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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

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Murali Krishna, Ghattu V. Krishnaveni, Veena Sargur, Kalyanaraman Kumaran, Mohan Kumar, Kiran Nagaraj, Patsy Coakley, Samuel Chirstaprasad Karat, Giriraj R. Chandak, Mathew Varghese, Martin Prince, Clive Osmond, Caroline H.D. Fall

Original languageEnglish
Pages (from-to)353-366
Number of pages14
JournalInternational Psychogeriatrics
Issue number4
Published20 Apr 2022

Bibliographical note

Funding Information: This study was supported by an Early Career Fellowship grant awarded to Dr Murali Krishna by Welcome DBT India Alliance. Funding Information: This study was supported by an Early Career Fellowship grant awarded to Dr Murali Krishna by Welcome DBT India Alliance. We are grateful to participants and their families for their cooperation and participation in this study. We acknowledge the contributions of the present and previous staff at Holdsworth Memorial Hospital, Mysore. They include Dr Sona Rao, Saroja A, Ramya MC, Bhavya, Praveen, Santhosh N, Somashekara R, Malathi MP, Pavithra Rani HD, Tony Gerald, Jayakumar MN, Geetha S, Annamma, Chachyamma, Tonaly Gerald Lawrence, Tony Clifford Onslow, Swaranagowri MN, Surekha, Gopal Singh, Shylaja, Harini, Shobha, Poornima, Srinivas, and Stephen Justine Manohar. We are thankful to the late Professor David JP Barker for his support in establishing the cohort and the research centre at CSI Holdsworth Memorial Hospital. We also thank other members of the MRC Lifecourse Epidemiology Unit who have contributed to the Mysore Birth Records Cohort studies including Claudia Stein, who created the cohort by tracing people born in HMH in 1993-1995. Publisher Copyright: ©

King's Authors


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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