Early-life origins of brain resilience to mental illness and cognitive impairment across the life-course

Research in children in North America using brain scanning has shown that the brain develops less well and has a smaller surface area in children of families with less income. This result was not found in a study from Norway, where there is greater socioeconomic equality. Our own research has shown that being poor as a child is associated with more brain abnormalities in later life, which are associated with depression and dementia. Countries such as India are experiencing a rapid rise in what were considered "Western diseases", such as diabetes, combined with an increase in older people. In addition, there remain significant disparities in socioeconomic circumstance, access to education and healthcare. Researchers in the UK, in Mysore and in Mumbai have established groups of normal people (cohorts) at different ages and from different socioeconomic circumstances that have already provided much evidence on the early life origins of later life diseases, such as heart disease and diabetes. Here we will carry out work that will pave the way for a future large-scale study of mental health and thinking (cognitive) abilities in these groups. Concentrating on the Mysore groups in this application, we plan four projects that will help us design our future project to include people in Mysore and Mumbai.

1. We will invite a small number of the younger and older Mysore cohorts to have a brain scan first to find out how acceptable scanning is for them and secondly as a pilot study to test whether early life circumstances influence measurable changes on brain scans. We will investigate what factors in early life (such as your father's job, your birth weight) predict brain scan appearances.

2. By speaking with participants we will find out what people who are part of these informative cohorts think about volunteering for brain scans, blood tests and new computer tests of their thinking (cognitive) abilities. We will ask them how they view keeping information about them on a computer and their opinions of combining this information with other health and education information about them. We will also take account of local permissions, participants' and researchers' views on creation of a future database that allows their information to be securely stored, transferred between institutions in India and anonymously available to future researchers. Such a collection of information would grow over time and allow future research to answer our question about the impact of early life environment on important mental health outcomes.

3. Provided participants agree, we will collect blood samples, cheek scrape samples, repeat tests of thinking abilities and depressive symptoms to add to existing research records and to allow us to calculate how many scans and tests would be needed in a future large-scale study to provide meaningful information. We will also take account of local permissions, participants' and researchers' views on creation of a future database that allows this information to be securely stored, transferred between institutions in India and anonymously available to future researchers.

4. We will host a workshop at the University of Aberdeen for investigators from India and Aberdeen to discuss and plan analysis of the extensive information available in these participants and how we best design a data analysis plan, based on pilot data, existing expertise on "big data" approaches and meaningful statistical analysis for a future large-scale application to address our research question.

The work we propose here will provide the preparatory work for a future study to discover what aspects of early life environment can be modified to reduce mental illness and cognitive decline in India. This addresses three of the Sustainable Development Goals: i) Goal 3-to ensure healthy lives and promote well-being for all at all ages; ii) Goal 4-to promote lifelong learning opportunities for all; iii) Goal 10-to reduce inequalities.