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J. Clin. Med. 2019, 8(4), 484;

Early-Life Exposure to the Chinese Famine and Risk of Cognitive Decline

China Center for Health Development Studies, Peking University, Beijing 100083, China
Department of Family Medicine, University of Michigan, Ann Arbor, MI 48109, USA
Author to whom correspondence should be addressed.
Received: 18 March 2019 / Revised: 4 April 2019 / Accepted: 8 April 2019 / Published: 10 April 2019
(This article belongs to the Section Pathergasiology & Psychology)
PDF [287 KB, uploaded 10 April 2019]


Previous studies on the Chinese famine suggested long-term effects of early-life famine exposure on health conditions. This study aims to investigate the association between exposure to the Chinese famine of 1959–1961 at different early-life stages and the risk of cognitive decline in adulthood. A total of 6417 adults born between 1952 and 1964 in the 2015 survey data of China Health and Retirement Longitudinal Study were included in this study. Cognitive performance was estimated through a series of comprehensive neuropsychological tests, including the Telephone Interview of Cognitive Status (TICS-10), word recall, and pentagon drawing. Multiple generalized linear model (GLM) was employed to detect the association between multi-stage early-life famine exposure and late-life cognitive performance. Compared with the unexposed group, respondents exposed to famine in the fetal period performed worse in the TICS (difference −0.52, 95% confidence interval (CI): −0.93 to −0.10), word recall (difference −0.46, 95% CI: −0.74 to −0.19), and general cognition (difference −1.05, 95% CI: −1.64 to −0.47). Furthermore, we also found negative effects of famine exposure on performance of word recall and pentagon drawing in the early (word recall difference −0.56, 95% CI: −1.00 to −0.11; pentagon drawing difference −0.76, 95% CI: −1.40 to −0.12), mid (word recall difference −0.46, 95% CI: −0.81 to −0.11; pentagon drawing difference −0.66, 95% CI: −1.16 to −0.16), and late (word recall difference −0.30, 95% CI: −0.55 to −0.04; pentagon drawing difference −0.75, 95% CI: −1.13 to −0.37) childhood-exposed groups. Early-life famine exposure in different stages is positively associated with late-life cognitive decline. Fetal famine exposure might affect the overall cognitive status in adulthood, and childhood famine exposure has potential adverse effects on visuospatial episodic memory. View Full-Text
Keywords: China; cognitive decline; fetal; childhood; famine China; cognitive decline; fetal; childhood; famine

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Rong, H.; Lai, X.; Mahmoudi, E.; Fang, H. Early-Life Exposure to the Chinese Famine and Risk of Cognitive Decline. J. Clin. Med. 2019, 8, 484.

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