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Therese Nilsson. Photo.

Therese Nilsson

Professor

Therese Nilsson. Photo.

Very Early Life Risk Factors for Developing Dementia : Evidence from full population registers

Author

  • Martin Fischer
  • Martin Lövdén
  • Therese Nilsson
  • Nika Seblova

Summary, in English

OBJECTIVES: Very early-life conditions are recognized as critical for healthy brain development. This study assesses early-life risk factors for developing dementia. In the absence of historical medical birth records, we leverage an alternative full population approach using demographic characteristics obtained from administrative data to derive proxy indicators for birth complications and unfavorable birth outcomes. We use proxy variables to investigate the impact of early-life risk factors on dementia risk. METHODS: We use administrative individual-level data for full cohorts born 1932-1950 in Sweden with multigenerational linkages. Records on hospitalization and mortality are used to identify dementia cases. We derive 3 birth risk factors based on demographic characteristics: advanced maternal age, narrow sibling spacing, and twin births, and apply survival analysis to evaluate long-term effects on dementia risk. We control for confounding using multiple indicators for socio-economic status (SES), including parental surnames, and by implementing a sibling design. As comparison exposure, we add low education from the 1970 Census. RESULTS: The presence of at least 1 birth risk factor increases dementia risk (HR = 1.059; 95% CI: 1.034, 1.085). The occurrence of twin births poses a particularly heightened risk (HR = 1.166; 95% CI: 1.084, 1.255). DISCUSSION: Improvements to the very early-life environment hold significant potential to mitigate dementia risk. A comparison to the influence of low education on dementia (the largest known modifiable risk factor) suggests that demographic birth characteristics are of relevant effect sizes. Our findings underscore the relevance of providing assistance for births experiencing complications and adverse health outcomes to reduce dementia cases.

Department/s

  • Centre for Economic Demography
  • Health Economics
  • Department of Economics
  • LU Profile Area: Proactive Ageing

Publishing year

2023

Language

English

Pages

2131-2140

Publication/Series

Journals of Gerontology - Series B Psychological Sciences and Social Sciences

Volume

78

Issue

12

Document type

Journal article

Publisher

Oxford University Press

Topic

  • Economics

Status

Published

Research group

  • Health Economics

ISBN/ISSN/Other

  • ISSN: 1079-5014