Early life risk factors for cerebrovascular disease: A systematic review and meta-analysis

Neurology. 2017 Mar 7;88(10):976-984. doi: 10.1212/WNL.0000000000003687. Epub 2017 Feb 10.

Abstract

Objective: Cerebrovascular disease (CVD) causes subclinical brain vascular lesions detected using neuroimaging and childhood factors may increase later CVD risk.

Methods: We searched MEDLINE, PsycINFO, and EMBASE, and meta-analyzed all available evidence on childhood (premorbid) IQ, socioeconomic status (SES), education, and subclinical CVD in later life. Overall odds ratios (OR), mean difference or correlation, and 95% confidence intervals (CIs) were calculated using random effects methods.

Results: We identified 30 relevant studies (n = 22,890). Lower childhood IQ and lower childhood SES were associated with more white matter hyperintensities (WMH) (IQ: n = 1,512, r = -0.07, 95% CI -0.12 to -0.02, p = 0.007; SES: n = 243, deep WMH r = -0.18, periventricular WMH r = -0.146). Fewer years of education were associated with several CVD markers (n = 15,439, OR = 1.17, 95% CI 1.05 to 1.31, p = 0.003). No studies assessed early life factors combined.

Conclusions: Childhood IQ, SES, and education are associated with increased risk of CVD on neuroimaging in later life. Further studies are required to provide further evidence and thereby inform policy.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Cerebrovascular Disorders / diagnostic imaging
  • Cerebrovascular Disorders / epidemiology*
  • Child
  • Child Abuse / psychology*
  • Child Abuse / statistics & numerical data
  • Databases, Bibliographic / statistics & numerical data
  • Humans
  • Life Change Events*
  • Neuroimaging
  • Risk Factors
  • Socioeconomic Factors