Lifespan influences on mid- To late-life cognitive function in a Chinese birth cohort

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 socioenvironmental 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 [Cl]: 1.25-2.42) had poorer cognitive outcomes, while individuals who drank milk daily in childhood (OR 0.65; 95% Cl: 0.54-0.80), had more years of education (OR_{10.12 years} 0.60; 95% Cl: 0.45-0.81; OR_13-yrs 0.29; 95% Cl: 0.23-0.38), and were taller adults (OR_{height ≥} SD 0.65; 95% Cl: 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. Conclusion: 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.