Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey

Martin Prince; Daisy Acosta; Alan D. Dangour; Ricardo Uauy; Mariella Guerra; Yueqin Huang; K. S. Jacob; Juan J. Llibre Rodriguez; Aquiles Salas; Ana Luisa Sosa; Joseph D. Williams; Isaac Acosta; Emiliano Albanese; Michael E. Dewey; Cleusa P. Ferri; Robert Stewart; Ciro Gaona; A. T. Jotheeswaran; P. Senthil Kumar; Shuran Li; Juan C. Llibre Guerra; Diana Rodriguez; Guillermina Rodriguez

doi:10.1017/S1041610210001274

Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey

Martin Prince, Daisy Acosta, Alan D. Dangour, Ricardo Uauy, Mariella Guerra, Yueqin Huang, K. S. Jacob, Juan J. Llibre Rodriguez, Aquiles Salas, Ana Luisa Sosa, Joseph D. Williams, Isaac Acosta, Emiliano Albanese, Michael E. Dewey, Cleusa P. Ferri, Robert Stewart, Ciro Gaona, A. T. Jotheeswaran, P. Senthil Kumar, Shuran LiJuan C. Llibre Guerra, Diana Rodriguez, Guillermina Rodriguez

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

Background: Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. There is a limited literature linking short legs and small skulls to an increased risk for cognitive impairment and dementia in late life. Methods: One phase cross-sectional surveys were carried out of all residents aged over 65 years in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru (n = 14,960). The cross-culturally validated 10/66 dementia diagnosis, and a sociodemographic and risk factor questionnaire were administered to all participants, and anthropometric measures taken. Poisson regression was used to calculate prevalence ratios for the effect of leg length and skull circumference upon 10/66 dementia, controlling for age, gender, education and family history of dementia. Results: The pooled meta-analyzed fixed effect for leg length (highest vs. lowest quarter) was 0.82 (95% CI, 0.68-0.98) and for skull circumference 0.75 (95% CI, 0.63-0.89). While point estimates varied between sites, the proportion of the variability attributable to heterogeneity between studies as opposed to sampling error (I-2) was 0% for leg length and 22% for skull circumference. The effects were independent and not mediated by family history of dementia. The effect of skull circumference was not modified by educational level or gender, and the effect of leg length was not modified by gender. Conclusions: Since leg length and skull circumference are said to remain stable throughout adulthood into old age, reverse causality is an unlikely explanation for the findings. Early life nutritional programming, as well as neurodevelopment may protect against neurodegeneration.

Original language	English
Pages (from-to)	202 - 213
Number of pages	12
Journal	International Psychogeriatrics
Volume	23
Issue number	2
DOIs	https://doi.org/10.1017/S1041610210001274
Publication status	Published - 2011

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10.1017/S1041610210001274

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Prince, M., Acosta, D., Dangour, A. D., Uauy, R., Guerra, M., Huang, Y., Jacob, K. S., Llibre Rodriguez, J. J., Salas, A., Luisa Sosa, A., Williams, J. D., Acosta, I., Albanese, E., Dewey, M. E., Ferri, C. P., Stewart, R., Gaona, C., Jotheeswaran, A. T., Kumar, P. S., ... Rodriguez, G. (2011). Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey. International Psychogeriatrics, 23(2), 202 - 213. https://doi.org/10.1017/S1041610210001274

@article{22279e2f0db3499d8fc2be9805253760,

title = "Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey",

abstract = "Background: Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. There is a limited literature linking short legs and small skulls to an increased risk for cognitive impairment and dementia in late life. Methods: One phase cross-sectional surveys were carried out of all residents aged over 65 years in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru (n = 14,960). The cross-culturally validated 10/66 dementia diagnosis, and a sociodemographic and risk factor questionnaire were administered to all participants, and anthropometric measures taken. Poisson regression was used to calculate prevalence ratios for the effect of leg length and skull circumference upon 10/66 dementia, controlling for age, gender, education and family history of dementia. Results: The pooled meta-analyzed fixed effect for leg length (highest vs. lowest quarter) was 0.82 (95% CI, 0.68-0.98) and for skull circumference 0.75 (95% CI, 0.63-0.89). While point estimates varied between sites, the proportion of the variability attributable to heterogeneity between studies as opposed to sampling error (I-2) was 0% for leg length and 22% for skull circumference. The effects were independent and not mediated by family history of dementia. The effect of skull circumference was not modified by educational level or gender, and the effect of leg length was not modified by gender. Conclusions: Since leg length and skull circumference are said to remain stable throughout adulthood into old age, reverse causality is an unlikely explanation for the findings. Early life nutritional programming, as well as neurodevelopment may protect against neurodegeneration.",

