title: Lifespan influences on mid- to late-life cognitive function in a Chinese birth cohort.
abstract: OBJECTIVE
  To explore factors throughout the lifespan that influence cognition in midlife to late life.
  
  
  METHODS
  We conducted a retrospective birth cohort study of 2,062 individuals born during 1921-1954 in Beijing, China. In 2003-2005, birth records were abstracted, and participants then 50-82 years old received standardized examinations for health, cognition, and socio-environmental measures. Using cumulative logit models, we assessed adjusted relative effects of prenatal, early life, and adult factors on mid- to late-life cognition.
  
  
  RESULTS
  Most prenatal factors were associated with mid- to late-life cognition in the unadjusted models. However, when childhood and adult factors were sequentially added to the models, the impact of prenatal factors showed successive attenuation in effect size, and became insignificant. In contrast, early life factors remained significantly associated with mid- to late-life cognition even after full life-course adjustments. Specifically, those whose fathers had laborer vs professional occupations (odds ratio [OR](Laborer) 1.74; 95% confidence interval [CI]: 1.25-2.42) had poorer cognitive outcomes, while individuals who drank milk daily in childhood (OR 0.65; 95% CI: 0.54-0.80), had more years of education (OR(10-12 years) 0.60; 95% CI: 0.45-0.81; OR(13+ yrs) 0.29; 95% CI: 0.23-0.38), and were taller adults (OR(height > or = SD) 0.65; 95% CI: 0.49-0.86) had better cognition. The high prenatal risk infants had similar patterns with a trend toward a stronger association between cognition and socioenvironmental factors.
  
  
  CONCLUSIONS
  Mid- to late-life cognition is influenced by factors over the entire lifespan with the greatest impact coming from early life exposures. Nutrition, education, social, and family environment in early life may have a long-term impact on cognition in developing countries.
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Wanfujing, Beijing 100730, China. wuzhangzhenxin@medmail.com.cn
authors.forename: Z X
authors.initials: ZX
authors.lastname: Zhang
authors.forename: B L
authors.initials: BL
authors.lastname: Plassman
authors.forename: Q
authors.initials: Q
authors.lastname: Xu
authors.forename: G E P
authors.initials: GE
authors.lastname: Zahner
authors.forename: B
authors.initials: B
authors.lastname: Wu
authors.forename: M Y
authors.initials: MY
authors.lastname: Gai
authors.forename: H B
authors.initials: HB
authors.lastname: Wen
authors.forename: X
authors.initials: X
authors.lastname: Chen
authors.forename: S
authors.initials: S
authors.lastname: Gao
authors.forename: D
authors.initials: D
authors.lastname: Hu
authors.forename: X H
authors.initials: XH
authors.lastname: Xiao
authors.forename: Y
authors.initials: Y
authors.lastname: Shen
authors.forename: A M
authors.initials: AM
authors.lastname: Liu
authors.forename: T
authors.initials: T
authors.lastname: Xu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D044466:Asian People / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D003611:Dairy Products / Q000706:statistics & numerical data; D004522:Educational Status; D004777:Environment; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors