Early-life environment is related to childhood brain development and cognitive function in later life. However, the associations of early-life risk factors with dementia and cognitive impairment were still controversial.
Objective:
Our study aims to investigate early-life risk factors for dementia and cognitive impairment.
Methods:
PubMed and Cochrane Library were searched to identify prospective cohort and retrospective case-control studies exploring early-life factors for dementia and cognitive impairment. Pooled effect estimates for each factor were calculated by random-effect model.
Results:
Thirty-seven studies with 46,727 participants were included. The pooled results indicated significant associations of dementia with food deficiency (OR = 2.05, 95% CI = 1. 22–3.44), low education level (RR = 1.80, 95% CI = 1.60–2.02), and shorter leg length (OR = 1.19, 95% CI = 1.07–1.32). Other potential risk factors identified in the systematic review include rural residence, number of siblings, history of head trauma, early parental death or re-marriage, and poor learning ability.
Conclusion:
Early-life factors, including education level, leg length, history of childhood head trauma, family-related factors and learning ability, were associated with the risk of dementia and cognitive impairment in later life. Further high-quality longitudinal studies are needed to verify the causality between early-life risk factors and dementia and cognitive impairment.
BeydounMA, BeydounHA, GamaldoAA, TeelA, ZondermanAB, WangY (2014) Epidemiologic studies of modifiable factors associated with cognition and dementia: Systematic review and meta-analysis. BMC Public Health14, 643.
2.
YangZ, LinPJ, LeveyA (2013) Monetary costs of dementia in the United States. N Engl J Med369, 489.
3.
(2016) 2016 Alzheimer’s disease facts and figures. Alzheimers Dement12, 459–509.
YasikAE, SaighPA, OberfieldRA, HalamandarisPV (2007) Posttraumatic stress disorder: Memory and learning performance in children and adolescents. Biol Psychiatry61, 382–388.
6.
SternY (2012) Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol11, 1006–1012.
7.
HeysM, SchoolingCM, JiangC, AdabP, ChengKK, LamTH, LeungaGM (2009) Childhood growth and adulthood cognition in a rapidly developing population. Epidemiology20, 91–99.
8.
The Lancet N (2017) Pointing the way to primary prevention of dementia. Lancet Neurol16, 677.
9.
MoceriVM, KukullWA, EmanuelI, van BelleG, LarsonEB (2000) Early-life risk factors and the development of Alzheimer’s disease. Neurology54, 415–420.
10.
SeifanA, SchelkeM, Obeng-AduasareY, IsaacsonR (2015) Early life epidemiology of Alzheimer’s disease–a critical review. Neuroepidemiology45, 237–254.
KimJM, StewartR, ShinIS, KimSW, YangSJ, YoonJS (2008) Associations between head circumference, leg length and dementia in a Korean population. Int J Geriatr Psychiatry23, 41–48.
13.
StewartR, HardyR, RichardsM (2015) Associations between skeletal growth in childhood and cognitive function in mid-life in a 53-year prospective birth cohort study. PLoS One10, e0124163.
14.
LiangX, LiX, DingD, ZhaoQ, LuoJ, GuoQ, HongZ (2015) Short sitting height and low relative sitting height are associated with severe cognitive impairment among older women in an urban community in China. Neuroepidemiology45, 257–263.
15.
BeeriMS, DavidsonM, SilvermanJM, NoyS, SchmeidlerJ, GoldbourtU (2005) Relationship between body height and dementia. Am J Geriatr Psychiatry13, 116–123.
16.
ShalatSL, SeltzerB, PidcockC, BakerEL, Jr (1987) Risk factors for Alzheimer’s disease: A case-control study. Neurology37, 1630–1633.
17.
MortimerJA, SnowdonDA, MarkesberyWR (2003) Head circumference, education and risk of dementia: Findings from the Nun Study. J Clin Exp Neuropsychol25, 671–679.
18.
StangA (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol25, 603–605.
19.
AsbridgeM, HaydenJA, CartwrightJL (2012) Acute cannabis consumption and motor vehicle collision risk: Systematic review of observational studies and meta-analysis. BMJ344, e536.
