Area-Level Infant Mortality Exposure in Early Life and Alzheimer’s Disease Mortality: Examining Variation Based on Age, Sex, and Place of Birth

Article type: Research Article

Authors: Topping, Michael^{a; b; c; *} | Kim, Jinho^{c; d; e} | Fletcher, Jason^{c; f; g}

Affiliations: [a] Department of Sociology, University of Wisconsin-Madison, Madison, WI, USA | [b] Center for Demography and Ecology, University of Wisconsin-Madison, Madison, WI, USA | [c] Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA | [d] Department of Health Policy and Management, Korea University, Seoul, Korea | [e] Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Korea | [f] Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA | [g] La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, WI, USA

Correspondence: [*] Correspondence to: Michael Topping, Department of Sociology, Center for Demography and Ecology, Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA. E-mail: mtopping@wisc.edu

Abstract: Background:Growing evidence suggests that critical periods in early life may contribute to one’s risk of Alzheimer’s disease and related dementias (ADRD) in later life. In this paper we explore the role that exposure to infant mortality plays in later life ADRD. Objective:To determine if exposure to early life infant mortality is associated with later mortality from ADRD. Also, we explore how these associations differ by sex and age group, along with the role of state of birth and competing risks of death. Methods:We use a sample of over 400,000 individuals aged 50 and above with the NIH-AARP Diet and Health Study with mortality follow-up, allowing us to examine how early life infant mortality rates along with other risk factors play in one’s individual mortality risk. Results:We show that infant mortality rates are associated with death from ADRD among those under 65 years of age, but not those over 65 at baseline interview. Moreover, when factoring in competing risks of death, the associations are relatively unchanged. Conclusion:These results suggest that those exposed to worse adverse conditions during critical periods increase their likelihood of death from ADRD earlier than average, due to that exposure increasing their susceptibility to develop illness later on in life.

Keywords: Alzheimer’s disease, early life, infant mortality, mortality, place of birth

DOI: 10.3233/JAD-230086

Journal: Journal of Alzheimer's Disease, vol. 93, no. 3, pp. 1007-1016, 2023