title: IQ in late adolescence/early adulthood, risk factors in middle age and later all-cause mortality in men: the Vietnam Experience Study.
abstract: OBJECTIVE
  To examine the role of potential mediating factors in explaining the IQ-mortality relation.
  
  
  METHODS
  A total of 4316 male former Vietnam-era US army personnel with IQ test results at entry into the service in late adolescence/early adulthood in the 1960/1970s (mean age at entry 20.4 years) participated in a telephone survey and medical examination in middle age (mean age 38.3 years) in 1985-6. They were then followed up for mortality experience for 15 years.
  
  
  RESULTS
  In age-adjusted analyses, higher IQ scores were associated with reduced rates of total mortality (hazard ratio (HR)(per SD increase in IQ) 0.71; 95% CI 0.63 to 0.81). This relation did not appear to be heavily confounded by early socioeconomic position or ethnicity. The impact of adjusting for some potentially mediating risk indices measured in middle age on the IQ-mortality relation (marital status, alcohol consumption, systolic and diastolic blood pressure, pulse rate, blood glucose, body mass index, psychiatric and somatic illness at medical examination) was negligible (<10% attenuation in risk). Controlling for others (cigarette smoking, lung function) had a modest impact (10-17%). Education (0.79; 0.69 to 0.92), occupational prestige (0.77; 0.68 to 0.88) and income (0.86; 0.75 to 0.98) yielded the greatest attenuation in the IQ-mortality gradient (21-52%); after their collective adjustment, the IQ-mortality link was effectively eliminated (0.92; 0.79 to 1.07).
  
  
  CONCLUSIONS
  In this cohort, socioeconomic position in middle age might lie on the pathway linking earlier IQ with later mortality risk but might also partly act as a surrogate for cognitive ability.
authors.affiliation: MRC Social & Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow G12 8RZ, UK. david-b@sphsu.mrc.ac.uk
authors.forename: G D
authors.initials: GD
authors.lastname: Batty
authors.forename: M J
authors.initials: MJ
authors.lastname: Shipley
authors.forename: L H
authors.initials: LH
authors.lastname: Mortensen
authors.forename: S H
authors.initials: SH
authors.lastname: Boyle
authors.forename: J
authors.initials: J
authors.lastname: Barefoot
authors.forename: M
authors.initials: M
authors.lastname: Grønbaek
authors.forename: C R
authors.initials: CR
authors.lastname: Gale
authors.forename: I J
authors.initials: IJ
authors.lastname: Deary
mesh_terms: D000293:Adolescent; D000328:Adult; D001519:Behavior; D015986:Confounding Factors, Epidemiologic; D004522:Educational Status; D006306:Health Surveys; D006801:Humans; D007360:Intelligence; D007361:Intelligence Tests; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009790:Occupations; D018570:Risk Assessment / Q000379:methods; D012907:Smoking; D012923:Social Class; D014481:United States; D014728:Veterans / Q000523:psychology*; D047829:Vietnam Conflict