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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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The relationship between childhood socioeconomic circumstance and late life whole brain hyperintensity burden.Structural equation model examining the relationship between childhood socioeconomic circumstance and late life whole brain hyperintensity burden, correcting for the mediating effects of childhood intelligence, education and adult socioeconomic circumstance. aSEC  =  adult socioeconomic circumstance, cSEC  =  childhood socioeconomic circumstance, Edu  =  educational score, CIQ  =  childhood IQ, lesion  =  latent variable contributed to by regional hyperintensity scores, GMH – grey matter hyperintensities, ITH  =  infratentorial hyperintensities, PVH  =  periventricular hyperintensities, WMH  =  white matter hyperintensities, HYP  =  treated or new hypertension
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pone-0088969-g003: The relationship between childhood socioeconomic circumstance and late life whole brain hyperintensity burden.Structural equation model examining the relationship between childhood socioeconomic circumstance and late life whole brain hyperintensity burden, correcting for the mediating effects of childhood intelligence, education and adult socioeconomic circumstance. aSEC  =  adult socioeconomic circumstance, cSEC  =  childhood socioeconomic circumstance, Edu  =  educational score, CIQ  =  childhood IQ, lesion  =  latent variable contributed to by regional hyperintensity scores, GMH – grey matter hyperintensities, ITH  =  infratentorial hyperintensities, PVH  =  periventricular hyperintensities, WMH  =  white matter hyperintensities, HYP  =  treated or new hypertension

Mentions: In order to examine the direct and indirect effects of cSEC on hyperintensity scores and to examine if this effect is a general effect rather than specific to WMH we used structural equation modelling. The model shown in Figure 3 hypothesises that all of the hyperintensity scores can be explained by a single ‘lesion’ latent variable. Childhood intelligence (CIQ) is hypothesised to have a direct effect on education (Edu), adult socioeconomic circumstance (aSEC), and lesion burden. Childhood socioeconomic circumstance (cSEC) is hypothesised to have a direct effect on lesion burden, aSEC and education. Hypertension was hypothesised to have a directed effect on lesion burden, as we have previously demonstrated [13]. Childhood SEC, hypertension, and CIQ were hypothesised to be correlated. A schematic representation of the model can be seen in Figure 3. For clarity, error terms, correlation arrows and regression weights have been excluded. Initial examination of the model using modification criteria of Joreskog and Sorbom [22] indicated that there was no modification that would substantially improve the fit of the model to the data. The regression weights for each hypothesized path can be seen in Table 4. The data were found to be an excellent fit to the model as indicated by the following indices; Chi Squared/df  = 1.31; Normed fit index  = 0.95 [23]; Comparative fit index  = 0.99 [24]; Root mean square error of approximation  = 0.037 [25]. The absence of any significant modification suggests that the effect of the hypothesised predictive variables is explained by their effect on the latent variable ‘lesion’ which estimates the shared variance between all regional hyperintensity scores rather than affecting one variable in particular. Calculating the direct and indirect influence of cSEC on this latent variable ‘lesion’ demonstrate that its influence on lesion burden is entirely direct.


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)

The relationship between childhood socioeconomic circumstance and late life whole brain hyperintensity burden.Structural equation model examining the relationship between childhood socioeconomic circumstance and late life whole brain hyperintensity burden, correcting for the mediating effects of childhood intelligence, education and adult socioeconomic circumstance. aSEC  =  adult socioeconomic circumstance, cSEC  =  childhood socioeconomic circumstance, Edu  =  educational score, CIQ  =  childhood IQ, lesion  =  latent variable contributed to by regional hyperintensity scores, GMH – grey matter hyperintensities, ITH  =  infratentorial hyperintensities, PVH  =  periventricular hyperintensities, WMH  =  white matter hyperintensities, HYP  =  treated or new hypertension
© Copyright Policy
Related In: Results  -  Collection

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

pone-0088969-g003: The relationship between childhood socioeconomic circumstance and late life whole brain hyperintensity burden.Structural equation model examining the relationship between childhood socioeconomic circumstance and late life whole brain hyperintensity burden, correcting for the mediating effects of childhood intelligence, education and adult socioeconomic circumstance. aSEC  =  adult socioeconomic circumstance, cSEC  =  childhood socioeconomic circumstance, Edu  =  educational score, CIQ  =  childhood IQ, lesion  =  latent variable contributed to by regional hyperintensity scores, GMH – grey matter hyperintensities, ITH  =  infratentorial hyperintensities, PVH  =  periventricular hyperintensities, WMH  =  white matter hyperintensities, HYP  =  treated or new hypertension
Mentions: In order to examine the direct and indirect effects of cSEC on hyperintensity scores and to examine if this effect is a general effect rather than specific to WMH we used structural equation modelling. The model shown in Figure 3 hypothesises that all of the hyperintensity scores can be explained by a single ‘lesion’ latent variable. Childhood intelligence (CIQ) is hypothesised to have a direct effect on education (Edu), adult socioeconomic circumstance (aSEC), and lesion burden. Childhood socioeconomic circumstance (cSEC) is hypothesised to have a direct effect on lesion burden, aSEC and education. Hypertension was hypothesised to have a directed effect on lesion burden, as we have previously demonstrated [13]. Childhood SEC, hypertension, and CIQ were hypothesised to be correlated. A schematic representation of the model can be seen in Figure 3. For clarity, error terms, correlation arrows and regression weights have been excluded. Initial examination of the model using modification criteria of Joreskog and Sorbom [22] indicated that there was no modification that would substantially improve the fit of the model to the data. The regression weights for each hypothesized path can be seen in Table 4. The data were found to be an excellent fit to the model as indicated by the following indices; Chi Squared/df  = 1.31; Normed fit index  = 0.95 [23]; Comparative fit index  = 0.99 [24]; Root mean square error of approximation  = 0.037 [25]. The absence of any significant modification suggests that the effect of the hypothesised predictive variables is explained by their effect on the latent variable ‘lesion’ which estimates the shared variance between all regional hyperintensity scores rather than affecting one variable in particular. Calculating the direct and indirect influence of cSEC on this latent variable ‘lesion’ demonstrate that its influence on lesion burden is entirely direct.

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