Advanced paternal age associated with adverse academic and psychiatric outcomes

Image: PD 

1. Children born to older fathers were more likely to develop adverse psychiatric and academic outcomes, including ADHD, autism, and psychosis, compared with their younger siblings. 

2. The magnitude of the risk was dose-dependent with increasing paternal age.  

Evidence Rating Level: 1 (Excellent)     

Study Rundown: In this population based cohort study out of Sweden, researchers found advanced paternal age was associated with ADHD, autism, psychosis, bipolar disorder, and low academic achievement in offspring. This is one of the largest studies on the effects of advanced paternal age and one of the first to assess incidences of psychiatric and academic outcomes specifically. Comparison of outcomes between siblings and first-born siblings is a strength. Future investigations might employ a more diverse study population, both ethnically and socioeconomically, while basic science investigations might expand on the mechanism suggested herein (increased genetic mutations in advanced-aged sperm) via microarray analysis of sperm in the same man at different times in the lifecourse.

Click to read the study in JAMA Psychiatry

Relevant Reading: Critical need for family-based, quasi-experimental designs in integrating genetic and social science research

Study Author, Dr. Brian M. D’Onofrio, PhD, talks to 2 Minute Medicine: Indiana University, Bloomington, Department of Psychological and Brain Sciences 

“This study adds to a growing body of research that suggests families, doctors, and society as a whole must consider both the pros and cons of delaying childbearing. Certainly delaying childbearing is associated with benefits such as advanced educational attainment and financial security for the parents. But, the implications of this study and others suggest that it may also be associated with increased risk for psychiatric and academic problems in offspring.”

In-Depth [cohort study]: Researchers used population based-registries to examine the association between paternal age at childbearing and psychiatric and academic morbidity in 2,615,081 offspring born in Sweden between 1973 and 2001 (89.6% of the population). The primary outcomes included psychiatric (autism, ADHD, psychosis, bipolar disorder, suicide attempt, and substance use problems) and academic (failing grades and low educational attainment) indices of morbidity.

Siblings born to fathers aged 45 years and older were more likely to be diagnosed with autism (HR:3.45, CI:1.62-7.33), ADHD (HR:13.13, CI:6.85-25.16), psychosis (HR:2.07, CI:1.35-3.20), bipolar disorder (HR:24.70, CI:12.12-50.31), suicide attempts (HR:2.72, CI:2.08-3.56), substance use problems (HR:2.44, CI:1.98-2.99) and to have failing grades (OR:1.59, 95%CI: 1.37-1.85) compared to siblings born to fathers 20-24 years old. These associations modeled a dose-dependent relationship, whereby hazard and odds ratios increased by paternal age for every index of morbidity.

More from this author: SSRI use during pregnancy not associated with fetal, neonatal or infant mortality, IUD contraception equally effective in teenagers as in older women, More US women using emergency contraception, Updated USPSTF guidelines favor treatment of mild gestational diabetes 

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