Consequences of early life exposure to the 1983-1985 Ethiopian Great Famine on cognitive function in adults: a historical cohort study

BMJ Open. 2020 Sep 24;10(9):e038977. doi: 10.1136/bmjopen-2020-038977.

Abstract

Objectives: To investigate the association between early life famine exposure and cognitive function in adults.

Design: Historical cohort study SETTING: North Wollo Zone, Northeast Ethiopia.

Participants: We recruited 1047 adult men and women aged 30-38 years who had history of early life exposure to Ethiopian great famine. Based on self-reported age and birth date, participants were categorised into famine exposed in early life (prenatal/postnatal) and non-exposed groups.

Outcome measures: The primary outcome measure of this study was cognitive function in adults after early life exposure to famine. Cognitive function was measured using Montreal Cognitive Assessment-basic. Associations between exposure and outcome variables were examined by linear regression analysis models.

Results: Adjusted for covariates, early life exposure to famine showed 1.29 (β=-1.29; 95% CI -2.16 to -0.52) points lower cognitive function score compared with non-exposed. Based on subanalysis for timing of famine exposure, postnatal exposure to famine resulted in 2.26 (β=-2.26; 95% CI -3.12 to -1.36) points lower cognitive function score compared with non-exposed groups. Prenatal famine exposure had 1.26 (β=-1.26; 95% CI -2.35 to 0.94) points lower cognitive function score although not statistically significant.

Conclusions: Famine exposure in early life was associated with cognitive functions in adults. While the overall findings highlight the importance of optimal nutrition in early life for brain growth and development, the association observed between postnatal famine exposure and adult cognitive function may indicate the relative importance of learning and experience during early childhood for optimal brain development after birth. Further studies are needed to elucidate the potential mechanism behind this association.

Keywords: adult neurology; nutrition & dietetics; nutritional support.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child, Preschool
  • China
  • Cognition
  • Cohort Studies
  • Ethiopia / epidemiology
  • Famine
  • Female
  • Humans
  • Male
  • Pregnancy
  • Prenatal Exposure Delayed Effects* / epidemiology
  • Starvation*