Exposures and conditions prior to age 16 are associated with incidence of dementia status among adults in the United States Health and Retirement Study

BackgroundDementia and cognitive impairment are prevalent conditions, and susceptibility likely begins years before symptoms. Early life has not been comprehensively tested for potential risk factors for dementia.ObjectiveTo explore the associations between childhood conditions and exposures and cognitive impairment in adulthood.MethodsIn the US Health and Retirement Study (normal baseline cognition; n = 16,509; 2008-2018 waves), 31 exposures before age 16 were retrospectively assessed with ten-year incident cognitive status (dementia, impaired, normal). Using parallel modified Poisson models, each exposure was tested with incident cognition, adjusting for sex, baseline age, follow-up, race/ethnicity, personal/parental education.ResultsAmong the analytic sample, participants were mean 61 years of age at baseline and all had normal cognition. During up to 10 years of follow-up, 14.5% developed cognitive impairment and 5.3% developed dementia. Participants with depression during childhood had 1.49 (95%CI:1.2,1.84) times higher risk of incident impairment, relative to normal cognition. Participants with headaches/migraines during childhood had 1.43 (95%CI:1.14,1.79) times higher risk of incidence of dementia. Participants with learning problems during childhood had 1.71 (95%CI:1.44,2.03) times higher risk of incident impairment. Childhood self-rated health of fair (1.59, 95%CI:1.2,2.1) and poor (2.42, 95%CI:1.62,3.61) had higher risk of incidence of dementia, relative to excellent self-rated health. Associations between additional exposures and either incident impairment or dementia did not reach the multiple testing threshold (false discovery rate < 0.01).ConclusionsConditions and exposures during the early life period may be important for later life cognitive impairment or dementia. These findings support extending the relevant dementia risk window to evaluate childhood.