British Birth Cohort Research Articles

Patterns of Atopic Eczema Disease Activity From Birth Through Midlife in 2 British Birth Cohorts

Atopic eczema is characterized by a heterogenous waxing and waning course, with variable age of onset and persistence of symptoms. Distinct patterns of disease activity such as early-onset/resolving and persistent disease have been identified throughout childhood; little is known about patterns into adulthood. This study aimed to identify subtypes of atopic eczema based on patterns of disease activity through mid-adulthood, to examine whether early life risk factors and participant characteristics are associated with these subtypes, and to determine whether subtypes are associated with other atopic diseases and general health in mid-adulthood. This study evaluated members of 2 population-based birth cohorts, the 1958 National Childhood Development Study (NCDS) and the 1970 British Cohort Study (BCS70). Participant data were collected over the period between 1958 and 2016. Data were analyzed over the period between 2018 and 2020. Subtypes of atopic eczema were identified based on self-reported atopic eczema period prevalence at multiple occasions. These subtypes were the outcome in models of early life characteristics and an exposure variable in models of midlife health. Latent class analysis identified 4 subtypes of atopic eczema with distinct patterns of disease activity among 15 939 individuals from the NCDS (51.4% male, 75.4% White) and 14 966 individuals from the BCS70 (51.6% male, 78.8% White): rare/no (88% to 91%), decreasing (4%), increasing (2% to 6%), and persistently high (2% to 3%) probability of reporting prevalent atopic eczema with age. Sex at birth and early life factors, including social class, region of residence, tobacco smoke exposure, and breastfeeding, predicted differences between the 3 atopic eczema subtypes and the infrequent/no atopic eczema group, but only female sex differentiated the high and decreasing probability subtypes (odds ratio [OR], 1.99; 95% CI, 1.66-2.38). Individuals in the high subtype were most likely to experience asthma and rhinitis, and those in the increasing subtype were at higher risk of poor self-reported general (OR, 1.29; 95% CI, 1.09-1.53) and mental (OR 1.45; 95% CI, 1.23-1.72) health in midlife. The findings of this cohort study suggest that extending the window of observation beyond childhood may reveal clear subtypes of atopic eczema based on patterns of disease activity. A newly identified subtype with increasing probability of activity in adulthood warrants additional attention given observed associations with poor self-reported health in midlife.

Child maltreatment, early life socioeconomic disadvantage and all-cause mortality in mid-adulthood: findings from a prospective British birth cohort

ObjectivesEarly-life adversities (ELAs) such as child maltreatment (neglect and abuse) and socioeconomic disadvantage have been associated with adult mortality. However, evidence is sparse for specific types of ELA. We aimed...

Grip strength from midlife as an indicator of later-life brain health and cognition: evidence from a British birth cohort

BackgroundGrip strength is an indicator of physical function with potential predictive value for health in ageing populations. We assessed whether trends in grip strength from midlife predicted later-life brain health and cognition.Methods446 participants in an ongoing British birth cohort study, the National Survey of Health and Development (NSHD), had their maximum grip strength measured at ages 53, 60–64, and 69, and subsequently underwent neuroimaging as part of a neuroscience sub-study, referred to as “Insight 46”, at age 69–71. A group-based trajectory model identified latent groups of individuals in the whole NSHD cohort with below- or above-average grip strength over time, plus a reference group. Group assignment, plus standardised grip strength levels and change from midlife were each related to measures of whole-brain volume (WBV) and white matter hyperintensity volume (WMHV), plus several cognitive tests. Models were adjusted for sex, body size, head size (where appropriate), sociodemographics, and behavioural and vascular risk factors.ResultsLower grip strength from midlife was associated with smaller WBV and lower matrix reasoning scores at age 69–71, with findings consistent between analysis of individual time points and analysis of trajectory groups. There was little evidence of an association between grip strength and other cognitive test scores. Although greater declines in grip strength showed a weak association with higher WMHV at age 69–71, trends in the opposite direction were seen at individual time points with higher grip strength at ages 60–64, and 69 associated with higher WMHV.ConclusionsThis study provides preliminary evidence that maximum grip strength may have value in predicting brain health. Future work should assess to what extent age-related declines in grip strength from midlife reflect concurrent changes in brain structure.

