Neuropsychological outcomes in pediatric brain tumor survivors: contributions of sociocontextual factors.
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Pediatric Brain Tumor Survivors (PBTS) are at elevated risk of neurocognitive impairments. This study aims to assess the contribution of sociodemographic and family functioning variables on cognitive outcomes in PBTS in the context of medical factors. PBTS (n = 100; 47% female) were included in the study. They were on average 5.68 years old at diagnosis and were 6.25 years from diagnosis. Participant intelligence quotient (IQ) was measured using the full-scale IQ of the WISC-IV and WISC-V, and executive function using the BRIEF2 Global Executive Composite. Sociocontextual variables included: parental education, parental employment, and family functioning (measured via the Family Assessment Device). Medical factors considered included: child age at diagnosis, sex, time since diagnosis, tumor location, radiation field, chemotherapy and the Neurological Predictor Scale (NPS). Multivariable models were fit separately for the association between sociocontextual variables and the four neurocognitive outcomes adjusting for medical factors. Having two employed parents (betas ranged from 14.79 to 15.63 for WISC outcomes) and higher parental education (betas ranged from 11.98 to 14.72 for WISC outcomes) were significantly associated with better neurocognitive outcomes in PBTS. Better family functioning was associated with higher total IQ (betas ranged from -0.80 to -0.82). Associations were consistent in magnitude and direction when adjusted for medical factors. Findings shed light on the impact of sociocontextual variables on neurocognitive outcomes in PBTS, emphasizing a need for a more holistic, family-centered approach to survivorship care.