Prenatal exposure to the Dutch famine is associated with more self-perceived cognitive problems at 72 years of age

Abstract

Background Undernutrition during critical periods of neurodevelopment can hinder the developing brain with lasting negative consequences for brain size, structure and function. In this study, we describe self-perceived cognitive problems of men and women who were born around the time of the Dutch famine of 1944–45. Methods We compared self-perceived cognitive problems between men and women who had been exposed to the 1944–45 Dutch famine in late, mid or early gestation and those who were born before or conceived after the famine (and had thus not been exposed prenatally). We included 595 participants aged 71–74 years. Results Women who had been exposed to famine in late gestation more often reported cognitive problems compared to those who had not been exposed (OR 2.2 [95% CI 1.1–4.4]), whereas for men, this was the case for those exposed in early gestation (OR 2.3 [0.9–5.5]). Furthermore, men and women exposed in early gestation more often reported consulting a healthcare practitioner for cognitive problems in the past 12 months (OR 3.2 [1.3–8.1]). Especially men exposed in early gestation reported having consulted a healthcare practitioner more often than unexposed men (OR 4.4 [1.2–16.0]). Conclusions These findings suggest that prenatal undernutrition does not only have lasting effects on brain size, but also on its function, with more self-perceived cognitive problems at older age, which also require more medical attention. Also, the effects of undernutrition depend on sex and its timing during gestation.

Exposure to the Dutch Famine in Early Gestation and Cognitive Function and Decline in Older Age

“…We indeed observed more self-perceived cognitive problems in men exposed to famine in early gestation compared with unexposed men in the current study. Although the difference was not statistically significant, the effect size was in line with what we have observed before in a larger sample in the DFBC [ 12 ]. Due to undernutrition, fewer children were conceived during the famine [ 24 , 43 ]; therefore, the number of eligible participants exposed to famine in early gestation was limited.…”

“…Therefore, our findings on the Stroop-like task may have been an early sign of accelerated cognitive aging [ 11 ]. Our subsequent findings, that men exposed to famine in early gestation reported more self-perceived cognitive problems at age 72 and more often consulted a healthcare professional for these problems, is in line with this hypothesis, as self-perceived cognitive problems have been associated with (future) cognitive decline and increased dementia risk [ 12 , 13 , 14 , 15 ]. Apart from worse performance on the Stroop-like task and poorer self-perceived cognitive function, we found that men exposed to famine in early gestation had worse brain perfusion, smaller total brain volumes, and increased BrainAGE (an MRI-based measure estimating clinical brain aging).…”

“…Together, these findings do not support our hypothesis of accelerated cognitive aging after famine exposure in early gestation. Accelerated cognitive aging in those exposed to famine in early gestation was expected based on our previous findings showing more self-perceived cognitive problems, which may be predictive of future cognitive decline [ 12 , 13 , 14 ]. Furthermore, findings suggesting more rapid aging of the brain, especially in men exposed to famine in early gestation, would also indicate accelerated cognitive decline [ 16 , 17 , 18 , 19 ].…”

“…In addition to the three cognitive tasks that were repeated over time, we performed the standardized Montreal cognitive assessment (MoCA; multiple cognitive domains) and measured self-perceived cognitive problems at age 74 to obtain a more complete picture of the cognitive function of the participants at an older age [ 29 , 30 ]. Similar to these measurements performed at age 72, we assessed self-perceived cognitive problems with two questions, assessing if participants had problems with their memory, attention, and thinking and if they ever consulted a healthcare practitioner for these problems [ 12 ]. In addition, we used the Dutch version of the Cognitive Failures Questionnaire (CFQ) to measure self-perceived cognitive functioning in daily life [ 31 ].…”

Correction: Prenatal exposure to the Dutch famine is associated with more self-perceived cognitive problems at 72 years of age

“…Author details 1 Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. 2 Department of Obstetrics and Gynaecology, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.…”