Prenatal Exposure to the 1944-45 Dutch Famine and Risk for Dementia up to Age 75: An Analysis of Primary Care Data

Aline Marileen Wiegersma; Amber Boots; Emma F van Bussel; Birgit I Lissenberg; Mark M J Nielen; Tessa J Roseboom; Susanne R de Rooij

doi:10.2174/0115672050290699240422050036

Prenatal Exposure to the 1944-45 Dutch Famine and Risk for Dementia up to Age 75: An Analysis of Primary Care Data

Curr Alzheimer Res. 2024 May 3. doi: 10.2174/0115672050290699240422050036. Online ahead of print.

Authors

Aline Marileen Wiegersma^{1

2

3}, Amber Boots^{1

2

3}, Emma F van Bussel⁴, Birgit I Lissenberg⁵, Mark M J Nielen⁶, Tessa J Roseboom^{1

7

2

3}, Susanne R de Rooij^{1

2

3}

Affiliations

¹ Amsterdam UMC location University of Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, The Netherlands.
² Amsterdam Public Health research institute, Aging & Later life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.
³ Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
⁴ Amsterdam UMC location University of Amsterdam, Eerstelijnsgeneeskunde, Meibergdreef 9, Amsterdam, The Netherlands.
⁵ Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, The Netherlands.
⁶ Nivel, Utrecht, The Netherlands.
⁷ Amsterdam UMC location University of Amsterdam, Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, The Netherlands.

PMID: 38706355
DOI: 10.2174/0115672050290699240422050036

Abstract

Background: A poor prenatal environment adversely affects brain development. Studies investigating long-term consequences of prenatal exposure to the 1944-45 Dutch famine have shown that those exposed to famine in early gestation had poorer selective attention, smaller brain volumes, poorer brain perfusion, older appearing brains, and increased reporting of cognitive problems, all indicative of increased dementia risk.

Objective: In the current population-based study, we investigated whether dementia incidence up to age 75 was higher among individuals who had been prenatally exposed to famine.

Methods: We included men (n=6,714) and women (n=7,051) from the Nivel Primary Care Database who had been born in seven cities affected by the Dutch famine. We used Cox regression to compare dementia incidence among individuals exposed to famine during late (1,231), mid (1,083), or early gestation (601) with those unexposed (born before or conceived after the famine).

Results: We did not observe differences in dementia incidence for those exposed to famine in mid or early gestation compared to those unexposed. Men and women exposed to famine in late gestation had significantly lower dementia rates compared to unexposed individuals (HR 0.52 [95%CI 0.30-0.89]). Sex-specific analyses showed a lower dementia rate in women exposed to famine in late gestation (HR 0.39 [95%CI 0.17-0.86]) but not in men (HR 0.68 [95%CI 0.33-1.41]).

Conclusion: Although prenatal exposure to the Dutch famine has previously been associated with measures of accelerated brain aging, the present population-based study did not show increased dementia incidence up to age 75 in those exposed to famine during gestation.

Keywords: Prenatal famine; aging; dementia; prenatal undernutrition; primary care; registry data..