. 2020 Aug 5;18(1):210.

doi: 10.1186/s12916-020-01671-1.

Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study

Jong Bin Bae^{1

2}, Darren M Lipnicki³, Ji Won Han^{1

2}, Perminder S Sachdev^{3

4}, Tae Hui Kim⁵, Kyung Phil Kwak⁶, Bong Jo Kim⁷, Shin Gyeom Kim⁸, Jeong Lan Kim⁹, Seok Woo Moon¹⁰, Joon Hyuk Park¹¹, Seung-Ho Ryu¹², Jong Chul Youn¹³, Dong Young Lee^{2

14}, Dong Woo Lee¹⁵, Seok Bum Lee¹⁶, Jung Jae Lee¹⁶, Jin Hyeong Jhoo¹⁷, Juan J Llibre-Rodriguez¹⁸, Jorge J Llibre-Guerra^{19

20}, Adolfo J Valhuerdi-Cepero²¹, Karen Ritchie^{22

23}, Marie-Laure Ancelin²², Isabelle Carriere²², Ingmar Skoog²⁴, Jenna Najar²⁴, Therese Rydberg Sterner²⁴, Nikolaos Scarmeas^{25

26}, Mary Yannakoulia²⁷, Efthimios Dardiotis²⁸, Kenichi Meguro²⁹, Mari Kasai²⁹, Kei Nakamura²⁹, Steffi Riedel-Heller³⁰, Susanne Roehr³⁰, Alexander Pabst³⁰, Martin van Boxtel³¹, Sebastian Köhler³¹, Ding Ding^{32

33}, Qianhua Zhao^{32

33}, Xiaoniu Liang^{32

33}, Marcia Scazufca³⁴, Antonio Lobo^{35

36

37}, Concepción De-la-Cámara^{35

36

37}, Elena Lobo^{35

36

37}, Ki Woong Kim^{38

39

40}; for Cohort Studies of Memory in an International Consortium (COSMIC)

Collaborators, Affiliations

Collaborators

for Cohort Studies of Memory in an International Consortium (COSMIC):
Perminder S Sachdev, Darren M Lipnicki, Steve R Makkar, John D Crawford, Anbupalam Thalamuthu, Nicole A Kochan, Yvonne Leung, Jessica W Lo, Yuda Turana, Erico Castro-Costa, Bagher Larijani, Iraj Nabipour, Kenneth Rockwood, Xiao Shifu, Richard B Lipton, Mindy J Katz, Pierre-Marie Preux, Maëlenn Guerchet, Linda Lam, Ingmar Skoog, Toshiharu Ninimiya, Richard Walker, Hugh Hendrie, Antonio Guaita, Liang-Kung Chen, Suzana Shahar, Jacqueline Dominguez, Murali Krishna, Mary Ganguli, Kaarin J Anstey, Michael Crowe, Mary N Haan, Shuzo Kumagai, Tze Pin Ng, Henry Brodaty, Kenichi Meguro, Richard Mayeux, Nicole Schupf, Perminder Sachdev, Mary Ganguli, Ronald Petersen, Richard Lipton, Edwin S Lowe, Karen Ritchie, Ki-Woong Kim, Louisa Jorm, Henry Brodaty

Affiliations

¹ Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
² Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea.
³ Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
⁴ Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia.
⁵ Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea.
⁶ Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea.
⁷ Department of Psychiatry, School of Medicine, Gyeongsang National University, Jinju, South Korea.
⁸ Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
⁹ Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea.
¹⁰ Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Chungju Hospital, Chungju, South Korea.
¹¹ Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea.
¹² Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Medical Center, Seoul, South Korea.
¹³ Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea.
¹⁴ Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.
¹⁵ Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea.
¹⁶ Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea.
¹⁷ Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, South Korea.
¹⁸ Finlay-Albarrán Faculty of Medical Sciences, Medical University of Havana, Havana, Cuba.
¹⁹ Institute of Neurology and Neurosurgery, Havana, Cuba.
²⁰ Medical University of Matanzas, Matanzas, Cuba.
²¹ Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA.
²² Inserm U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier, France.
²³ Department of Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
²⁴ Department of Psychiatry and Neurochemistry, Institute of Neuroscience of Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden.
²⁵ 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
²⁶ Department of Neurology, Columbia University, New York, USA.
²⁷ Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
²⁸ Neurology Department, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
²⁹ Geriatric Behavioral Neurology, Tohoku University, Sendai, Japan.
³⁰ Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.
³¹ Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, Netherlands.
³² Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
³³ National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
³⁴ University of São Paulo, São Paulo, Brazil.
³⁵ Universidad de Zaragoza, Zaragoza, Spain.
³⁶ Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain.
³⁷ Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
³⁸ Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea. kwkimmd@snu.ac.kr.
³⁹ Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea. kwkimmd@snu.ac.kr.
⁴⁰ Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea. kwkimmd@snu.ac.kr.

PMID: 32753059
PMCID: PMC7406389
DOI: 10.1186/s12916-020-01671-1

Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study

Jong Bin Bae et al. BMC Med. 2020.

