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Early life socioeconomic circumstance and late life brain hyperintensities--a population based cohort study.

Murray AD, McNeil CJ, Salarirad S, Whalley LJ, Staff RT - PLoS ONE (2014)

Bottom Line: To test the hypothesis that childhood socioeconomic circumstance is associated with late life hyperintensity burden and that neither adult socioeconomic circumstance nor change in socioeconomic circumstance during life influence this effect.Significant correlations were also found between hypertension and hyperintensity burden in all brain regions (ρ = 0.15-0.24, P<0.05).The mechanism underlying this effect is unknown, but may act through fetal and/or early life programming of cerebrovascular disease.

View Article: PubMed Central - PubMed

Affiliation: Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom.

ABSTRACT

Context: There have been many reports confirming the association between lower childhood socioeconomic circumstance and cardiovascular disease but evidence for links with cerebrovascular disease is contradictory. Hyperintensities on brain magnetic resonance imaging are associated with vascular risk factors, cognitive decline, dementia and death. However, the relationship between childhood socioeconomic circumstance and these lesions is unclear.

Objective: To test the hypothesis that childhood socioeconomic circumstance is associated with late life hyperintensity burden and that neither adult socioeconomic circumstance nor change in socioeconomic circumstance during life influence this effect.

Design: Cohort study.

Setting: Community.

Participants: 227 community dwelling members of the 1936 Aberdeen Birth Cohort aged 68 years, who were free from dementia.

Main outcome measures: Relationship between early life socioeconomic circumstance (paternal occupation) and abundance of late life brain hyperintensities.

Results: We find significant negative correlations between childhood socioeconomic circumstance and white matter hyperintensities (ρ = -0.18, P<0.01), and periventricular hyperintensities (ρ = -0.15, P<0.05), between educational attainment and white matter hyperintensities (ρ = -0.15, P<0.05) and periventricular hyperintensities (ρ = -0.17, P<0.05), and between childhood intelligence and periventricular hyperintensities (ρ = -0.14, P<0.05). The relationship is strongest for childhood socioeconomic circumstance and regional white matter hyperintensities, where there is a step change in increased burden from paternal occupation grades equivalent to a shift from "white collar" to "blue collar" paternal occupation. Significant correlations were also found between hypertension and hyperintensity burden in all brain regions (ρ = 0.15-0.24, P<0.05). In models that include hypertension, the magnitude of the effect of childhood socioeconomic circumstance is similar to and independent from that of hypertension.

Conclusions: Childhood socioeconomic circumstance predicts the burden of brain white matter hyperintensities aged 68 years. The mechanism underlying this effect is unknown, but may act through fetal and/or early life programming of cerebrovascular disease. Future work to understand this vulnerability will inform strategies to reduce dementia and stroke.

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Related in: MedlinePlus

Childhood and adult socioeconomic circumstances compared.A comparison of the highest occupational status of the participant (adult SEC, aSEC) and that of their father when the participant was aged 11y (childhood SEC, cSEC). Population histograms demonstrate the distribution of SECs at these stages.
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pone-0088969-g001: Childhood and adult socioeconomic circumstances compared.A comparison of the highest occupational status of the participant (adult SEC, aSEC) and that of their father when the participant was aged 11y (childhood SEC, cSEC). Population histograms demonstrate the distribution of SECs at these stages.

Mentions: Participants in this brain imaging study had significantly higher cSEC (P<0.01), aSEC (P<0.05) and demonstrated a trend for better educational achievement than ABC36 participants who did not undergo MRI (Table 1). There was no difference in prevalence of hypertension or plasma levels of cholesterol and triglyceride between these groups. Virtually complete measures of childhood and adult socioeconomic circumstance, and education data were available in 227 participants (108 male) with MRI data. Seven of these participants had one missing data point. Median values for the group were used in these cases. Examination of paternal and participant occupation codes shows social mobility in both directions (Figure 1). The mean difference between paternal and participant occupational grade was 1.44, indicating a generational shift to occupations considered to be of higher social status. This reflects the known shift from “blue” to “white collar” occupations in the mid to late twentieth century. Individuals who experienced no social mobility were in the minority with only 13% unchanged since childhood. Inspection of the occupational score distributions indicated that they were not normally distributed in childhood or in adult life. Spearman's rho correlations between socioeconomic measures (cSEC, aSEC), childhood intelligence (CIQ), educational achievement (Edu), and MRI measures (WMH, PVH, GMH and ITH) are shown in Table 2. The results show no association between aSEC and hyperintensity burden. Education and cSEC were associated with PVH and WMH scores. Splitting the group into two (low and high) according to both paternal and own occupation (Table 3) at a SEC classification of >5 we found 42 participants had high cSEC and 115 had high aSEC. Eighty-seven moved from low cSEC to high aSEC and only 14 moved from high to low. Examining the MRI hyperintensity scores in both groups in terms of the other variables showed that the WMH scores were significantly higher in the low SEC groups (both childhood and adult) and PVH in the cSEC group. Education and childhood intelligence were significantly higher in the childhood and adult high SEC groups. These results indicate that early life environment and measures are associated with WMH and, to a lesser extent, PVH scores. These relationships are most obvious for regional WMH scores, where there is a cut-off between paternal occupation codes of 5 and 6 (Figure 2). It is unclear if these associations are independent of each other. Seventy-nine of the participants had a history of hypertension. Those with a history of hypertension had higher MRI scores for all regions (Table 3). There was no significant difference between those with a history of hypertension and those without in terms of education and childhood intelligence (Table 3). In addition using a chi squared test we found no association between aSES and cSES and a history of hypertension.


