Exploring the relationship between childhood adverse events, cardiovascular risk factors and brain health later in life
The formative years, childhood can lay the groundwork for lifelong health. But is there a connection between childhood, cardiovascular risk factors and cognitive functioning later in life?
In the 1970s and 1980s, the seven longitudinal cohorts across the world that make up the International Childhood Cardiovascular Cohort (i3C) Consortium, began examining the importance of childhood risk factors as predictors for subsequent clinical cardiovascular disease by enrolling children and measuring cardiovascular risk factors. An outgrowth of i3C, the i3C Outcomes Study recently contacted about 20,000 participants from its seven cohorts, with over 700 adjudicated cases of cardiovascular morbidity or mortality observed.
“These children are now in their 40s, 50s and 60s and starting to develop some of the diseases of older age, including cardiovascular disease and cognitive decline,” said Jessica Woo, MHSA, PhD, an epidemiologist in the Division of Biostatistics and Epidemiology at Cincinnati Children’s Hospital Medical Center.
What can these cases tell us about the relationship between childhood, particularly disadvantage and adversity in childhood, and adult brain health?
Dr. Woo drew upon longstanding data from two of the studies in the i3C Consortium — the Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study — to shed light on the important relationship between childhood adverse events, cardiovascular risk factors and adult brain health.
Many retrospective studies have been done on childhood adverse events, such as disadvantaged households or stressful environments, and the impact on later cognition. However, Dr. Woo addressed prospective evaluations that link childhood disparities to cardiovascular risk factors, which are related to cognitive and structural brain outcomes. “We’re seeing there are links in a chain, and it starts in childhood,” Dr. Woo said.
Building a life-course view of the development of cognitive decline or lower cognition scores from this longitudinal view of vascular development can provide evidence for broader public health initiatives to improve the health of children. It may also provide the impetus for clinicians to consider preserving cardiovascular health in childhood as a way of preventing cognitive decline in midlife.
Pediatricians and others who are caring for children need to be aware of these long-range impacts on the health of children. “There’s potential for clinicians to improve adult brain health as early as childhood, when risk factors such as obesity and blood pressure are more modifiable,” Dr. Woo said.
A child’s fate isn’t sealed early in life. Home life situations can improve; health risk factors can change over time. But recognizing the impact of early adversity on brain health is important to help develop strategies to positively impact long-term cardiovascular and brain health sequalae.
“We’re the first consortium that can provide long-range outcome information about the importance of preserving cardiovascular health in childhood to prevent cognitive decline in midlife,” Dr. Woo said. “It’s an exciting time.”