Paternal age and mental health of offspring

Paternal aging predicts increasing risks for offspring schizophrenia, autism, bipolar disorder, and other behavioral conditions. De novo mutations are implicated, but other interrelated factors are being studied, including paternal age at marriage, duration of marriage, and maternal age.

Dolores Malaspina, M.D., M.S.P.H., Caitlin Gilman, M.D., M.P.H., Thorsten Manfred Kranz, Ph.D.

Volume 103, Issue 6, Pages 1392-1396


The influence of paternal age on the risk for sporadic forms of Mendelian disorders is well known, but a burgeoning recent literature demonstrates, in addition, a paternal age effect for complex neuropsychiatric conditions, including schizophrenia, autism, bipolar disorder, and even for learning potential, expressed as intelligence. Mental illness is costly to patients, their family, and the public health system, accounting for the largest portion of disability costs in our economy. The delayed onset of neuropsychiatric conditions and lack of physical manifestations at birth are common frequencies in the population that have obscured the recognition that a portion of the risks for mental conditions is associated with paternal age. Identification of these risk pathways may be leveraged for knowledge about mental function and for future screening tests. However, only a small minority of at-risk offspring are likely to have such a psychiatric or learning disorder attributable to paternal age, including the children of older fathers.

  • We have counseled couples for a long time about the risk of advanced maternal age on the offspring. However, this article focuses the attention to male age as also being an important counseling point for our couples – males are not exempt from negatively contributing to psychiatric and behavioral disorders as they age.

    Couples must be made aware of a tripling of the rate of neuropsychiatric disorders with advanced paternal age. What is concerning are the likely under-reported rates due to the delayed presentation of many of these disorders. This is of utmost importance especially when we counsel our 40+ year old vasectomy reversal candidates who desire fertility restoration to have additional children with their younger partners.

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