MomtazYA, HaronSA, HamidTA, IbrahimR, MasudJ (2015) Does food insufficiency in childhood contribute to dementia in later life?Clin Interv Aging10, 49–53.
22.
WangC, AnY, YuH, FengL, LiuQ, LuY, WangH, XiaoR (2016) Association between exposure to the chinese famine in different stages of early life and decline in cognitive functioning in adulthood. Front Behav Neurosci10, 146.
23.
KimJM, StewartR, ShinIS, YoonJS (2003) Limb length and dementia in an older Korean population. J Neurol Neurosurg Psychiatry74, 427–432.
24.
MakZ, KimJM, StewartR (2006) Leg length, cognitive impairment and cognitive decline in an African-Caribbean population. Int J Geriatr Psychiatry21, 266–272.
25.
SchofieldPW, LogroscinoG, AndrewsHF, AlbertS, SternY (1997) An association between head circumference and Alzheimer’s disease in a population-based study of aging and dementia. Neurology49, 30–37.
26.
GravesAB, MortimerJA, LarsonEB, WenzlowA, BowenJD, McCormickWC (1996) Head circumference as a measure of cognitive reserve. Association with severity of impairment in Alzheimer’s disease. Br J Psychiatry169, 86–92.
27.
KarpA, KareholtI, QiuC, BellanderT, WinbladB, FratiglioniL (2004) Relation of education and occupation-based socioeconomic status to incident Alzheimer’s disease. Am J Epidemiol159, 175–183.
28.
QiuC, BackmanL, WinbladB, Aguero-TorresH, FratiglioniL (2001) The influence of education on clinically diagnosed dementia incidence and mortality data from the Kungsholmen Project. Arch Neurol58, 2034–2039.
29.
CobbJL, WolfPA, AuR, WhiteR, D’AgostinoRB (1995) The effect of education on the incidence of dementia and Alzheimer’s disease in the Framingham Study. Neurology45, 1707–1712.
30.
LetenneurL, GilleronV, CommengesD, HelmerC, OrgogozoJM, DartiguesJF (1999) Are sex and educational level independent predictors of dementia and Alzheimer’s disease? Incidence data from the PAQUID project. J Neurol Neurosurg Psychiatry66, 177–183.
31.
ChibnallJT, EastwoodR (1998) Postsecondary education and dementia risk in older Jesuit priests. Int Psychogeriatr10, 359–368.
32.
SternY, GurlandB, TatemichiTK, TangMX, WilderD, MayeuxR (1994) Influence of education and occupation on the incidence of Alzheimer’s disease. JAMA271, 1004–1010.
33.
McDowellI, XiG, LindsayJ, TierneyM (2007) Mapping the connections between education and dementia. J Clin Exp Neuropsychol29, 127–141.
34.
OttA, van RossumCT, van HarskampF, van de MheenH, HofmanA, BretelerMM (1999) Education and the incidence of dementia in a large population-based study: The Rotterdam Study. Neurology52, 663–666.
35.
CrooksVC, LubbenJ, PetittiDB, LittleD, ChiuV (2008) Social network, cognitive function, and dementia incidence among elderly women. Am J Public Health98, 1221–1227.
36.
Bermejo-ParejaF, Benito-LeonJ, VegaS, MedranoMJ, RomanGC (2008) Incidence and subtypes of dementia in three elderly populations of central Spain. J Neurol Sci264, 63–72.
37.
LindsayJ, LaurinD, VerreaultR, HebertR, HelliwellB, HillGB, McDowellI (2002) Risk factors for Alzheimer’s disease: A prospective analysis from the Canadian Study of Health and Aging. Am J Epidemiol156, 445–453.
38.
LetenneurL, LaunerLJ, AndersenK, DeweyME, OttA, CopelandJR, DartiguesJF, Kragh-SorensenP, BaldereschiM, BrayneC, LoboA, Martinez-LageJM, StijnenT, HofmanA (2000) Education and the risk for Alzheimer’s disease: Sex makes a difference. EURODEM pooled analyses. EURODEM Incidence Research Group. Am J Epidemiol151, 1064–1071.
