Dataset Information

Childhood socio-economic circumstances and dementia: prospective register-based cohort study of adulthood socio-economic and cardiovascular health mediators.

ABSTRACT:

Background

This study analysed the association between childhood socio-economic circumstances and the risk of dementia, and investigated the mediating role of potentially modifiable risk factors including adulthood socio-economic position and cardiovascular health.

Methods

We used a 10% sample of the 1950 Finnish population census linked with subsequent population and health registers (n = 95 381). Information of socio-economic characteristics, family structure and housing conditions at the age of 0-15 years was obtained from the 1950 census. We identified cohort members who developed dementia in 2000-2018 using national hospital, medication and death registers. Discrete time survival analysis using logistic regression and mediation analysis applying the Karlson-Holm-Breen (KHB) method were employed.

Results

An excess risk of dementia was observed for household crowding [odds ratio (OR) = 1.10; 95% CI 1.02-1.18 for 3 to <4 persons per heated room; OR = 1.19; 95% CI 1.11-1.27 for ≥4 persons], single-father family (OR = 1.27; 95% CI 1.07-1.51) and eastern and northern region of residence (OR = 1.19; 95% CI 1.10-1.28). The effects of single-father family and region of residence were mostly direct with adulthood characteristics mediating 14% and 29% of the total effect, respectively. The largest indirect effect was observed for household crowding mediated through adulthood socio-economic position (47-65%).

Conclusions

The study shows that childhood socio-economic circumstances are associated with dementia, and that the underlying mechanisms only partly relate to adulthood socio-economic position and cardiovascular health. Socio-economic and health interventions targeted at families with children may carry long-term benefits by contributing to a lower dementia risk in later life.

SUBMITTER: Korhonen K

PROVIDER: S-EPMC10114069 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Publications

Childhood socio-economic circumstances and dementia: prospective register-based cohort study of adulthood socio-economic and cardiovascular health mediators.

Korhonen Kaarina K Leinonen Taina T Tarkiainen Lasse L Einiö Elina E Martikainen Pekka P

International journal of epidemiology 20230401 2

<h4>Background</h4>This study analysed the association between childhood socio-economic circumstances and the risk of dementia, and investigated the mediating role of potentially modifiable risk factors including adulthood socio-economic position and cardiovascular health.<h4>Methods</h4>We used a 10% sample of the 1950 Finnish population census linked with subsequent population and health registers (n = 95 381). Information of socio-economic characteristics, family structure and housing conditi ...[more]

PMID: 36343014

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Project description:IntroductionCardiovascular disease (CVD) is a leading cause of death and disability and living in areas with low socio-economic status (SES) is associated with increased risk of CVD. Lifestyle factors such as smoking, physical inactivity, an unhealthy diet and harmful alcohol use are main risk factors that contribute to other modifiable risk factors, such as hypertension, raised blood cholesterol, obesity, and diabetes. The potential impact of area-level socio-economic status (ASES) on metabolic CVD risk factors via lifestyle behaviors independent of individual SES has not been investigated previously.AimsTo estimate associations of ASES with CVD risk factors and the mediating role of lifestyle behaviors independent of individual-level SES.MethodsIn this cross-sectional study, we included 19,415 participants (52% women) from the seventh survey of the Tromsø Study (2015-2016) (Tromsø7). The exposure variable ASES was created by aggregating individual-level SES variables (education, income, housing ownership) at the geographical subdivision level. Individual-level SES data and geographical subdivision of Tromsø municipality (36 areas) were obtained from Statistics Norway. Variables from questionnaires and clinical examinations obtained from Tromsø7 were used as mediators (smoking, snuff, alcohol, and physical activity), while the outcome variables were body mass index (BMI), total/high-density lipoprotein (HDL) cholesterol ratio, waist circumference, hypertension, diabetes. Mediation and mediated moderation analysis were performed with age as a moderator, stratified by sex.ResultsASES was significantly associated with all outcome variables. CVD risk factor level declined with an increase in ASES. These associations were mediated by differences in smoking habits, alcohol use and physical activity. The associations of ASES with total/HDL cholesterol ratio and waist circumference (women) were moderated by age, and the moderating effects were mediated by smoking and physical activity in both sexes. The largest mediated effects were seen in the associations of ASES with total/HDL cholesterol ratio, with the mediators accounting for 43% of the observed effects.ConclusionsLiving in lower SES areas is associated with increased CVD risk due to unhealthy lifestyle behaviors, such as smoking, alcohol use and physical inactivity. These associations were stronger in women and among older participants.

