Early life risk factors for cerebrovascular disease: A systematic review and meta-analysis
Ellen V Backhouse1, Caroline A McHutchison1, Vera Cvoro1
1From the Centre for Clinical Brain Sciences (E.V.B., C.A.M., V.C., J.M.W.), Centre for Cognitive Ageing and Cognitive Epidemiology (C.A.M., V.C., S.D.S., J.M.W.), and Geriatric Medicine, Department of Clinical and Surgical Sciences (S.D.S.), University of Edinburgh; and Scottish Imaging Network (V.C., S.D.S., J.M.W.), A Platform for Scientific Excellence (SINAPSE), UK.
Insights
Childhood intelligence quotient (IQ), socioeconomic status (SES), and education levels are linked to an increased risk of cerebrovascular disease (CVD) markers in adulthood. These early life factors may influence later brain health and vascular lesion development.
Area of Science:
- Neuroscience
- Public Health
- Epidemiology
Background:
- Cerebrovascular disease (CVD) contributes to subclinical brain vascular lesions, detectable via neuroimaging.
- Childhood factors are increasingly recognized as potential contributors to later-life CVD risk.
Purpose of the Study:
- To systematically review and meta-analyze the association between childhood IQ, socioeconomic status (SES), and education with subclinical CVD in later life.
Main Methods:
- A comprehensive literature search was conducted across MEDLINE, PsycINFO, and EMBASE.
- Meta-analysis using random effects models was employed to calculate overall odds ratios (OR), mean differences, or correlations with 95% confidence intervals (CIs).
Main Results:
- Thirty studies (n=22,890) were included. Lower childhood IQ and SES were associated with increased white matter hyperintensities (WMH).
- Fewer years of education correlated with several CVD markers (OR = 1.17, 95% CI 1.05 to 1.31).
- No studies examined the combined effects of these early life factors.
Conclusions:
- Childhood IQ, SES, and education are significantly associated with an elevated risk of CVD detected by neuroimaging later in life.
- Further research is needed to strengthen evidence and inform public health policy regarding early life determinants of cerebrovascular health.
Objective:
Cerebrovascular disease (CVD) causes subclinical brain vascular lesions detected using neuroimaging and childhood factors may increase later CVD risk.
Methods:
We searched MEDLINE, PsycINFO, and EMBASE, and meta-analyzed all available evidence on childhood (premorbid) IQ, socioeconomic status (SES), education, and subclinical CVD in later life. Overall odds ratios (OR), mean difference or correlation, and 95% confidence intervals (CIs) were calculated using random effects methods.
Results:
We identified 30 relevant studies (n = 22,890). Lower childhood IQ and lower childhood SES were associated with more white matter hyperintensities (WMH) (IQ: n = 1,512, r = -0.07, 95% CI -0.12 to -0.02, p = 0.007; SES: n = 243, deep WMH r = -0.18, periventricular WMH r = -0.146). Fewer years of education were associated with several CVD markers (n = 15,439, OR = 1.17, 95% CI 1.05 to 1.31, p = 0.003). No studies assessed early life factors combined.
Conclusions:
Childhood IQ, SES, and education are associated with increased risk of CVD on neuroimaging in later life. Further studies are required to provide further evidence and thereby inform policy.
