Clinical nutrition (Edinburgh, Scotland) · 2025
Association between early-life famine exposure and cognitive function trajectories from midlife to late-life: The mediating role of depressive symptoms.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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He Hao, Li Fangfei, Zhu Zhuoqi, Liao Yunfei, Li Han, Zou Yunfeng, Peng Yang
Аннотация
BACKGROUND: The long-term effects of early famine exposure on cognitive function remain understudied. This study examined the association between famine exposure and 10-year trajectories of cognitive function, and also assessed the mediating role of depressive symptoms.
METHODS: We included 2434 participants from waves 1-5 of the China Health and Retirement Longitudinal Study (CHARLS), with complete baseline data and at least three cognitive assessments. Famine exposure data were obtained from the 2000 China Census, and its severity was determined using the pre-famine Cohort Size Shrinkage Index. Group-based trajectory modeling was used to identify distinct 10-year cognitive function trajectories, and logistic regression was used to estimate the association between famine exposure and trajectory membership. The mediating effect of depressive symptoms was assessed using the Karlson-Holm-Breen method.
RESULTS: Among the 2434 participants, two global cognitive function trajectories were identified: persistently low (n = 743, 30.5 %) and persistently high (n = 1691, 69.5 %). Similar patterns were found across cognitive dimensions, including orientation, memory, computation, and drawing. In the fully adjusted model, moderate famine exposure was associated with an increased risk of a persistently low global cognition trajectory [odds ratio (OR) = 1.37, 95 % confidence interval (CI): 1.04-1.82], and severe famine exposure showed a similar trend (OR = 1.57, 95 % CI: 0.97-2.56). Moreover, both moderate (OR = 1.67, 95 % CI: 1.28-2.15) and severe (OR = 1.61, 95 % CI: 1.01-2.54) famine exposures were linked to a heightened risk of a persistently low trajectory for computation, while severe famine exposure was additionally associated with a persistently low trajectory for orientation (OR = 1.90, 95 % CI: 1.15-3.14). Moderate famine exposure, however, was not associated with a persistently low trajectory for orientation (OR = 0.98, 95 % CI: 0.71-1.36). Additionally, while depressive symptoms did not mediate the associations between moderate famine and any cognitive trajectories, they partially mediated the associations between severe famine and global, computation, and orientation trajectories by 20.07 %, 11.76 %, and 10.38 %, respectively.
CONCLUSION: Our study identified two distinct cognitive function trajectories, with both moderate and severe famine exposure being linked to persistently low trajectories. Furthermore, depressive symptoms partially mediated the association between severe famine exposure and cognitive function in middle-aged and older adults.
METHODS: We included 2434 participants from waves 1-5 of the China Health and Retirement Longitudinal Study (CHARLS), with complete baseline data and at least three cognitive assessments. Famine exposure data were obtained from the 2000 China Census, and its severity was determined using the pre-famine Cohort Size Shrinkage Index. Group-based trajectory modeling was used to identify distinct 10-year cognitive function trajectories, and logistic regression was used to estimate the association between famine exposure and trajectory membership. The mediating effect of depressive symptoms was assessed using the Karlson-Holm-Breen method.
RESULTS: Among the 2434 participants, two global cognitive function trajectories were identified: persistently low (n = 743, 30.5 %) and persistently high (n = 1691, 69.5 %). Similar patterns were found across cognitive dimensions, including orientation, memory, computation, and drawing. In the fully adjusted model, moderate famine exposure was associated with an increased risk of a persistently low global cognition trajectory [odds ratio (OR) = 1.37, 95 % confidence interval (CI): 1.04-1.82], and severe famine exposure showed a similar trend (OR = 1.57, 95 % CI: 0.97-2.56). Moreover, both moderate (OR = 1.67, 95 % CI: 1.28-2.15) and severe (OR = 1.61, 95 % CI: 1.01-2.54) famine exposures were linked to a heightened risk of a persistently low trajectory for computation, while severe famine exposure was additionally associated with a persistently low trajectory for orientation (OR = 1.90, 95 % CI: 1.15-3.14). Moderate famine exposure, however, was not associated with a persistently low trajectory for orientation (OR = 0.98, 95 % CI: 0.71-1.36). Additionally, while depressive symptoms did not mediate the associations between moderate famine and any cognitive trajectories, they partially mediated the associations between severe famine and global, computation, and orientation trajectories by 20.07 %, 11.76 %, and 10.38 %, respectively.
CONCLUSION: Our study identified two distinct cognitive function trajectories, with both moderate and severe famine exposure being linked to persistently low trajectories. Furthermore, depressive symptoms partially mediated the association between severe famine exposure and cognitive function in middle-aged and older adults.