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产前暴露于 1944-1945 年荷兰饥荒与 75 岁前痴呆风险:初级保健数据分析。

Prenatal Exposure to the 1944-45 Dutch Famine and Risk for Dementia up to Age 75: An Analysis of Primary Care Data.

机构信息

Department of Epidemiology and Data Science, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.

Amsterdam Public Health Research Institute, Aging & Later life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.

出版信息

Curr Alzheimer Res. 2024;21(2):101-108. doi: 10.2174/0115672050290699240422050036.

DOI:10.2174/0115672050290699240422050036
PMID:38706355
Abstract

BACKGROUND

A poor prenatal environment adversely affects brain development. Studies investigating long-term consequences of prenatal exposure to the 1944-45 Dutch famine have shown that those exposed to famine in early gestation had poorer selective attention, smaller brain volumes, poorer brain perfusion, older appearing brains, and increased reporting of cognitive problems, all indicative of increased dementia risk.

OBJECTIVE

In the current population-based study, we investigated whether dementia incidence up to age 75 was higher among individuals who had been prenatally exposed to famine.

METHODS

We included men (n=6,714) and women (n=7,051) from the Nivel Primary Care Database who had been born in seven cities affected by the Dutch famine. We used Cox regression to compare dementia incidence among individuals exposed to famine during late (1,231), mid (1,083), or early gestation (601) with those unexposed (born before or conceived after the famine).

RESULTS

We did not observe differences in dementia incidence for those exposed to famine in mid or early gestation compared to those unexposed. Men and women exposed to famine in late gestation had significantly lower dementia rates compared to unexposed individuals (HR 0.52 (95%CI 0.30-0.89)). Sex-specific analyses showed a lower dementia rate in women exposed to famine in late gestation (HR 0.39 (95%CI 0.17-0.86)) but not in men (HR 0.68 (95%CI 0.33-1.41)).

CONCLUSION

Although prenatal exposure to the Dutch famine has previously been associated with measures of accelerated brain aging, the present population-based study did not show increased dementia incidence up to age 75 in those exposed to famine during gestation.

摘要

背景

不良的产前环境会对大脑发育产生不利影响。研究表明,那些在妊娠早期暴露于 1944-1945 年荷兰饥荒的人,其选择性注意力较差、脑容量较小、脑灌注较差、大脑看起来更老,并且认知问题的报告也更多,这些都表明痴呆症的风险增加。

目的

在当前基于人群的研究中,我们调查了在妊娠期间暴露于饥荒的个体是否会增加痴呆症的发病率,直至 75 岁。

方法

我们纳入了来自受荷兰饥荒影响的七个城市的 Nivel 初级保健数据库中的男性(n=6714)和女性(n=7051)。我们使用 Cox 回归比较了在妊娠晚期(1231 例)、中期(1083 例)或早期(601 例)暴露于饥荒的个体与未暴露于饥荒的个体(出生前或受孕后饥荒)之间的痴呆症发病率。

结果

我们没有观察到暴露于妊娠中晚期或早期的个体与未暴露的个体在痴呆症发病率上的差异。与未暴露的个体相比,暴露于妊娠晚期的男性和女性的痴呆症发生率显著降低(HR 0.52(95%CI 0.30-0.89))。性别特异性分析显示,暴露于妊娠晚期的女性的痴呆症发病率较低(HR 0.39(95%CI 0.17-0.86)),但男性则不然(HR 0.68(95%CI 0.33-1.41))。

结论

尽管之前有研究表明,妊娠期间暴露于荷兰饥荒与加速大脑衰老的指标有关,但本基于人群的研究并未显示在妊娠期间暴露于饥荒的个体在 75 岁之前痴呆症的发病率增加。

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