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

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, EMBASE and meta-analysed 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 (CI) were calculated using random effects methods.
RESULTS: We identified 30 relevant studies (n=23,626). Lower childhood IQ and lower childhood SES were associated with more white matter hyperintensities (WMH) (IQ; n=1512, 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=17,164, 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.