Background: Nutrition during the critical periods of first 1000 days of life are fundamental determinants of neuro-developmental process and could affect adulthood cognitive functions. Hence, this study aimed to examine the relation between famine exposure during the first 1000 days of life and cognitive function in adulthood among Ethiopian Great Famine survivors.

Methods: A historical cohort study design was employed among 1064 study participants (35e non-exposed and 711 exposed groups). Cognitive functions of the participants were assessed using Montreal Cognitive Assessment (MoCA) tool. Participants who were in utero and bellow two years of age during the Ethiopian famine were considered as exposed and those born after the famine were considered as non-exposed. The associations of famine exposure during the first 1000 days of life and MoCA score were examined using multiple linear regression analyses. The estimate (β coefficient) and 95% CI were reported to describe associations.

Results: Data from a total of 1047 study subject (350 non-exposed and 697 exposed groups) were collected and included in the analysis. The overall mean MoCA score was 19.1 ± 7.4. It was 17.9 ± 7.4 and 21.1 ± 6.8 for those exposed during the first 1000 days and non-exposed respectively. Accounted for the effect of potential covariates, exposure to famine during the first 1000 days of life was negatively associated with cognitive score during adulthood (β= -1.23, 95% CI: -1.99, -0.45). Among covariates being male (β=1.62, 95% CI: 0.86, 2.32) and higher education (secondary and above) (β= 1.51, 95% CI: 0.39, 2.63) were positively associated with MoCA score.

Conclusions: Famine exposure during prenatal and the first two years of age were associated with MoCA score among adults who survived the Ethiopian great famine. This finding provides further evidence for the hypothesis of developmental origin of adulthood disease including cognitive function. This implies nutrition during prenatal and the first two years of postnatal life plays a pivotal role on cognitive performance in later life.

Key words:  Famine exposure, first 1000 days, cognitive function, DOHaD, Ethiopia