39.
ZhangM, KatzmanR, YuE, LiuW, XiaoSF, YanH (1998) A preliminary analysis of incidence of dementia in Shanghai, China. Psychiatry Clin Neurosci52(Suppl), S291–S294.
40.
SchmandB, SmitJ, LindeboomJ, SmitsC, HooijerC, JonkerC, DeelmanB (1997) Low education is a genuine risk factor for accelerated memory decline and dementia. J Clin Epidemiol50, 1025–1033.
41.
LiW, RisacherSL, McAllisterTW, SaykinAJ (2017) Age at injury is associated with the long-term cognitive outcome of traumatic brain injuries. Alzheimers Dement (Amst)6, 196–200.
42.
ChuSF, ChiuWT, LinHW, ChiangYH, LiouTH (2016) Hazard ratio and repeat injury for dementia in patients with and without a history of traumatic brain injury: A population-based secondary data analysis in Taiwan. Asia Pac J Public Health28, 519–527.
43.
LeeYK, HouSW, LeeCC, HsuCY, HuangYS, SuYC (2013) Increased risk of dementia in patients with mild traumatic brain injury: A nationwide cohort study. PLoS One8, e62422.
44.
BurriA, MaerckerA, KrammerS, Simmen-JanevskaK (2013) Childhood trauma and PTSD symptoms increase the risk of cognitive impairment in a sample of former indentured child laborers in old age. PLoS One8, e57826.
45.
BazarianJJ, CernakI, Noble-HaeussleinL, PotolicchioS, TemkinN (2009) Long-term neurologic outcomes after traumatic brain injury. J Head Trauma Rehabil24, 439–451.
46.
ShivelyS, ScherAI, PerlDP, Diaz-ArrastiaR (2012) Dementia resulting from traumatic brain injury: What is the pathology?Arch Neurol69, 1245–1251.
47.
BonnierC, MariqueP, Van HoutA, PotelleD (2007) Neurodevelopmental outcome after severe traumatic brain injury in very young children: Role for subcortical lesions. J Child Neurol22, 519–529.
48.
MoceriVM, KukullWA, EmanualI, van BelleG, StarrJR, SchellenbergGD, McCormickWC, BowenJD, TeriL, LarsonEB (2001) Using census data and birth certificates to reconstruct the early-life socioeconomic environment and the relation to the development of Alzheimer’s disease. Epidemiology12, 383–389.
49.
KaplanGA, TurrellG, LynchJW, EversonSA, HelkalaEL, SalonenJT (2001) Childhood socioeconomic position and cognitive function in adulthood. Int J Epidemiol30, 256–263.
50.
HallKS, GaoS, UnverzagtFW, HendrieHC (2000) Low education and childhood rural residence: Risk for Alzheimer’s disease in African Americans. Neurology54, 95–99.
51.
ContadorI, Bermejo-ParejaF, Puertas-MartinV, Benito-LeonJ (2015) Childhood and adulthood rural residence increases the risk of dementia: NEDICES study. Curr Alzheimer Res12, 350–357.
52.
NortonMC, OstbyeT, SmithKR, MungerRG, TschanzJT (2009) Early parental death and late-life dementia risk: Findings from the Cache County Study. Age Ageing38, 340–343.
53.
NortonMC, SmithKR, OstbyeT, TschanzJT, SchwartzS, CorcoranC, BreitnerJC, SteffensDC, SkoogI, RabinsPV, Welsh-BohmerKA (2011) Early parental death and remarriage of widowed parents as risk factors for Alzheimer disease: The Cache County study. Am J Geriatr Psychiatry19, 814–824.
54.
RussTC, HannahJ, BattyGD, BoothCC, DearyIJ, StarrJM (2017) Childhood cognitive ability and incident dementia: The 1932 scottish mental survey cohort into their 10th decade. Epidemiology28, 361–364.
55.