Early life socioeconomic circumstance and late life brain hyperintensities--a population based cohort study.

Murray AD, McNeil CJ, Salarirad S, Whalley LJ, Staff RT - PLoS ONE (2014)

Childhood and adult socioeconomic circumstances compared.A comparison of the highest occupational status of the participant (adult SEC, aSEC) and that of their father when the participant was aged 11y (childhood SEC, cSEC). Population histograms demonstrate the distribution of SECs at these stages.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928340&req=5

pone-0088969-g001: Childhood and adult socioeconomic circumstances compared.A comparison of the highest occupational status of the participant (adult SEC, aSEC) and that of their father when the participant was aged 11y (childhood SEC, cSEC). Population histograms demonstrate the distribution of SECs at these stages.
Mentions: Participants in this brain imaging study had significantly higher cSEC (P<0.01), aSEC (P<0.05) and demonstrated a trend for better educational achievement than ABC36 participants who did not undergo MRI (Table 1). There was no difference in prevalence of hypertension or plasma levels of cholesterol and triglyceride between these groups. Virtually complete measures of childhood and adult socioeconomic circumstance, and education data were available in 227 participants (108 male) with MRI data. Seven of these participants had one missing data point. Median values for the group were used in these cases. Examination of paternal and participant occupation codes shows social mobility in both directions (Figure 1). The mean difference between paternal and participant occupational grade was 1.44, indicating a generational shift to occupations considered to be of higher social status. This reflects the known shift from “blue” to “white collar” occupations in the mid to late twentieth century. Individuals who experienced no social mobility were in the minority with only 13% unchanged since childhood. Inspection of the occupational score distributions indicated that they were not normally distributed in childhood or in adult life. Spearman's rho correlations between socioeconomic measures (cSEC, aSEC), childhood intelligence (CIQ), educational achievement (Edu), and MRI measures (WMH, PVH, GMH and ITH) are shown in Table 2. The results show no association between aSEC and hyperintensity burden. Education and cSEC were associated with PVH and WMH scores. Splitting the group into two (low and high) according to both paternal and own occupation (Table 3) at a SEC classification of >5 we found 42 participants had high cSEC and 115 had high aSEC. Eighty-seven moved from low cSEC to high aSEC and only 14 moved from high to low. Examining the MRI hyperintensity scores in both groups in terms of the other variables showed that the WMH scores were significantly higher in the low SEC groups (both childhood and adult) and PVH in the cSEC group. Education and childhood intelligence were significantly higher in the childhood and adult high SEC groups. These results indicate that early life environment and measures are associated with WMH and, to a lesser extent, PVH scores. These relationships are most obvious for regional WMH scores, where there is a cut-off between paternal occupation codes of 5 and 6 (Figure 2). It is unclear if these associations are independent of each other. Seventy-nine of the participants had a history of hypertension. Those with a history of hypertension had higher MRI scores for all regions (Table 3). There was no significant difference between those with a history of hypertension and those without in terms of education and childhood intelligence (Table 3). In addition using a chi squared test we found no association between aSES and cSES and a history of hypertension.

Bottom Line: To test the hypothesis that childhood socioeconomic circumstance is associated with late life hyperintensity burden and that neither adult socioeconomic circumstance nor change in socioeconomic circumstance during life influence this effect.Significant correlations were also found between hypertension and hyperintensity burden in all brain regions (ρ = 0.15-0.24, P<0.05).The mechanism underlying this effect is unknown, but may act through fetal and/or early life programming of cerebrovascular disease.

View Article: PubMed Central - PubMed

Affiliation: Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom.

ABSTRACT

Context: There have been many reports confirming the association between lower childhood socioeconomic circumstance and cardiovascular disease but evidence for links with cerebrovascular disease is contradictory. Hyperintensities on brain magnetic resonance imaging are associated with vascular risk factors, cognitive decline, dementia and death. However, the relationship between childhood socioeconomic circumstance and these lesions is unclear.

Objective: To test the hypothesis that childhood socioeconomic circumstance is associated with late life hyperintensity burden and that neither adult socioeconomic circumstance nor change in socioeconomic circumstance during life influence this effect.

Design: Cohort study.

Setting: Community.

Participants: 227 community dwelling members of the 1936 Aberdeen Birth Cohort aged 68 years, who were free from dementia.

Main outcome measures: Relationship between early life socioeconomic circumstance (paternal occupation) and abundance of late life brain hyperintensities.

Results: We find significant negative correlations between childhood socioeconomic circumstance and white matter hyperintensities (ρ = -0.18, P<0.01), and periventricular hyperintensities (ρ = -0.15, P<0.05), between educational attainment and white matter hyperintensities (ρ = -0.15, P<0.05) and periventricular hyperintensities (ρ = -0.17, P<0.05), and between childhood intelligence and periventricular hyperintensities (ρ = -0.14, P<0.05). The relationship is strongest for childhood socioeconomic circumstance and regional white matter hyperintensities, where there is a step change in increased burden from paternal occupation grades equivalent to a shift from "white collar" to "blue collar" paternal occupation. Significant correlations were also found between hypertension and hyperintensity burden in all brain regions (ρ = 0.15-0.24, P<0.05). In models that include hypertension, the magnitude of the effect of childhood socioeconomic circumstance is similar to and independent from that of hypertension.

Conclusions: Childhood socioeconomic circumstance predicts the burden of brain white matter hyperintensities aged 68 years. The mechanism underlying this effect is unknown, but may act through fetal and/or early life programming of cerebrovascular disease. Future work to understand this vulnerability will inform strategies to reduce dementia and stroke.

Show MeSH
Related in: MedlinePlus