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Very Early Life Risk Factors for Developing Dementia : Evidence from full population registers

Fischer, Martin LU ; Lövdén, Martin ; Nilsson, Therese LU and Seblova, Nika (2023) In Journals of Gerontology - Series B Psychological Sciences and Social Sciences 78(12). p.2131-2140
Abstract
OBJECTIVES: Very early-life conditions are recognized as critical for healthy brain development. This study assesses early-life risk factors for developing dementia. In the absence of historical medical birth records, we leverage an alternative full population approach using demographic characteristics obtained from administrative data to derive proxy indicators for birth complications and unfavorable birth outcomes. We use proxy variables to investigate the impact of early-life risk factors on dementia risk. METHODS: We use administrative individual-level data for full cohorts born 1932-1950 in Sweden with multigenerational linkages. Records on hospitalization and mortality are used to identify dementia cases. We derive 3 birth risk... (More)
OBJECTIVES: Very early-life conditions are recognized as critical for healthy brain development. This study assesses early-life risk factors for developing dementia. In the absence of historical medical birth records, we leverage an alternative full population approach using demographic characteristics obtained from administrative data to derive proxy indicators for birth complications and unfavorable birth outcomes. We use proxy variables to investigate the impact of early-life risk factors on dementia risk. METHODS: We use administrative individual-level data for full cohorts born 1932-1950 in Sweden with multigenerational linkages. Records on hospitalization and mortality are used to identify dementia cases. We derive 3 birth risk factors based on demographic characteristics: advanced maternal age, narrow sibling spacing, and twin births, and apply survival analysis to evaluate long-term effects on dementia risk. We control for confounding using multiple indicators for socio-economic status (SES), including parental surnames, and by implementing a sibling design. As comparison exposure, we add low education from the 1970 Census. RESULTS: The presence of at least 1 birth risk factor increases dementia risk (HR = 1.059; 95% CI: 1.034, 1.085). The occurrence of twin births poses a particularly heightened risk (HR = 1.166; 95% CI: 1.084, 1.255). DISCUSSION: Improvements to the very early-life environment hold significant potential to mitigate dementia risk. A comparison to the influence of low education on dementia (the largest known modifiable risk factor) suggests that demographic birth characteristics are of relevant effect sizes. Our findings underscore the relevance of providing assistance for births experiencing complications and adverse health outcomes to reduce dementia cases. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journals of Gerontology - Series B Psychological Sciences and Social Sciences
volume
78
issue
12
pages
2131 - 2140
publisher
Oxford University Press
external identifiers
  • scopus:85180011025
  • pmid:37756487
ISSN
1079-5014
DOI
10.1093/geronb/gbad142
language
English
LU publication?
yes
id
7113dec2-5628-4238-acdf-7181144ca04d
date added to LUP
2023-09-11 09:02:21
date last changed
2024-01-04 03:00:08
@article{7113dec2-5628-4238-acdf-7181144ca04d,
  abstract     = {{OBJECTIVES: Very early-life conditions are recognized as critical for healthy brain development. This study assesses early-life risk factors for developing dementia. In the absence of historical medical birth records, we leverage an alternative full population approach using demographic characteristics obtained from administrative data to derive proxy indicators for birth complications and unfavorable birth outcomes. We use proxy variables to investigate the impact of early-life risk factors on dementia risk. METHODS: We use administrative individual-level data for full cohorts born 1932-1950 in Sweden with multigenerational linkages. Records on hospitalization and mortality are used to identify dementia cases. We derive 3 birth risk factors based on demographic characteristics: advanced maternal age, narrow sibling spacing, and twin births, and apply survival analysis to evaluate long-term effects on dementia risk. We control for confounding using multiple indicators for socio-economic status (SES), including parental surnames, and by implementing a sibling design. As comparison exposure, we add low education from the 1970 Census. RESULTS: The presence of at least 1 birth risk factor increases dementia risk (HR = 1.059; 95% CI: 1.034, 1.085). The occurrence of twin births poses a particularly heightened risk (HR = 1.166; 95% CI: 1.084, 1.255). DISCUSSION: Improvements to the very early-life environment hold significant potential to mitigate dementia risk. A comparison to the influence of low education on dementia (the largest known modifiable risk factor) suggests that demographic birth characteristics are of relevant effect sizes. Our findings underscore the relevance of providing assistance for births experiencing complications and adverse health outcomes to reduce dementia cases.}},
  author       = {{Fischer, Martin and Lövdén, Martin and Nilsson, Therese and Seblova, Nika}},
  issn         = {{1079-5014}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{2131--2140}},
  publisher    = {{Oxford University Press}},
  series       = {{Journals of Gerontology - Series B Psychological Sciences and Social Sciences}},
  title        = {{Very Early Life Risk Factors for Developing Dementia : Evidence from full population registers}},
  url          = {{http://dx.doi.org/10.1093/geronb/gbad142}},
  doi          = {{10.1093/geronb/gbad142}},
  volume       = {{78}},
  year         = {{2023}},
}