Childhood neglect and trajectories of affective symptoms throughout adulthood: A British birth cohort study

BackgroundChildhood maltreatment, including neglect, can affect an individual's mental health. However, there is a gap in current literature investigating the long-term, dynamic effects of childhood neglect on adult affective symptoms (AS). MethodData were used from the National Child Development Study (a British 1958 birth cohort). Childhood neglect was prospectively measured at ages 7 and 11. Five distinct trajectories of AS have been derived previously, using data from the Malaise Inventory Scale (at ages 23, 33, 42 and 50): ‘no symptoms’, ‘persistent mild/moderate symptoms’, ‘low and increasing symptoms’, ‘high and increasing symptoms’ and ‘high and decreasing symptoms’ (John et al., 2019). Multinomial logistic regressions were used to explore whether childhood neglect was associated with AS trajectory membership, while adjusting for a number of covariates. ResultsResults revealed that childhood neglect was significantly associated with ‘high and decreasing’, ‘high and increasing’ and ‘persistent mild/moderate’ AS trajectories from young adulthood through midlife. There was no association with the ‘low and increasing’ AS trajectory. When testing for at age specific effects, neglect experienced at age 7 only, or at age 11 only, was predictive of ‘high and decreasing symptoms’ trajectory, whereas neglect experienced at both ages was predictive of ‘persistent mild/moderate symptoms’ trajectory. ConclusionsChildhood neglect has negative long-lasting effects on trajectories of adult mental health. This finding has important implications for early intervention for individuals who have experienced childhood neglect.

Clinical symptoms of anxiety disorders as predictors of political attitudes: A prospective cohort study.

Conservative political ideologies have been suggested to correlate with elevated sensitivity to threat. However, it is unclear whether the associations between threat sensitivity and political attitudes can be observed with clinical measures of mental health. We examined how anxiety disorders predicted attitudes on several political issues. Participants were 7253 individuals from the 1958 British Birth Cohort study. Symptoms of generalised anxiety disorder, phobia and panic were assessed in a clinical interview at age 44, and opinions about political issues were self-reported by the participants 6 years later. Anxiety symptoms were associated with higher concerns about economic inequality, preservation of the environment, distrust in politics and lower work ethic. No associations were observed with racist or authoritarian attitudes, or support for traditional family values. We also assessed how political attitudes at ages 33 and 42 predicted anxiety disorder symptoms at age 44, revealing a possible bidirectional association between concern for economic inequality and anxiety disorder symptoms. These findings do not support an association between conservative political attitudes and elevated threat sensitivity. Rather, elevated anxiety may increase concerns about social inequality and the environment.

Adolescent Sexual Behavior Patterns, Mental Health, and Early Life Adversities in a British Birth Cohort

ABSTRACT This study tested adolescent sexual behavior patterns at age 14, their association with mental health at age 17 (psychological well-being, substance use, and self-harm attempts), and the influence of early life adversities upon this association. A British birth cohort (5,593 boys and 5,724 girls from the Millennium Cohort Study) was used. Latent class analysis suggested five subgroups of adolescent sexual behaviors: a “no sexual behavior” (50.74%), a “kisser” (39.92%), a “touching under clothes” (4.71%), a “genital touching” (2.64%), and an “all sexual activities” class (1.99%). Adolescents from the “kisser,” “touching under clothes,” “genital touching,” and “all sexual activities” classes reported significantly more substance use and self-harm attempts compared to adolescents from the “no sexual behavior” group. The associations became weaker after controlling for early life adversities (reducing around 4.38% to 37.35% for boys, and 9.29% to 52.56% for girls), and reduced to a smaller degree after further controlling for mental health variables at 14. The associations between sexual behaviors and psychological well-being became non-significant after controlling for early life adversities. Adolescents who have engaged in low-intensity sexual activities at early age may have poorer reported mental health, a pattern that is stronger for girls and early life adversity may partially explain this association.

Life Course Neighborhood Deprivation Effects on Body Mass Index: Quantifying the Importance of Selective Migration

Neighborhood effects research is plagued by the inability to circumvent selection effects —the process of people sorting into neighborhoods. Data from two British Birth Cohorts, 1958 (ages 16, 23, 33, 42, 55) and 1970 (ages 16, 24, 34, 42), and structural equation modelling, were used to investigate life course relationships between body mass index (BMI) and area deprivation (addresses at each age linked to the closest census 1971–2011 Townsend score [TOWN], re-calculated to reflect consistent 2011 lower super output area boundaries). Initially, models were examined for: (1) area deprivation only, (2) health selection only and (3) both. In the best-fitting model, all relationships were then tested for effect modification by residential mobility by inclusion of interaction terms. For both cohorts, both BMI and area deprivation strongly tracked across the life course. Health selection, or higher BMI associated with higher area deprivation at the next study wave, was apparent at three intervals: 1958 cohort, BMI at age 23 y and TOWN at age 33 y and BMI at age 33 y and TOWN at age 42 y; 1970 cohort, BMI at age 34 y and TOWN at age 42 y, while paths between area deprivation and BMI at the next interval were seen in both cohorts, over all intervals, except for the association between TOWN at age 23 y and BMI at age 33 y in the 1958 cohort. None of the associations varied by moving status. In conclusion, for BMI, selective migration does not appear to account for associations between area deprivation and BMI across the life course.

Bi-directional associations between religious attendance and mental health: findings from a British birth cohort study

BackgroundThere is evidence that religious attendance is associated with positive outcomes for mental health; however, there are few longitudinal studies, and even fewer, which take into account the possibility of...

Prevalence and early-life determinants of mid-life multimorbidity: evidence from the 1970 British birth cohort

BackgroundWe sought to: [1] estimate the prevalence of multimorbidity at age 46–48 in the 1970 British Cohort Study—a nationally representative sample in mid-life; and [2] examine the association between early-life characteristics and mid-life multimorbidity. MethodA prospective longitudinal birth cohort of a community-based sample from the 1970 British Cohort Study (BCS70). Participants included all surviving children born in mainland Britain in a single week in April 1970; the analytical sample included those with valid data at age 46–48 (n = 7951; 2016–2018). The main outcome was multimorbidity, which was operationalised as a binary indicator of two or more long-term health conditions where at least one of these conditions was of physical health. It also included symptom complexes (e.g., chronic pain), sensory impairments, and alcohol problems.ResultsPrevalence of mid-life multimorbidity was 33.8% at age 46–48. Those with fathers from unskilled social occupational class (vs professional) at birth had 43% higher risk of mid-life multimorbidity (risk ratio = 1.43, 95% confidence interval 1.15 to 1.77). After accounting for potential child and family confounding, an additional kilogram of birthweight was associated with 10% reduced risk of multimorbidity (risk ratio = 0.90, 95% confidence interval 0.84 to 0.96); a decrease of one body mass index point at age 10 was associated with 3% lower risk (risk ratio = 1.03, 95% confidence interval 1.01 to 1.05); one standard deviation higher cognitive ability score at age 10 corresponded to 4% lower risk (risk ratio = 0.96, 95% confidence interval 0.91 to 1.00); an increase of one internalising problem at age 16 was equated with 4% higher risk (risk ratio = 1.04, 95% confidence interval 1.00 to 1.08) and of one externalising problem at age 16 with 6% higher risk (risk ratio = 1.06, 1.03 to 1.09).ConclusionPrevalence of multimorbidity was high in mid-life (33.8% at age 46–48) in Britain. Potentially modifiable early-life exposures, including early-life social circumstances, cognitive, physical and emotional development, were associated with elevated risk of mid-life multimorbidity.

Changes in the adult consequences of adolescent mental ill-health: findings from the 1958 and 1970 British birth cohorts.

Adolescent mental health difficulties are increasing over time. However, it is not known whether their adulthood health and socio-economic sequelae are changing over time. Participants (N = 31 349) are from two prospective national birth cohort studies: 1958 National Child Development Study (n = 16 091) and the 1970 British Cohort Study (n = 15 258). Adolescent mental health was operationalised both as traditional internalising and externalising factors and a hierarchical bi-factor. Associations between adolescent psychopathology and age 42 health and wellbeing (mental health, general health, life satisfaction), social (cohabitation, voting behaviour) and economic (education and employment) outcomes are estimated using linear and logistic multivariable regressions across cohorts, controlling for a wide range of early life potential confounding factors. The prevalence of adolescent mental health difficulties increased and their associations with midlife health, wellbeing, social and economic outcomes became more severe or remained similar between those born in 1958 and 1970. For instance, a stronger association with adolescent mental health difficulties was found for those born in 1970 for midlife psychological distress [odds ratio (OR) 1970 = 1.82 (1.65-1.99), OR 1958 = 1.60 (1.43-1.79)], cohabitation [OR 1970 = 0.64 (0.59-0.70), OR 1958 = 0.79 (0.72-0.87)], and professional occupations [OR 1970 = 0.75 (0.67-0.84), OR 1958 = 1.05 (0.88-1.24)]. The associations of externalising symptoms with later outcomes were mainly explained by their shared variance with internalising symptoms. The widening of mental health-based inequalities in midlife outcomes further supports the need to recognise that secular increases in adolescent mental health symptoms is a public health challenge with measurable negative consequences through the life-course. Increased public health efforts to minimise adverse outcomes are needed.

488 GRIP STRENGTH FROM MIDLIFE AS AN INDICATOR OF LATER-LIFE COGNITION AND BRAIN HEALTH: EVIDENCE FROM A BRITISH BIRTH COHORT

Abstract Introduction Grip strength is an objective measure of physical function with potential predictive value for health in ageing populations. We aimed to assess whether levels and changes in grip strength from midlife predicted later-life brain health and cognition. Methods 446 participants in an ongoing British birth cohort study, the MRC National Survey of Health and Development (NSHD), had their maximum grip strength measured at ages 53, 60–64, and 69, and underwent neuroimaging as part of its neuroscience sub-study, Insight 46, at 69–71. A group-based trajectory model identified latent groups of individuals in the whole NSHD cohort with below- and above-average grip strength over time, plus a reference group. Trajectory group membership, plus standardised grip strength levels and change from age 53, were each related to MRI-derived measures of whole-brain volume (WBV) and white-matter hyperintensity volume (WMHV), plus several cognitive tests. Models were adjusted for sex, body size, head size (where appropriate), sociodemographics, and behavioural and vascular risk factors. Results Consistently below-average grip strength from midlife was associated with lower WBV and non-verbal reasoning ability at age 69–71 (e.g. low group WBV vs. reference group β = −13.38 cm^3; 95% CI = (−24.12 cm^3, −2.64 cm^3); p = 0.015). There was some accompanying evidence that above-average maximum grip strength showed a positive association with WBV, which was more pronounced in female participants (high group female WBV vs. reference group β = 18.30 cm^3; 95% CI = (1.34 cm^3, 35.29 cm^3); p = 0.034). Steeper than average declines in grip strength between 53 and 69 were additionally weakly associated with an estimated 10% higher WMHV at age 69–71 (β = 1.10, 95% CI = (1.00, 1.22); p = 0.053). Conclusion This study provides preliminary evidence that tests of maximum grip strength may have value in predicting brain health. Future work should assess how these observed differences relate to later-life negative health outcomes, and whether changes in grip strength reflect concurrent changes in brain structure and connectivity.

Associations of Word Memory, Verbal Fluency, Processing Speed, and Crystallized Cognitive Ability With One-Legged Balance Performance in Mid- and Later Life.

