Generic placeholder image

Current Alzheimer Research

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Research Article

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

Author(s): Aline Marileen Wiegersma*, Amber Boots, Emma F. van Bussel, Birgit I. Lissenberg-Witte, Mark M.J. Nielen, Tessa J. Roseboom and Susanne R. de Rooij

Volume 21, Issue 2, 2024

Published on: 03 May, 2024

Page: [101 - 108] Pages: 8

DOI: 10.2174/0115672050290699240422050036

Price: $65

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.

Next »
[1]
Short AK, Baram TZ. Early-life adversity and neurological disease: Age-old questions and novel answers. Nat Rev Neurol 2019; 15(11): 657-69.
[http://dx.doi.org/10.1038/s41582-019-0246-5] [PMID: 31530940]
[2]
Van den Bergh BRH, van den Heuvel MI, Lahti M, et al. Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy. Neurosci Biobehav Rev 2020; 117: 26-64.
[http://dx.doi.org/10.1016/j.neubiorev.2017.07.003] [PMID: 28757456]
[3]
Georgieff MK, Ramel SE, Cusick SE. Nutritional influences on brain development. Acta Paediatr 2018; 107(8): 1310-21.
[http://dx.doi.org/10.1111/apa.14287] [PMID: 29468731]
[4]
Wiegersma AM, Boots A, Langendam MW, et al. Do prenatal factors shape the risk for dementia?: A systematic review of the epidemiological evidence for the prenatal origins of dementia. Soc Psychiatr Epidemiol 2023; 1-15.
[http://dx.doi.org/10.1007/s00127-023-02471-7] [PMID: 37029828]
[5]
Gilsanz P, Mayeda ER, Glymour MM, Quesenberry CP, Whitmer RA. Association between birth in a high stroke mortality state, race, and risk of dementia. JAMA Neurol 2017; 74(9): 1056-62.
[http://dx.doi.org/10.1001/jamaneurol.2017.1553] [PMID: 28759663]
[6]
Gilsanz P, Mayeda ER, Glymour MM, et al. Birth in high infant mortality states and dementia risk in a cohort of elderly african american and white health care members. Alzheimer Dis Assoc Disord 2019; 33(1): 1-6.
[http://dx.doi.org/10.1097/WAD.0000000000000270] [PMID: 30106754]
[7]
Mosing MA, Lundholm C, Cnattingius S, Gatz M, Pedersen NL. Associations between birth characteristics and age-related cognitive impairment and dementia: A registry-based cohort study. PLoS Med 2018; 15(7): e1002609.
[http://dx.doi.org/10.1371/journal.pmed.1002609] [PMID: 30020924]
[8]
Syddall HE, Sayer AA, Simmonds SJ, et al. Birth weight, infant weight gain, and cause-specific mortality: The hertfordshire cohort study. Am J Epidemiol 2005; 161(11): 1074-80.
[http://dx.doi.org/10.1093/aje/kwi137] [PMID: 15901628]
[9]
Kang Y, Zhang Y, Feng Z, et al. Nutritional deficiency in early life facilitates aging-associated cognitive decline. Curr Alzheimer Res 2017; 14(8): 841-9.
[http://dx.doi.org/10.2174/1567205014666170425112331] [PMID: 28443508]
[10]
Bleker LS, de Rooij SR, Painter RC, Ravelli ACJ, Roseboom TJ. Cohort profile: The Dutch famine birth cohort (DFBC) a prospective birth cohort study in the Netherlands. BMJ Open 2021; 11(3): e042078.
[http://dx.doi.org/10.1136/bmjopen-2020-042078] [PMID: 33664071]
[11]
de Rooij SR, Caan MWA, Swaab DF, et al. Prenatal famine exposure has sex-specific effects on brain size. Brain 2016; 139(8): 2136-42.
[http://dx.doi.org/10.1093/brain/aww132] [PMID: 27401522]
[12]
Franke K, Gaser C, Roseboom TJ, Schwab M, de Rooij SR. Premature brain aging in humans exposed to maternal nutrient restriction during early gestation. Neuroimage 2018; 173: 460-71.
[http://dx.doi.org/10.1016/j.neuroimage.2017.10.047] [PMID: 29074280]
[13]
de Rooij SR, Mutsaerts HJMM, Petr J, et al. Late-life brain perfusion after prenatal famine exposure. Neurobiol Aging 2019; 82: 1-9.
[http://dx.doi.org/10.1016/j.neurobiolaging.2019.06.012] [PMID: 31376728]
[14]
Boots A, Thomason ME, Espinoza-Heredia C, et al. Sex-specific effects of prenatal undernutrition on resting-state functional connectivity in the human brain at age 68. Neurobiol Aging 2022; 112: 129-38.
[http://dx.doi.org/10.1016/j.neurobiolaging.2022.01.003] [PMID: 35151035]
[15]
de Rooij SR, Wouters H, Yonker JE, Painter RC, Roseboom TJ. Prenatal undernutrition and cognitive function in late adulthood. Proc Natl Acad Sci 2010; 107(39): 16881-6.
[http://dx.doi.org/10.1073/pnas.1009459107] [PMID: 20837515]
[16]
Wiegersma AM, Boots A, Roseboom TJ, de Rooij SR. Prenatal exposure to the Dutch famine is associated with more self-perceived cognitive problems at 72 years of age. BMC Geriatr 2022; 22(1): 176.
