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. 2011 Mar;23(2):202-13.
doi: 10.1017/S1041610210001274. Epub 2010 Aug 12.

Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey

Martin Prince  1 , Daisy Acosta, Alan D Dangour, Ricardo Uauy, Mariella Guerra, Yueqin Huang, K S Jacob, Juan J Llibre Rodriguez, Aquiles Salas, Ana Luisa Sosa, Joseph D Williams, Isaac Acosta, Emiliano Albanese, Michael E Dewey, Cleusa P Ferri, Robert Stewart, Ciro Gaona, A T Jotheeswaran, P Senthil Kumar, Shuran Li, Juan C Llibre Guerra, Diana Rodriguez, Guillermina Rodriguez
Affiliations

Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey

Martin Prince et al. Int Psychogeriatr. 2011 Mar.

Abstract

Background: Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. There is a limited literature linking short legs and small skulls to an increased risk for cognitive impairment and dementia in late life.

Methods: One phase cross-sectional surveys were carried out of all residents aged over 65 years in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru (n = 14,960). The cross-culturally validated 10/66 dementia diagnosis, and a sociodemographic and risk factor questionnaire were administered to all participants, and anthropometric measures taken. Poisson regression was used to calculate prevalence ratios for the effect of leg length and skull circumference upon 10/66 dementia, controlling for age, gender, education and family history of dementia.

Results: The pooled meta-analyzed fixed effect for leg length (highest vs. lowest quarter) was 0.82 (95% CI, 0.68-0.98) and for skull circumference 0.75 (95% CI, 0.63-0.89). While point estimates varied between sites, the proportion of the variability attributable to heterogeneity between studies as opposed to sampling error (I2) was 0% for leg length and 22% for skull circumference. The effects were independent and not mediated by family history of dementia. The effect of skull circumference was not modified by educational level or gender, and the effect of leg length was not modified by gender.

Conclusions: Since leg length and skull circumference are said to remain stable throughout adulthood into old age, reverse causality is an unlikely explanation for the findings. Early life nutritional programming, as well as neurodevelopment may protect against neurodegeneration.

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Conflict of interest statement

Conflict of interest

None

Figures

Figure 1a
Figure 1a. Forest plot for the meta-analysis of independent associations (PRs*) between leg length (longest vs. shortest quarters) and dementia
* Prevalence ratios, adjusting for age, gender, educational level and family history of dementia
Figure 1b
Figure 1b. Forest plot for the meta-analysis of independent associations (PRs*) between skull circumference (longest vs. shortest quarters) and dementia
* Prevalence ratios, adjusting for age, gender, educational level and family history of dementia
See this image and copyright information in PMC

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