健康丨大饥荒时期出生的中国人，中年后容易失忆

2017-12-16 周大伟 新三届

最新研究分析

大饥荒时期出生中国人

中年后易失忆

密歇根大学助理教授徐宏伟表示，根据最新研究分析，曾在婴儿期遭遇中国大饥荒者，步入中年后，认知能力急遽下降。

由华裔学者徐宏伟发表的最新研究显示， 1959年到1961年间出生于中国大饥荒时期者，在步入50岁中年后，认知能力急遽下降，罹患失忆症、阿兹海默症的风险可能更高。

这份由密歇根大学、密歇根州立大学与哥伦比亚大学华裔学者共同完成的“早年经历中国1959─61年大饥荒与中年认知能力关系”的学术报告，发表在最新一期的“国际流行病学期刊”(International Journal of Epidemiology)，这也是第一份针对中国大饥荒时期，曾经历民众在进入中年认知能力变化的全国性研究。

该研究报告的第一作者，密歇根大学社会研究院的研究助理教授徐宏伟12日接受记者访问时说，很多人认为随着年龄增长，认知能力会下降。但1959年至1961年出生的中国人，明显比一般中年人下降速度更快。

此研究是根据中国2011年健康与养老追踪调查的数据，通过一系列对耆老注意力、时间感及情节记忆等认知力项目的实验，对2446名出生于1958到1963年的中国农村人士进行分析。研究者并追踪同一群受访者，于2013年的认知能力变化，比对两者数据。

徐宏伟说，选择研究出生在中国农村的中年人，是考虑当时中国官方对城市及农村对粮食的分配不同，而农村人口普遍受到饥荒影响较大。

2011年研究数据显示，1959年出生(即母胎时期及出生后两年遇大饥荒者)的认知能力，比1963年出生、未遭遇大饥荒者高。不过，2013年的研究指出，1959年出生者，认知能力在短短两年内大幅下降。徐宏伟认为，随着年龄增长，这群人的认知能力可能更恶化。尤其排除教育水平因素后，仍发现胎儿期曾遭遇饥荒、营养不良者，认知力下降现象依旧明显。透过这项研究，幼儿期曾遭遇中国大饥荒的华人，可能成为阿兹海默症“高危险群”的机率，将比一般人高。

他希望借此研究结果，呼吁华人“老人脑子不好使，不是病”的传统观念必须重塑，重视中老年人认知下降问题的多种原因，提早防范与治疗。

这篇研究的作者还包括：密歇根州立大学社会研究院教授张振梅、密歇根大学社工系的李慧玲、哥伦比亚大学的社工系的刘金玉。

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英文版

Babies born during famine

have lower cognition in midlife

Dec 11, 2017
Contact Debing Su

ANN ARBOR—Hunger and malnutrition in infancy may lead to poor cognitive performance in midlife, according to a new study.

Researchers at University of Michigan, Michigan State University and Columbia University have found that child survivors of China's 1959-61 famine that killed millions appear to be haunted by their past, as their cognitive performances go downhill in their early 50s.

Published in the International Journal of Epidemiology, the study is among the first to investigate the long-term cognitive consequences of early life exposure to famine in a non-Western context.

"Many people believe that one's cognitive ability will decline with increasing age. But for people who were conceived and born between 1959 and 1961 in China, the decline rate is more rapid than normal," said Hongwei Xu, the lead author of the study and research assistant professor at U-M's Institute for Social Research.

Drawing on data from China's nationally representative longitudinal survey of middle-aged and older adults in 2011, Xu and colleagues used validated assessments of cognitive functions, including attention, time orientation and episodic memory, as part of their tests with 2,446 rural Chinese who were born between 1958 and 1963.

Participants were also asked to redraw a picture of two overlapped pentagons shown to them, in a way to assess their visuospatial skills.

In addition, researchers analyzed data from a follow-up survey in 2013 to see changes in cognition between 2011 and 2013.

The study found that the group born in 1959, who had malnutrition in utero and in the first two years of life, scored higher in the baseline study than the reference group born in 1963—a year without famine.

"The surviving 1959 cohort may consist of the fittest of the fittest," Hongwei Xu said. "Despite having a higher general cognition at the baseline due to mortality selection, they experienced a sharper decline over a two-year follow-up."

According to the study, those born in 1961, the last year of the famine, had significantly lower cognitive scores than those born after the famine. And no significant negative famine effects were found in people born in 1962 who were mildly affected by famine during the prenatal period and no exposure to famine after birth.

After controlling for the education factor, researchers still found negative impacts on middle-aged adults born in China's three years of famine period.

Accelerated midlife cognitive decline could increase the risk of dementia or Alzheimer's diseases down the road. Xu is concerned that these groups may be at an elevated risk of these diseases in years to come.

"China's population aging is accelerating," he said. "But not enough attention from both the government and the public have been paid to cognitive decline in middle-aged adults and seniors. People tend to treat all types of cognitive decline as part of a normal aging process. But our study showed that these groups are very vulnerable due to hunger or malnutrition in utero and infancy."

Additional authors of this study include Zhenmei Zhang of Michigan State, Lydia Li of U-M and Jinyu Liu of Columbia. The study is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and Lieberthal-Rogel Center for Chinese Studies at U-M.

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