Project description:BackgroundMuch remains unknown regarding the associations of adversities in childhood and adulthood with incident cardiovascular diseases (CVD). We aimed to examine the independent and cumulative relations of adversities in childhood and adulthood with incident CVD and whether these associations can be mitigated by adopting a healthy lifestyle later in life.MethodsWe included 136,073 men and women [38-72 years at baseline] free of diagnosed CVD at baseline who responded to surveys on adversities in childhood and adulthood in the United Kingdom Biobank prospective cohort. They were recruited between 2006 and 2010 and were followed-up until 28 January 2021. Adversities included physical abuse, emotional abuse, sexual abuse, emotional neglect, and physical neglect. Participants were categorised into four groups according to the exposure periods, which were no adversity, childhood adversity only, adulthood adversity only, and cumulative adversity (both childhood and adulthood). The primary outcomes included incident fatal and non-fatal CVD events. The modifiable lifestyle factors were smoking, physical activity, diet, sleeping, social or leisure activities, and friend or family visits.FindingsWe identified 16,415 (10.71/1000 person-year) incident CVD during a median follow-up of 11.8 years. Compared with participants with no adversity, CVD incidence increased by 11% in those with childhood adversity only (adjusted hazard ratio [HR]: 1.11 [95% CI 1.06-1.17], p < 0.001), 4% in those with adulthood adversity only (1.04 [1.00-1.09], p = 0.05), and 21% in those with cumulative adversity (1.21 [1.16-1.26], p < 0.001). Analysis of interactions showed that adulthood adversity amplified the childhood adversity-CVD association (p for interaction = 0.03). Compared with the participants with one or fewer ideal lifestyle factors, those with more than four ideal factors had a 25%-36% lower risk of CVD across the three adversity groups.InterpretationOur findings suggested that childhood adversities were associated with an increased risk of CVD which can be magnified by adulthood adversities and substantially mitigated by adopting a healthy lifestyle later in life.FundingThe National Natural Science Foundation of China and Guangzhou Foundation for Basic and Applied Basic Research.

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Project description:ObjectiveDisadvantaged socioeconomic circumstances in early life have the potential to impact lung function. Thus, this study aimed to summarise evidence on the association between socioeconomic circumstances and respiratory function from childhood to young adulthood.DesignSystematic review and meta-analysis.MethodsFollowing the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, Medline, ISI-Web of Science and Scopus were searched from inception up to January 2018. Original studies on the association between socioeconomic circumstances and respiratory function in early ages (ie, participants younger than 25 years of age) were investigated. Two investigators independently evaluated articles, applied the exclusion criteria, extracted data and assessed the risk of bias using the Newcastle-Ottawa Scale. A meta-analysis of the standardised mean difference and 95% CI in respiratory function between participants from different socioeconomic circumstances was conducted, using a random-effects model.ResultsThirty-three papers were included in this review and 23 showed that disadvantaged socioeconomic circumstances were significantly associated with reduced respiratory function. The meta-analysis including seven papers showed a significant difference of -0.31 (95% CI -0.42 to -0.21) litres in forced expiratory volume in the first second between children, adolescents and young adults from disadvantaged versus advantaged socioeconomic circumstances. Specifically a difference of -0.31 (95% CI -0.51 to -0.10) litres in girls and -0.43 (95% CI -0.51 to -0.35) litres in boys was observed.ConclusionsChildren, adolescents and young adults from disadvantaged socioeconomic circumstances had lower respiratory function, and boys presented higher respiratory health inequalities. This information contributes to explain the social patterning of respiratory diseases, and might enable health policy makers to tackle respiratory health inequalities at early ages.

Dataset Information

Childhood socio-economic circumstances and dementia: prospective register-based cohort study of adulthood socio-economic and cardiovascular health mediators.

Background

Methods

Results

Conclusions

Publications

Childhood socio-economic circumstances and dementia: prospective register-based cohort study of adulthood socio-economic and cardiovascular health mediators.

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