BackgroundCognitive integration of sensory input and motor output plays an important role in balance. Despite this, it is not clear if specific cognitive processes are associated with balance and how these associations change with age. We examined longitudinal associations of word memory, verbal fluency, search speed, and reading ability with repeated measures of one-legged balance performance.MethodUp to 2 934 participants in the MRC National Survey of Health and Development, a British birth cohort study, were included. At age 53, word memory, verbal fluency, search speed, and reading ability were assessed. One-legged balance times (eyes closed) were measured at ages 53, 60–64, and 69 years. Associations between each cognitive measure and balance time were assessed using random-effects models. Adjustments were made for sex, death, attrition, height, body mass index, health conditions, health behaviors, education, and occupational class.ResultsIn sex-adjusted models, 1 SD higher scores in word memory, search speed, and verbal fluency were associated with 14.1% (95% CI: 11.3, 16.8), 7.2% (4.4, 9.9), and 10.3% (7.5, 13.0) better balance times at age 53, respectively. Higher reading scores were associated with better balance, although this association plateaued. Associations were partially attenuated in mutually adjusted models and effect sizes were smaller at ages 60–64 and 69. In fully adjusted models, associations were largely explained by education, although remained for word memory and search speed.ConclusionsHigher cognitive performance across all measures was independently associated with better balance performance in midlife. Identification of individual cognitive mechanisms involved in balance could lead to opportunities for targeted interventions in midlife.

Attitudes to work and time spent unemployed across 30 years

AbstractEmpirical studies have not previously related people's work attitudes to their chances of being unemployed for a substantial proportion of their lives. This study uses 1958 and 1970 British birth cohorts to show that responses to attitude questions offering a choice between an unattractive or disliked job and joblessness rival established unemployment risk variables as predictors of time spent unemployed between ages 16 and 46. The findings may help justify the provisions of the Welfare Reform Act 2012 for compelling unemployed benefit claimants to apply for, and subsequently retain, jobs they would otherwise have ruled out.

Insecure Housing and the Risk of Mortality: Analysis of Two Prospective Cohort Studies

Background: Rough sleepers and people who attend homeless shelters have an increased risk of premature mortality. Most homeless people live in insecure accommodation. Whether living in insecure accommodation is associated with an increased risk of mortality is unknown. Methods: In this individual participant meta-analysis, we combined data from two birth cohorts: The National Child Development Study and the 1970 British Birth Cohort study. Homelessness and type of accommodation were self-reported and records linked to the national death registry. Multivariable Cox regression models were used to estimate hazard ratios, then estimates were combined with random-effects meta-analyses. Findings: Out of the 23,678 participants, 1,444 (6·1%) reported having been homeless. 696 deaths occurred over a median follow up of 27·2 years (interquartile range, 19·5-32·7) in the 1958 and 8·7 years (3·8-11·2) in the 1970 cohort. After adjustment for sex, homelessness was associated with an elevated risk of death (hazard ratio 1·68; 95% confidence interval 1·24-2·26]). Death rates were raised for sleeping rough (4·71; 2·38-9·30), using a homeless shelter (4·89; 2·36-10·11), squatting (6·35; 2·73-14·75), and insecure housing, such as bed and breakfasts (3·38; 1·30-8·79;) and ‘sofa surfing’ (2·86; 1·84-4·42). Associations remained after separate control for socioeconomic status, mental health, substance use, accidents and assaults, and criminality. Interpretation: People housed in insecure accommodation experience an increased risk of mortality. Funding: British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, Welsh Government, Wellcome Trust, US National Institute on Aging, and Academy of Medical Sciences. Declaration of Interest: Nothing to disclose.

Evidence for a causal association between milk intake and cardiometabolic disease outcomes using a two-sample Mendelian Randomization analysis in up to 1,904,220 individuals

BackgroundHigh milk intake has been associated with cardio-metabolic risk. We conducted a Mendelian Randomization (MR) study to obtain evidence for the causal relationship between milk consumption and cardio-metabolic traits using the lactase persistence (LCT-13910 C > T, rs4988235) variant as an instrumental variable.MethodsWe tested the association of LCT genotype with milk consumption (for validation) and with cardio-metabolic traits (for a possible causal association) in a meta-analysis of the data from three large-scale population-based studies (1958 British Birth Cohort, Health and Retirement study, and UK Biobank) with up to 417,236 participants and using summary statistics from consortia meta-analyses on intermediate traits (N = 123,665–697,307) and extended to cover disease endpoints (N = 86,995–149,821).ResultsIn the UK Biobank, carriers of ‘T’ allele of LCT variant were more likely to consume milk (P = 7.02 × 10−14). In meta-analysis including UK Biobank, the 1958BC, the HRS, and consortia-based studies, under an additive model, ‘T’ allele was associated with higher body mass index (BMI) (Pmeta-analysis = 4.68 × 10−12) and lower total cholesterol (TC) (P = 2.40 × 10−36), low-density lipoprotein cholesterol (LDL-C) (P = 2.08 × 10−26) and high-density lipoprotein cholesterol (HDL-C) (P = 9.40 × 10−13). In consortia meta-analyses, ‘T’ allele was associated with a lower risk of coronary artery disease (OR:0.86, 95% CI:0.75–0.99) but not with type 2 diabetes (OR:1.06, 95% CI:0.97–1.16). Furthermore, the two-sample MR analysis showed a causal association between genetically instrumented milk intake and higher BMI (P = 3.60 × 10−5) and body fat (total body fat, leg fat, arm fat and trunk fat; P < 1.37 × 10−6) and lower LDL-C (P = 3.60 × 10−6), TC (P = 1.90 × 10−6) and HDL-C (P = 3.00 × 10−5).ConclusionsOur large-scale MR study provides genetic evidence for the association of milk consumption with higher BMI but lower serum cholesterol levels. These data suggest no need to limit milk intakes with respect to cardiovascular disease risk, with the suggested benefits requiring confirmation in further studies.

Social inequalities in early childhood competences, and the relative role of social and emotional versus cognitive skills in predicting adult outcomes

This study draws on the nationally representative British Birth Cohort Study (BCS70) to examine (1) the association between social background and early socio‐emotional and cognitive competences at age 5 and (2) the relative and independent contributions of early socio‐emotional and cognitive competences to educational and socio‐economic attainment in adulthood. A multi‐dimensional (multiple exposure, multiple outcome) approach is adopted in conceptualising social background, childhood competences and adult outcomes by age 42. Indicators of social background include parental education, social class, employment status, family income, as well as home ownership, enabling us to test which aspects of socio‐economic risk uniquely influence the development of early competences. Indicators of childhood competences include directly assessed cognitive competences (i.e. verbal and visual motor skills), while measures of socio‐emotional competences include hyperactivity, good conduct, emotional health and social skills, reported by the child’s mother at age 5. Adult outcomes include highest qualifications, social class and household income by age 42. The findings suggest that multiple indicators of social background are associated with both socio‐emotional and cognitive competences, although the associations with socio‐emotional competences are less strong than those with cognitive competences. We find significant long‐term predictive effects of early cognitive skills on adult outcomes, but also independent effects of socio‐emotional competences, in particular self‐regulation, over and above the role of family background. The study supports calls for early interventions aiming to reduce family socio‐economic risk exposure and supporting the development of cognitive skills and self‐regulation (i.e. reducing hyperactivity and conduct problems).

Intragenerational social mobility and self-rated oral health in the british cohort study

BackgroundMost studies on social mobility and oral health have focused on movement between generations (intergenerational mobility) rather than movement within an individual’s own lifetime (intragenerational mobility). The aim of this study was to investigate the association between intragenerational social mobility from early to middle adulthood and self-rated oral health.MethodsThis study used data from 6524 participants of the 1970 British Birth Cohort Study, an ongoing population-based birth cohort of individuals born in England, Scotland and Wales. Participants’ socioeconomic position was indicated by occupational social class at age 26 and 46 years (the first and latest adult waves, respectively). Self-rated oral health was measured at age 46 years. The association between social mobility and adult oral health was assessed using conventional regression models and diagonal reference models, adjusting for gender, ethnicity, country of residence and residence area.ResultsOver a fifth of participants (22.2%) reported poor self-rated oral health at age 46 years. In conventional regression analysis, the odds ratios for social mobility varied depending on whether they were adjusted for social class of origin or destination. In addition, all social trajectories had greater odds of reporting poor oral health than non-mobile adults in class I/II. In diagonal reference models, both upward (Odds Ratio 0.79; 95% CI 0.63–0.99) and downward mobility (0.90; 95% CI 0.71–1.13) were inversely associated with poor self-rated oral health. The origin weight was 0.48 (95% CI 0.33–0.63), suggesting that social class of origin was as important as social class of destination.ConclusionThis longitudinal analysis showed that intragenerational social mobility from young to middle adulthood was associated with self-rated oral health, independent of previous and current social class.

Early life mental health and problematic drinking in mid-adulthood: evidence from two British birth cohorts

PurposeAccumulating evidence suggests that externalising problems are consistently associated with alcohol use behaviours, but findings are inconsistent regarding the role of internalising problems. We investigate whether externalising and internalising problems are associated with problematic drinking in mid-adulthood, and whether potential associations are modified by age, sex and cohort.MethodsThe National Child Development Study (NCDS58, n = 17,633) and 1970 British Cohort Study (BCS70, n = 17,568) recruited new-borns in Great Britain in a single week in 1958 and 1970. Mental health was assessed with the Rutter Behaviour Questionnaire at ages 7, 11, and 16 in NCDS58 and ages 5, 10 and 16 in BCS70. Problematic drinking was measured with the CAGE questionnaire at age 33 in NCDS58 and age 34 in BCS70, and the AUDIT scale at age 44/45 in NCDS58 and age 46 in BCS70. Latent scores of externalising and internalising problems were added chronologically into lagged logistic regression models.ResultsExternalising and internalising problems were associated in opposite directions with problematic drinking in mid-adulthood. Externalising was a risk factor (OR [95% CI] ranging from 1.06 [1.03, 1.10] to 1.11 [1.07, 1.15] for different ages), and internalising was a protective factor (OR [95% CI] ranging from 0.95 [0.92, 0.99] to 0.90 [0.86, 0.94] for different ages). Associations between early life mental health and mid-adulthood problematic drinking did not differ by developmental timing but were stronger in males.ConclusionOur study provides new insights on links of externalising and internalising difficulties with alcohol use and has implications for public policy in the UK.

Mental health crisis in midlife – a proposed research agenda

There is a growing amount of evidence indicating increased levels of psychological distress, suicide rates and decreased well-being in midlife (age 45-55). We refer to this phenomenon as the ‘midlife mental health crisis’. As there is little empirical evidence or theoretical grounds to explain the midlife mental health crisis, we propose a research agenda. In order to facilitate further research, we consulted members of public, mental health professionals and researchers on potential reasons for the midlife mental health crisis. Subsequently, we translated those into research questions testable with the British birth cohorts. We propose a series of studies using three statistical modelling approaches: descriptive (what is the midlife mental health crisis?), predictive (who is at increased risk of experiencing the midlife mental health crisis?) and explanatory (what are the processes leading to the midlife mental health crisis?).

A population-based study of head injury, cognitive function and pathological markers.

ObjectiveTo assess associations between head injury (HI) with loss of consciousness (LOC), ageing and markers of later‐life cerebral pathology; and to explore whether those effects may help explain subtle cognitive deficits in dementia‐free individuals.MethodsParticipants (n = 502, age = 69–71) from the 1946 British Birth Cohort underwent cognitive testing (subtests of Preclinical Alzheimer Cognitive Composite), 18F‐florbetapir Aβ‐PET and MR imaging. Measures include Aβ‐PET status, brain, hippocampal and white matter hyperintensity (WMH) volumes, normal appearing white matter (NAWM) microstructure, Alzheimer’s disease (AD)‐related cortical thickness, and serum neurofilament light chain (NFL). LOC HI metrics include HI occurring: (i) >15 years prior to the scan (ii) anytime up to age 71.ResultsCompared to those with no evidence of an LOC HI, only those reporting an LOC HI>15 years prior (16%, n = 80) performed worse on cognitive tests at age 69–71, taking into account premorbid cognition, particularly on the digit‐symbol substitution test (DSST). Smaller brain volume (BV) and adverse NAWM microstructural integrity explained 30% and 16% of the relationship between HI and DSST, respectively. We found no evidence that LOC HI was associated with Aβ load, hippocampal volume, WMH volume, AD‐related cortical thickness or NFL (all p > 0.01).InterpretationHaving a LOC HI aged 50’s and younger was linked with lower later‐life cognitive function at age ~70 than expected. This may reflect a damaging but small impact of HI; explained in part by smaller BV and different microstructure pathways but not via pathology related to AD (amyloid, hippocampal volume, AD cortical thickness) or ongoing neurodegeneration (serum NFL).