. 2020 Aug 5;18(1):210.

doi: 10.1186/s12916-020-01671-1.

Authors

Collaborators

for Cohort Studies of Memory in an International Consortium (COSMIC):
Perminder S Sachdev, Darren M Lipnicki, Steve R Makkar, John D Crawford, Anbupalam Thalamuthu, Nicole A Kochan, Yvonne Leung, Jessica W Lo, Yuda Turana, Erico Castro-Costa, Bagher Larijani, Iraj Nabipour, Kenneth Rockwood, Xiao Shifu, Richard B Lipton, Mindy J Katz, Pierre-Marie Preux, Maëlenn Guerchet, Linda Lam, Ingmar Skoog, Toshiharu Ninimiya, Richard Walker, Hugh Hendrie, Antonio Guaita, Liang-Kung Chen, Suzana Shahar, Jacqueline Dominguez, Murali Krishna, Mary Ganguli, Kaarin J Anstey, Michael Crowe, Mary N Haan, Shuzo Kumagai, Tze Pin Ng, Henry Brodaty, Kenichi Meguro, Richard Mayeux, Nicole Schupf, Perminder Sachdev, Mary Ganguli, Ronald Petersen, Richard Lipton, Edwin S Lowe, Karen Ritchie, Ki-Woong Kim, Louisa Jorm, Henry Brodaty

Affiliations

¹ Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
² Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea.
³ Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
⁴ Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia.
⁵ Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea.
⁶ Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea.
⁷ Department of Psychiatry, School of Medicine, Gyeongsang National University, Jinju, South Korea.
⁸ Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
⁹ Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea.
¹⁰ Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Chungju Hospital, Chungju, South Korea.
¹¹ Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea.
¹² Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Medical Center, Seoul, South Korea.
¹³ Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea.
¹⁴ Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.
¹⁵ Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea.
¹⁶ Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea.
¹⁷ Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, South Korea.
¹⁸ Finlay-Albarrán Faculty of Medical Sciences, Medical University of Havana, Havana, Cuba.
¹⁹ Institute of Neurology and Neurosurgery, Havana, Cuba.
²⁰ Medical University of Matanzas, Matanzas, Cuba.
²¹ Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA.
²² Inserm U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier, France.
²³ Department of Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
²⁴ Department of Psychiatry and Neurochemistry, Institute of Neuroscience of Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden.
²⁵ 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
²⁶ Department of Neurology, Columbia University, New York, USA.
²⁷ Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
²⁸ Neurology Department, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
²⁹ Geriatric Behavioral Neurology, Tohoku University, Sendai, Japan.
³⁰ Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.
³¹ Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, Netherlands.
³² Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
³³ National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
³⁴ University of São Paulo, São Paulo, Brazil.
³⁵ Universidad de Zaragoza, Zaragoza, Spain.
³⁶ Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain.
³⁷ Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
³⁸ Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea. kwkimmd@snu.ac.kr.
³⁹ Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea. kwkimmd@snu.ac.kr.
⁴⁰ Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea. kwkimmd@snu.ac.kr.

PMID: 32753059
PMCID: PMC7406389
DOI: 10.1186/s12916-020-01671-1

Abstract

Background: Dementia shows sex difference in its epidemiology. Childbirth, a distinctive experience of women, is associated with the risk for various diseases. However, its association with the risk of dementia in women has rarely been studied.

Methods: We harmonized and pooled baseline data from 11 population-based cohorts from 11 countries over 3 continents, including 14,792 women aged 60 years or older. We investigated the association between parity and the risk of dementia using logistic regression models that adjusted for age, educational level, hypertension, diabetes mellitus, and cohort, with additional analyses by region and dementia subtype.

Results: Across all cohorts, grand multiparous (5 or more childbirths) women had a 47% greater risk of dementia than primiparous (1 childbirth) women (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.10-1.94), while nulliparous (no childbirth) women and women with 2 to 4 childbirths showed a comparable dementia risk to primiparous women. However, there were differences associated with region and dementia subtype. Compared to women with 1 to 4 childbirths, grand multiparous women showed a higher risk of dementia in Europe (OR = 2.99, 95% CI = 1.38-6.47) and Latin America (OR = 1.49, 95% CI = 1.04-2.12), while nulliparous women showed a higher dementia risk in Asia (OR = 2.15, 95% CI = 1.33-3.47). Grand multiparity was associated with 6.9-fold higher risk of vascular dementia in Europe (OR = 6.86, 95% CI = 1.81-26.08), whereas nulliparity was associated with a higher risk of Alzheimer disease (OR = 1.91, 95% CI 1.07-3.39) and non-Alzheimer non-vascular dementia (OR = 3.47, 95% CI = 1.44-8.35) in Asia.

Conclusion: Parity is associated with women's risk of dementia, though this is not uniform across regions and dementia subtypes.

Keywords: Alzheimer’s disease; Dementia; Parity; Risk factors; Women.

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Conflict of interest statement

All authors declare no competing financial interests.

References

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Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study

Collaborators

Affiliations

Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical