Cockell Scarlet, Wang Herong, Benke Kelly S, Ware Erin B, Bakulski Kelly M
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
J Alzheimers Dis. 2025 Aug 14:13872877251365283. doi: 10.1177/13872877251365283.
BackgroundDementia and cognitive impairment are prevalent conditions, and susceptibility likely begins years before symptoms. Early life has not been comprehensively tested for potential risk factors for dementia.ObjectiveTo explore the associations between childhood conditions and exposures and cognitive impairment in adulthood.MethodsIn the US Health and Retirement Study (normal baseline cognition; n = 16,509; 2008-2018 waves), 31 exposures before age 16 were retrospectively assessed with ten-year incident cognitive status (dementia, impaired, normal). Using parallel modified Poisson models, each exposure was tested with incident cognition, adjusting for sex, baseline age, follow-up, race/ethnicity, personal/parental education.ResultsAmong the analytic sample, participants were mean 61 years of age at baseline and all had normal cognition. During up to 10 years of follow-up, 14.5% developed cognitive impairment and 5.3% developed dementia. Participants with depression during childhood had 1.49 (95%CI:1.2,1.84) times higher risk of incident impairment, relative to normal cognition. Participants with headaches/migraines during childhood had 1.43 (95%CI:1.14,1.79) times higher risk of incidence of dementia. Participants with learning problems during childhood had 1.71 (95%CI:1.44,2.03) times higher risk of incident impairment. Childhood self-rated health of fair (1.59, 95%CI:1.2,2.1) and poor (2.42, 95%CI:1.62,3.61) had higher risk of incidence of dementia, relative to excellent self-rated health. Associations between additional exposures and either incident impairment or dementia did not reach the multiple testing threshold (false discovery rate < 0.01).ConclusionsConditions and exposures during the early life period may be important for later life cognitive impairment or dementia. These findings support extending the relevant dementia risk window to evaluate childhood.
背景
痴呆和认知障碍是常见病症，易感性可能在症状出现前数年就已开始。早年生活中的潜在痴呆风险因素尚未得到全面检验。
目的
探讨儿童时期的状况和暴露因素与成年后认知障碍之间的关联。
方法
在美国健康与退休研究中（基线认知正常；n = 16509；2008 - 2018年各波次），回顾性评估了16岁之前的31种暴露因素与十年期的认知状态（痴呆、受损、正常）。使用平行修正泊松模型，对每种暴露因素与新发认知情况进行检验，并对性别、基线年龄、随访情况、种族/族裔、个人/父母教育程度进行校正。
结果
在分析样本中，参与者基线时的平均年龄为61岁，且认知均正常。在长达10年的随访期间，14.5%的人出现了认知障碍，5.3%的人患上了痴呆。童年时期患抑郁症的参与者出现新发认知障碍的风险比认知正常者高1.49倍（95%置信区间：1.2，1.84）。童年时期患头痛/偏头痛的参与者患痴呆症的风险比正常情况高1.43倍（95%置信区间：1.14，1.79）。童年时期有学习问题的参与者出现新发认知障碍的风险高1.71倍（95%置信区间：1.44，2.03）。童年时期自我评定健康状况为中等（1.59，95%置信区间：1.2，2.1）和较差（2.42，95%置信区间：1.62，3.61）的参与者患痴呆症的风险相对于自我评定健康状况极佳者更高。其他暴露因素与新发认知障碍或痴呆之间的关联未达到多重检验阈值（错误发现率<0.01）。
结论
早年时期的状况和暴露因素可能对晚年的认知障碍或痴呆很重要。这些发现支持将相关痴呆风险窗口扩展至童年时期进行评估。