[http://dx.doi.org/10.1186/s12877-022-02820-2] [PMID: 35236291]
[17]
Mortimer JA, Borenstein AR, Gosche KM, Snowdon DA. Very early detection of Alzheimer neuropathology and the role of brain reserve in modifying its clinical expression. J Geriatr Psychiatry Neurol 2005; 18(4): 218-23.
[http://dx.doi.org/10.1177/0891988705281869] [PMID: 16306243]
[18]
Gaser C, Franke K, Klöppel S, Koutsouleris N, Sauer H. BrainAGE in mild cognitive impaired patients: Predicting the conversion to alzheimer’s disease. PLoS One 2013; 8(6): e67346.
[http://dx.doi.org/10.1371/journal.pone.0067346] [PMID: 23826273]
[19]
Zhang N, Gordon ML, Goldberg TE. Cerebral blood flow measured by arterial spin labeling MRI at resting state in normal aging and Alzheimer’s disease. Neurosci Biobehav Rev 2017; 72: 168-75.
[http://dx.doi.org/10.1016/j.neubiorev.2016.11.023] [PMID: 27908711]
[20]
Balota DA, Tse CS, Hutchison KA, Spieler DH, Duchek JM, Morris JC. Predicting conversion to dementia of the Alzheimer’s type in a healthy control sample: The power of errors in stroop color naming. Psychol Aging 2010; 25(1): 208-18.
[http://dx.doi.org/10.1037/a0017474] [PMID: 20230140]
[21]
Rabin LA, Smart CM, Amariglio RE. Subjective cognitive decline in preclinical alzheimer’s disease. Annu Rev Clin Psychol 2017; 13(1): 369-96.
[http://dx.doi.org/10.1146/annurev-clinpsy-032816-045136] [PMID: 28482688]
[22]
Kielb S, Rogalski E, Weintraub S, Rademaker A. Objective features of subjective cognitive decline in a United States national database. Alzheimers Dement 2017; 13(12): 1337-44.
[http://dx.doi.org/10.1016/j.jalz.2017.04.008] [PMID: 28586648]
[23]
Wiegersma AM, Boots A, van Bussel EF, Lissenberg-Witte BI, Nielen MM. The Role of Prenatal Factors in Cognitive Decline and Dementia. Available From: https://pure.uva.nl/ws/files/137806465/Chapter_5.pdf
[24]
[25]
Nielen MMJ, Spronk I, Davids R, et al. Estimating morbidity rates based on routine electronic health records in primary care: Observational study. JMIR Med Inform 2019; 7(3): e11929.
[http://dx.doi.org/10.2196/11929] [PMID: 31350839]
[26]
Lumey LH, van Poppel FWA. The Dutch Famine of 1944-45 as a Human Laboratory: Changes in the early life environment and adult health. Early Life Nutr Adult Heal Dev Lessons from Chang DietsFamines Exp Stud 2013; 3: 59-70.
[27]
Trienekes GMT. Tussen Ons Volk.De Honger: De Voedselvoorziening, 1940 - 1945. Utrecht, The Netherlands: Matrijs 1985.
[28]
van den Dungen P, van Marwijk HWM, van der Horst HE, et al. The accuracy of family physicians’ dementia diagnoses at different stages of dementia: A systematic review. Int J Geriatr Psychiatry 2012; 27(4): 342-54.
[http://dx.doi.org/10.1002/gps.2726] [PMID: 21626568]
[29]
Rademakers R, Cruts M, Van Broeckhoven C. Genetics of early-onset Alzheimer dementia. ScientWorldJ 2003; 3: 497-519.
[http://dx.doi.org/10.1100/tsw.2003.39] [PMID: 12847300]
[30]
van Abeelen AFM, Veenendaal MVE, Painter RC, et al. Survival effects of prenatal famine exposure. Am J Clin Nutr 2012; 95(1): 179-83.
[http://dx.doi.org/10.3945/ajcn.111.022038] [PMID: 22170371]
[31]
De Rooij SR, Bleker LS, Painter RC, Ravelli AC, Roseboom TJ. Lessons learned from 25 years of research into long term consequences of prenatal exposure to the dutch famine 1944–45: The dutch famine birth cohort. Int J Environ Health Res 2022; 32(7): 1432-46.
[http://dx.doi.org/10.1080/09603123.2021.1888894] [PMID: 33949901]
[32]
Xue M, Xu W, Ou YN, et al. Diabetes mellitus and risks of cognitive impairment and dementia: A systematic review and meta-analysis of 144 prospective studies. Ageing Res Rev 2019; 55: 100944.
[http://dx.doi.org/10.1016/j.arr.2019.100944] [PMID: 31430566]
[33]
Deckers K, Schievink SHJ, Rodriquez MMF, et al. Coronary heart disease and risk for cognitive impairment or dementia: Systematic review and meta-analysis. PLoS One 2017; 12(9): e0184244.
[http://dx.doi.org/10.1371/journal.pone.0184244] [PMID: 28886155]
[34]
Bamford C, Eccles M, Steen N, Robinson L. Can primary care record review facilitate earlier diagnosis of dementia? Fam Pract 2007; 24(2): 108-16.
[http://dx.doi.org/10.1093/fampra/cml068] [PMID: 17237496]
[35]
van Bussel EF, Richard E, Arts DL, et al. Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data. PLoS Med 2017; 14(3): e1002235.
[http://dx.doi.org/10.1371/journal.pmed.1002235] [PMID: 28267788]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy