Birth size, risk factors across life and cognition in late life: protocol of prospective longitudinal follow-up of the MYNAH (MYsore studies of Natal effects on Ageing and Health) cohort

Krishna, Murali; Kumar, G. Mohan; Veena, Sargoor R.; Krishnaveni, Ghattu V.; Kumaran, Kalyanaraman; Karat, Samuel C; Coakley, Patsy; Osmond, Clive; Copeland, J. R. M.; Chandak, Giriraj Ratan; Bhat, Dattatray; Varghese, Mathew; Prince, Martin; Fall, Caroline H.D.

doi:10.1136/bmjopen-2016-012552

Cited by 10 publications

(7 citation statements)

References 39 publications

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“…10/66 Dementia Diagnostic assessments were included in the EPIDEMCA surveys conducted in Central African Republic and Republic of Congo, (University of Limoges, INSERM UMR 1094) [ 20 ], and in the rural Hai district of northern Tanzania (Newcastle University) [ 21 ]. 10/66 methodologies are also being used to study dementia and cognitive outcomes in the MYsore studies of Natal effects on Ageing and Health (MYNAH—Epidemiology Research Unit, CSI Holdsworth Memorial Hospital and University of Southampton) lifecourse cohort in southern India [ 62 ].…”

Section: Resultsmentioning

confidence: 99%

A review of the 10/66 dementia research group

Prina

Mayston

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

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Well-designed epidemiological research is relatively lacking in low and middle income countries where two-thirds of the world’s estimated 24 million people with dementia live. The 10/66 Dementia Research Group has sought since 1998 to redress this imbalance. Pilot studies to develop and validate dementia diagnostic measures and study care arrangements in 26 centers worldwide were followed by one phase cross-sectional catchment area surveys in eight Latin American countries, China, India, Nigeria and South Africa. The protocol includes assessment of sociodemographics, disability, care arrangements, physical and mental health, and dementia diagnosis with (more restrictive) DSM-IV and (less restrictive) 10/66 dementia criteria. An incidence phase is underway in eight countries. 10/66 dementia prevalence is generally double that of DSM-IV dementia. DSM-IV dementia is particularly rare in India, attributable to the small proportion of family informants confirming cognitive decline and social impairment. Carer psychological and economic strain is as high as in the developed world, despite traditional family care arrangements. A significant minority of people with dementia are vulnerable due to lack of family support and economic resources. Earlier studies probably underestimated dementia prevalence in regions with very low awareness of this emerging public health problem. More research is needed to delineate the impact of dementia relative to other chronic diseases, and secular trends in countries experiencing rapid demographic ageing and health transition. Packages of care are also a priority - healthcare services and governments have not responded to families’ complex needs for support in their long-term care role.

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Section: Resultsmentioning

confidence: 99%

A review of the 10/66 dementia research group

Prina

Mayston

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

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Section: Discussionmentioning

confidence: 90%

“…The effect sizes of the associations of measurement of size at birth with various cognitive outcomes reported in the above studies have been synthesized in our systematic review (Krishna et al, 2017). Direct comparisons of all measurements of size at birth with all reported cognitive outcomes in our study with those from the above-mentioned studies Birth size and cognition in late life 361 In this study, there was no evidence to support the DOHaD hypothesis that programming of cardiometabolic outcomes due to reduced prenatal growth and development had resulted in lower cognitive function in late life.…”

Section: Discussionmentioning

confidence: 99%

“…All participants underwent standardized assessments for sociodemographic characteristics, cardiometabolic risk factors, cognitive function, and mental health, details of which have been published in a study protocol (Krishna et al, 2017) and are briefly summarized here: et al, 2007). This included the following: (i) Community Screening Instrument for Dementia (CSID), a 32-item test assessing orientation, comprehension, memory, naming, and language (Hall et al, 2000), (ii) animal naming task (Hall et al, 2000;Morris et al, 1989) from the CERAD (Centre for European Registry for Alzheimer's disease) test for assessing verbal fluency.…”

Section: Assessmentsmentioning

confidence: 99%

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Size at birth, lifecourse factors, and cognitive function in late life: findings from the MYsore study of Natal effects on Ageing and Health (MYNAH) cohort in South India

Krishna

Krishnaveni

Sargur

et al. 2021

Int. Psychogeriatr.