author = "Martin Prince and Daisy Acosta and Dangour, {Alan D.} and Ricardo Uauy and Mariella Guerra and Yueqin Huang and Jacob, {K. S.} and {Llibre Rodriguez}, {Juan J.} and Aquiles Salas and {Luisa Sosa}, Ana and Williams, {Joseph D.} and Isaac Acosta and Emiliano Albanese and Dewey, {Michael E.} and Ferri, {Cleusa P.} and Robert Stewart and Ciro Gaona and Jotheeswaran, {A. T.} and Kumar, {P. Senthil} and Shuran Li and {Llibre Guerra}, {Juan C.} and Diana Rodriguez and Guillermina Rodriguez",

year = "2011",

doi = "10.1017/S1041610210001274",

language = "English",

volume = "23",

pages = "202 -- 213",

journal = "International Psychogeriatrics",

publisher = "Cambridge University Press",

number = "2",

}

Prince, M, Acosta, D, Dangour, AD, Uauy, R, Guerra, M, Huang, Y, Jacob, KS, Llibre Rodriguez, JJ, Salas, A, Luisa Sosa, A, Williams, JD, Acosta, I, Albanese, E , Dewey, ME, Ferri, CP, Stewart, R, Gaona, C, Jotheeswaran, AT, Kumar, PS, Li, S, Llibre Guerra, JC, Rodriguez, D & Rodriguez, G 2011, 'Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey', International Psychogeriatrics, vol. 23, no. 2, pp. 202 - 213. https://doi.org/10.1017/S1041610210001274

TY - JOUR

T1 - Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey

AU - Prince, Martin

AU - Acosta, Daisy

AU - Dangour, Alan D.

AU - Uauy, Ricardo

AU - Guerra, Mariella

AU - Huang, Yueqin

AU - Jacob, K. S.

AU - Llibre Rodriguez, Juan J.

AU - Salas, Aquiles

AU - Luisa Sosa, Ana

AU - Williams, Joseph D.

AU - Acosta, Isaac

AU - Albanese, Emiliano

AU - Dewey, Michael E.

AU - Ferri, Cleusa P.

AU - Stewart, Robert

AU - Gaona, Ciro

AU - Jotheeswaran, A. T.

AU - Kumar, P. Senthil

AU - Li, Shuran

AU - Llibre Guerra, Juan C.

AU - Rodriguez, Diana

AU - Rodriguez, Guillermina

PY - 2011

Y1 - 2011

N2 - Background: Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. There is a limited literature linking short legs and small skulls to an increased risk for cognitive impairment and dementia in late life. Methods: One phase cross-sectional surveys were carried out of all residents aged over 65 years in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru (n = 14,960). The cross-culturally validated 10/66 dementia diagnosis, and a sociodemographic and risk factor questionnaire were administered to all participants, and anthropometric measures taken. Poisson regression was used to calculate prevalence ratios for the effect of leg length and skull circumference upon 10/66 dementia, controlling for age, gender, education and family history of dementia. Results: The pooled meta-analyzed fixed effect for leg length (highest vs. lowest quarter) was 0.82 (95% CI, 0.68-0.98) and for skull circumference 0.75 (95% CI, 0.63-0.89). While point estimates varied between sites, the proportion of the variability attributable to heterogeneity between studies as opposed to sampling error (I-2) was 0% for leg length and 22% for skull circumference. The effects were independent and not mediated by family history of dementia. The effect of skull circumference was not modified by educational level or gender, and the effect of leg length was not modified by gender. Conclusions: Since leg length and skull circumference are said to remain stable throughout adulthood into old age, reverse causality is an unlikely explanation for the findings. Early life nutritional programming, as well as neurodevelopment may protect against neurodegeneration.

AB - Background: Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. There is a limited literature linking short legs and small skulls to an increased risk for cognitive impairment and dementia in late life. Methods: One phase cross-sectional surveys were carried out of all residents aged over 65 years in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru (n = 14,960). The cross-culturally validated 10/66 dementia diagnosis, and a sociodemographic and risk factor questionnaire were administered to all participants, and anthropometric measures taken. Poisson regression was used to calculate prevalence ratios for the effect of leg length and skull circumference upon 10/66 dementia, controlling for age, gender, education and family history of dementia. Results: The pooled meta-analyzed fixed effect for leg length (highest vs. lowest quarter) was 0.82 (95% CI, 0.68-0.98) and for skull circumference 0.75 (95% CI, 0.63-0.89). While point estimates varied between sites, the proportion of the variability attributable to heterogeneity between studies as opposed to sampling error (I-2) was 0% for leg length and 22% for skull circumference. The effects were independent and not mediated by family history of dementia. The effect of skull circumference was not modified by educational level or gender, and the effect of leg length was not modified by gender. Conclusions: Since leg length and skull circumference are said to remain stable throughout adulthood into old age, reverse causality is an unlikely explanation for the findings. Early life nutritional programming, as well as neurodevelopment may protect against neurodegeneration.

U2 - 10.1017/S1041610210001274

DO - 10.1017/S1041610210001274

M3 - Article

VL - 23

SP - 202

EP - 213

JO - International Psychogeriatrics

JF - International Psychogeriatrics

IS - 2

ER -

Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey

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