probe causal relationships, we performed Mendelian randomization utilizing external Genome Wide Association Study (GWAS) data on age at menarche (N = 632,955), male puberty timing (N = 205,354), and executive functioning (N = 427,037).

RESULTS

In the ABCD study, earlier puberty timing was associated with poorer performance pooled across timepoints on the NIH Toolbox® Picture Sequence Memory Task (girls: standardized β = .04, 95% CI [0.02, 0.06]; boys: β = .04, 95% CI [0.01, 0.06]), the learning of a word list (girls: β = .05, 95% CI [0.02, 0.08]; boys: β = .03, 95% CI [0.01, 0.05]), and NIH Toolbox® List Sorting Task (boys only: boys: β = .03, 95% CI [0.01, 0.06]). Mendelian randomization indicated better executive functioning with later age at menarche (b = 0.005/year, 95% CI [0.000, 0.011]). The association with male puberty timing was directionally consistent but remained nonsignificant (b = 0.012/year, 95% CI [-0.004, 0.028]).

CONCLUSIONS

These findings suggest a causal link between earlier puberty timing and poorer cognitive performance. However, effect sizes were small, indicating limited clinical implications at the individual level, while potentially remaining relevant at the population level. Future research on atypical pubertal development or medically induced puberty suppression should include assessment of cognitive outcomes.