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Objective: To examine if smaller size at birth, an indicator of growth restriction in utero, is associated with lower cognition in late life, and whether this may be mediated by impaired early life brain development and/or adverse cardiometabolic programming. Design: Longitudinal follow-up of a birth cohort. Setting: CSI Holdsworth Memorial Hospital (HMH), Mysore South India. Participants: 721 men and women (55–80 years) whose size at birth was recorded at HMH. Approximately 20 years earlier, a subset (n = 522) of them had assessments for cardiometabolic disorders in mid-life. Measurements: Standardized measurement of cognitive function, depression, sociodemographic, and lifestyle factors; blood tests and assessments for cardiometabolic disorders Results: Participants who were heavier at birth had higher composite cognitive scores (0.12 SD per SD birth weight [95% CI 0.05, 0.19] p = 0.001) in late life. Other lifecourse factors independently positively related to cognition were maternal educational level and participants’ own educational level, adult leg length, body mass index, and socioeconomic position, and negatively were diabetes in mid-life and current depression and stroke. The association of birth weight with cognition was independent cardiometabolic risk factors and was attenuated after adjustment for all lifecourse factors (0.08 SD per SD birth weight [95% CI −0.01, 0.18] p = 0.07). Conclusions: The findings are consistent with positive effects of early life environmental factors (better fetal growth, education, and childhood socioeconomic status) on brain development resulting in greater long-term cognitive function. The results do not support a pathway linking poorer fetal development with reduced late life cognitive function through cardiometabolic programming.

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“…Between 2013-2016, 721 (408 men and 313 women born between 1934 and 1955) aged above 55 years were retraced through door to door survey by research assistants and recruited to this study after obtaining written informed consent (Figure 1), a detailed protocol of which has been published elsewhere 30 .…”

Section: Recruitmentmentioning

confidence: 99%

A lifecourse approach to the relationship between lung function and cognition function in late life: findings from the Mysore studies of Natal effect on Ageing and Health (MYNAH) in South India

Krishna¹,

Majgi²,

Du³

et al. 2022

Wellcome Open Res

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Background: Emerging evidence from high income settings indicates that lung function may be an independent determinant of cognitive abilities in late life. Despite a high burden of chronic lung disorders and neurocognitive disorders, there are limited data exploring the relationship between lung and cognitive function in later life in low- and middle-income (LMIC) settings. Methods: Between 2013 and 2016, 721 men and women from the Mysore Birth Records Cohort in South India, aged 55-80 years, were retraced and underwent standardised assessments for sociodemographic characteristics, cardiometabolic risk factors, lung function, cognitive function and mental health. Approximately 20 years earlier, a subset of them had assessments for cardiometabolic risk factors (n=522) and lung function (n=143). Results: Forced Expiratory Volume at one second (FEV1) and six seconds (FEV6) were higher among men than women. Women had higher immediate and delayed recall scores compared to men. Multivariate models indicated that those with lower FEV1 (lts) and FEV1/FEV6 ratio in late life had lower composite cognitive score (SD, standard deviation), independent of growth and environment in early life and childhood, attained education, socioeconomic position, cardiometabolic disorders in mid-and late life and lifestyle factors (0.29 SD per litre 95% confidence interval [CI] (0.10, 0.50) p=0.006 for FEV1 and 1.32 SD (0.20, 2.50) p=0.02 for FEV1/FEV6 ratio). Lung function in midlife was unrelated to cognitive outcomes in late life. Conclusions: Causality cannot be inferred from cross sectional associations. Therefore, causality is best explored in longitudinal studies with serial, but contemporaneous measurements of both lung and cognitive function. Mechanistic studies that examine the role of shared risk factors like environmental pollutants and biomass exposure on this relationship are urgently required in LMICs.

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Birth size, risk factors across life and cognition in late life: protocol of prospective longitudinal follow-up of the MYNAH (MYsore studies of Natal effects on Ageing and Health) cohort

Cited by 10 publications

References 39 publications

A review of the 10/66 dementia research group

A review of the 10/66 dementia research group

Size at birth, lifecourse factors, and cognitive function in late life: findings from the MYsore study of Natal effects on Ageing and Health (MYNAH) cohort in South India

A lifecourse approach to the relationship between lung function and cognition function in late life: findings from the Mysore studies of Natal effect on Ageing and Health (MYNAH) in South India

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