FritschT, SmythKA, McClendonMJ, OgrockiPK, SantillanC, LarsenJD, StraussME (2005) Associations between dementia/mild cognitive impairment and cognitive performance and activity levels in youth. J Am Geriatr Soc53, 1191–1196.
56.
DekhtyarS, WangHX, FratiglioniL, HerlitzA (2016) Childhood school performance, education and occupational complexity: A life-course study of dementia in the Kungsholmen Project. Int J Epidemiol45, 1207–1215.
57.
SeifanA, AssurasS, HueyED, MezJ, TsapanouA, CaccappoloE (2015) Childhood learning disabilities and atypical dementia: A retrospective chart review. PLoS One10, e0129919.
58.
BezerraAB, CoutinhoES, BarcaML, EngedalK, EngelhardtE, LaksJ (2012) School attainment in childhood is an independent risk factor of dementia in late life: Results from a Brazilian sample. Int Psychogeriatr24, 55–61.
59.
AbbottRD, WhiteLR, RossGW, PetrovitchH, MasakiKH, SnowdonDA, CurbJD (1998) Height as a marker of childhood development and late-life cognitive function: The Honolulu-Asia Aging Study. Pediatrics102, 602–609.
60.
JeongSK, KimJM, KweonSS, ShinMH, SeoMW, KimYH (2005) Does arm length indicate cognitive and functional reserve?Int J Geriatr Psychiatry20, 406–412.
61.
PereiraVH, CostaPS, SantosNC, CunhaPG, Correia-NevesM, PalhaJA, SousaN (2016) Adult body height is a good predictor of different dimensions of cognitive function in aged individuals: A cross-sectional study. Front Aging Neurosci8, 217.
62.
HuangTL, CarlsonMC, FitzpatrickAL, KullerLH, FriedLP, ZandiPP (2008) Knee height and arm span: A reflection of early life environment and risk of dementia. Neurology70, 1818–1826.
63.
JormAF (2001) History of depression as a risk factor for dementia: An updated review. Aust N Z J Psychiatry35, 776–781.
64.
ZhangZ, GuD, HaywardMD (2010) Childhood nutritional deprivation and cognitive impairment among older Chinese people. Soc Sci Med71, 941–949.
65.
HarrisMA, BrettCE, DearyIJ, StarrJM (2016) Associations among height, body mass index and intelligence from age 11 to age 78 years. BMC Geriatr16, 167.
66.
AdairLS (1999) Filipino children exhibit catch-Up growth from age 2 to 12 years. J Nutr129, 1140–1148.
67.
EdlandSD, XuY, PlevakM, O’BrienP, TangalosEG, PetersenRC, JackCRJr (2002) Total intracranial volume: Normative values and lack of association with Alzheimer’s disease. Neurology59, 272–274.
68.
MarklundN, FarrokhniaN, HanellA, VanmechelenE, EnbladP, ZetterbergH, BlennowK, HilleredL (2014) Monitoring of beta-amyloid dynamics after human traumatic brain injury. J Neurotrauma31, 42–55.
69.
UryuK, ChenXH, MartinezD, BrowneKD, JohnsonVE, GrahamDI, LeeVM, TrojanowskiJQ, SmithDH (2007) Multiple proteins implicated in neurodegenerative diseases accumulate in axons after brain trauma in humans. Exp Neurol208, 185–192.
70.
SmithC, GrahamDI, MurrayLS, NicollJA (2003) Tau immunohistochemistry in acute brain injury. Neuropathol Appl Neurobiol29, 496–502.
71.
FlemingerS, OliverDL, LovestoneS, Rabe-HeskethS, GioraA (2003) Head injury as a risk factor for Alzheimer’s disease: The evidence 10 years on; a partial replication. J Neurol Neurosurg Psychiatry74, 857–862.
72.
JohnsonVE, StewartW, SmithDH (2012) Widespread tau and amyloid-beta pathology many years after a single traumatic brain injury in humans. Brain Pathol22, 142–149.
73.
BrennerT, FreierMC, HolshouserBA, BurleyT, AshwalS (2003) Predicting neuropsychologic outcome after traumatic brain injury in children. Pediatr Neurol28, 104–114.
