Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China.
J Alzheimers Dis. 2019;67(1):221-229. doi: 10.3233/JAD-180856.
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.
Our study aims to investigate early-life risk factors for dementia and cognitive impairment.
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.
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.
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.
人生早期的环境与儿童期大脑发育和晚年认知功能有关。然而，人生早期危险因素与痴呆和认知障碍的关联仍存在争议。
本研究旨在探讨人生早期危险因素与痴呆和认知障碍的关系。
通过检索 PubMed 和 Cochrane Library，我们确定了探讨人生早期因素与痴呆和认知障碍关系的前瞻性队列研究和回顾性病例对照研究。采用随机效应模型计算每个因素的汇总效应估计值。
共纳入 37 项研究，包含 46727 名参与者。汇总结果表明，痴呆与食物缺乏（OR = 2.05，95%CI = 1.22-3.44）、低教育水平（RR = 1.80，95%CI = 1.60-2.02）和下肢长度较短（OR = 1.19，95%CI = 1.07-1.32）显著相关。系统评价中还确定了其他潜在的危险因素，包括农村居住、兄弟姐妹数量、童年期头部外伤史、早逝或再婚的父母以及学习能力差。
人生早期的多种因素，包括教育水平、下肢长度、儿童期头部外伤史、家庭相关因素和学习能力，与晚年痴呆和认知障碍的风险相关。需要进一步开展高质量的纵向研究来验证人生早期危险因素与痴呆和认知障碍之间的因果关系。
