Title:Prenatal Exposure to the 1944-45 Dutch Famine and Risk for Dementia up
to Age 75: An Analysis of Primary Care Data
Volume: 21
Issue: 2
Author(s): Aline Marileen Wiegersma*, Amber Boots, Emma F. van Bussel, Birgit I. Lissenberg-Witte, Mark M.J. Nielen, Tessa J. Roseboom and Susanne R. de Rooij
Affiliation:
- Department of Epidemiology and Data Science, Amsterdam UMC location University of Amsterdam, Meibergdreef 9,
Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later life, Health Behaviors &
Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
Keywords:
Prenatal famine, prenatal undernutrition, dementia, aging, primary care, registry data.
Abstract:
Background: A poor prenatal environment adversely affects brain development.
Studies investigating long-term consequences of prenatal exposure to the 1944-45 Dutch famine
have shown that those exposed to famine in early gestation had poorer selective attention, smaller
brain volumes, poorer brain perfusion, older appearing brains, and increased reporting of cognitive
problems, all indicative of increased dementia risk.
Objective: In the current population-based study, we investigated whether dementia incidence up
to age 75 was higher among individuals who had been prenatally exposed to famine.
Methods: We included men (n=6,714) and women (n=7,051) from the Nivel Primary Care
Database who had been born in seven cities affected by the Dutch famine. We used Cox regression
to compare dementia incidence among individuals exposed to famine during late (1,231), mid
(1,083), or early gestation (601) with those unexposed (born before or conceived after the famine).
Results: We did not observe differences in dementia incidence for those exposed to famine in mid
or early gestation compared to those unexposed. Men and women exposed to famine in late gestation
had significantly lower dementia rates compared to unexposed individuals (HR 0.52 (95%CI
0.30-0.89)). Sex-specific analyses showed a lower dementia rate in women exposed to famine in
late gestation (HR 0.39 (95%CI 0.17-0.86)) but not in men (HR 0.68 (95%CI 0.33-1.41)).
Conclusion: Although prenatal exposure to the Dutch famine has previously been associated with
measures of accelerated brain aging, the present population-based study did not show increased dementia
incidence up to age 75 in those exposed to famine during gestation.
