Abstract
Objective: The aim of this study was to investigate whether people exposed to the Chinese Famine in fetal period or in multiple stages of childhood are associated with cognitive decline in adulthood. Furthermore, the nutritional environment of adulthood was explored as an important factor in this correlation.Methods: 1162 adults born between 1952 and 1964 were recruited. They were divided into five groups which were non-exposed group, fetal-exposed group, early childhood-exposed group, mid childhood-exposed group and late childhood-exposed group. Cognitive function was measured by using a comprehensive neuropsychological battery test, including Montreal cognitive assessment-Beijing version, mini-mental state examination, auditory verbal learning test, digit span forward, digit span backward, trail making test, and digit symbol test. Semi-quantified food frequency questionnaire (FFQ) was used to assess the dietary nutrition in their adulthood. The dietary nutrient consumption pattern was identified by Two-step and K-means cluster analysis.Results: The significant differences in cognitive function were manifested in different groups. Compared with non-exposed group, subjects in fetal-exposed group had a higher risk of mild cognitive impairment (MCI) (OR 1.51 95% CI 1.02–2.23, P = 0.039) and global cognitive decline (OR 1.68 59% CI 1.02–2.77, P = 0.044). The similar result was also observed in subjects of early childhood-exposed group. Otherwise, subjects who were classified in high nutrient consumption pattern had higher risk of cognitive decline. Moreover, the higher consumption of several nutrients such as fat, carbohydrate and manganese were associated with worse performance on digit span forward, digit span backward, trail making test A, trail making test B and digit symbol.Conclusion: Early stages of life exposed to the Chinese Famine were associated with higher risk of cognitive decline in adulthood. The stronger associations were manifested in the people with high nutrient consumption pattern. The consumption of fat, carbohydrate and manganese were associated with multiple domains cognitive decline.
Highlights
Rapid demographic aging is becoming a vigilant public health issue in the developing countries including China (Kunna et al, 2017)
Similar to the demonstration of Dutch famine birth cohort study (Uchida et al, 2016), our results implied that people who experienced early life malnutrition might be prone to high-fat diet especially in the people of later childhood malnutrition exposure, and the habit of higher intake of fatty food might be a vital factor in the association between early life malnutrition and adult cognitive decline
Present study, as a result of our phased study, indicated that different stages of early life exposed to Famine was associated with higher risk of cognitive decline in adulthood
Summary
Rapid demographic aging is becoming a vigilant public health issue in the developing countries including China (Kunna et al, 2017). Characterized by deficits in attention, executive function, working memory and information processing (Sampath et al, 2017), Mild Cognitive Impairment (MCI) is considered to be a critical stage intermediate period between normal aging and dementia. Based on epidemiological surveys and animal experiments over the past decades, studies support the idea that AD-related brain changes may originate from conception and early life (Albert, 2015; Seifan et al, 2015; Mormino et al, 2016; Rannikko et al, 2016). Malnutrition during fetal and early postnatal life may result in a permanent deficit of brain structure development. It prompts that malnutrition in early life may have the irreversible impact on catch-up growth in childhood, and have the longterm effects on cognitive function in adulthood (Lucas, 2010)
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