Current Alzheimer ResearchCurrent Alzheimer ResearchCurrent Alzheimer Research1567-20501875-582864372910.2174/0115672050290699240422050036MedicineResearch ArticlePrenatal Exposure to the 1944-45 Dutch Famine and Risk for Dementia up to Age 75: An Analysis of Primary Care DataWiegersmaAlineinfo@benthamscience.netBootsAmberinfo@benthamscience.netvan BusselEmmainfo@benthamscience.netLissenberg-WitteBirgitinfo@benthamscience.netNielenMarkinfo@benthamscience.netRoseboomTessainfo@benthamscience.netde RooijSusanneinfo@benthamscience.netDepartment of Epidemiology and Data Science,, Amsterdam UMC location University of AmsterdamDepartment of Eerstelijnsgeneeskunde, Amsterdam UMC location University of Amsterdam,Department of Epidemiology and Data Scienc, Amsterdam UMC location Vrije Universiteit Amsterdam, NivelDepartment of Epidemiology and Data Science, Amsterdam UMC location University of Amsterdam0102202421210110807012025Copyright ©; 2024, Bentham Science Publishers2024Bentham Science Publishershttps://journals.eco-vector.com/1567-2050/article/view/643729

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]).

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.

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