Psychological functioning across the life course and risk of cardiovascular and metabolic diseases

Background: The development of cardiovascular and metabolic diseases has its origins in early life and may depend, in part, upon psychological functioning (PF) across the lifespan. The aim of this study was to assess whether life course patterns of PF from birth to mid-adulthood were prospectively associated with adult cardiometabolic risk (CMR). Methods: The sample consisted of members of the 1958 British Birth Cohort who completed a biomedical survey at age 45 yrs and repeated measures of PF (N=6768). PF profiles (persistently satisfactory, poor in childhood-only, poor in adulthood-only, or persistently poor) were identified from 6 assessments between ages 7 and 42 yrs. CMR was identified by combining information on 9 biomarkers of immune, cardiovascular, and metabolic system function. Linear regression models were used to test the association between PF profiles and CMR, with adjustment for covariates in childhood and adulthood. Results: Compared to those with satisfactory PF, CMR was worse among people with poor PF in childhood-only (β=0.12, SE=0.03, p<.0001), adulthood-only (β=0.09, SE=0.03, p=0.01), and persisting (β=0.25, SE=0.04, p<.0001), after adjustment for covariates. Conclusion: Persistently poor PF conferred the greatest cardiometabolic risk, yet a significant association between poor PF in childhood and higher CMR was evident even when PF was satisfactory in adulthood. These findings suggest that prevention and intervention strategies for reducing risk of cardiometabolic disease should address psychological functioning and may be most effective at younger ages. Improving psychological functioning across the life course may reduce the burden of adult cardiometabolic disease.