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. 2022 May 4:14:864128.
doi: 10.3389/fnagi.2022.864128. eCollection 2022.

Associations of Parity With Change in Global Cognition and Incident Cognitive Impairment in Older Women

Rui Zhou  1 , Hua-Min Liu  1 , Lian-Wu Zou  2 , Hong-Xia Wei  3 , Yi-Ning Huang  1 , Qi Zhong  1 , Shan-Yuan Gu  4 , Ming-Feng Chen  2 , Shao-Li Wang  5 , Hai-Xia Sun  6 , Xian-Bo Wu  1
Affiliations

Associations of Parity With Change in Global Cognition and Incident Cognitive Impairment in Older Women

Rui Zhou et al. Front Aging Neurosci. .

Abstract

Background: The evidence of the association between parity and risk of mild cognitive impairment (MCI) or dementia is mixed, and the relationship between parity and longitudinal cognitive changes is less clear. We investigated these issues in a large population of older women who were carefully monitored for development of MCI and probable dementia.

Methods: Using the Women's Health Initiative Memory Study, 7,100 postmenopausal women (mean age 70.1 ± 3.8 years) with information on baseline parity (defined as the number of term pregnancies), measures of global cognition (Modified Mini-Mental State Examination score) from 1996-2007, and cognitive impairment (centrally adjudicated diagnoses of MCI and dementia) from 1996-2016 were included. Multivariable linear mixed-effects models were used to analyze the rate of changes in global cognition. Cox regression models were used to evaluate the risk of MCI/dementia across parity groups.

Results: Over an average of 10.5 years, 465 new cases of MCI/dementia were identified. Compared with nulliparous women, those with a parity of 1-3 and ≥4 had a lower MCI/dementia risk. The HRs were 0.75 (0.56-0.99) and 0.71 (0.53-0.96), respectively (P < 0.01). Similarly, a parity of 1-3 and ≥4 was related to slower cognitive decline (β = 0.164, 0.292, respectively, P < 0.05).

Conclusion: Higher parity attenuated the future risk for MCI/dementia and slowed the rates of cognitive decline in elderly women. Future studies are needed to determine how parity affects late-life cognitive function in women.

Keywords: cognitive decline; cognitive impairment; dementia; epidemiology; parity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart.
FIGURE 2
FIGURE 2
Kaplan–Meier curves of survival to MCI/PD onset over the follow-up stratified by parity groups. MCI, mild cognitive impairment; PD, probable dementia.
FIGURE 3
FIGURE 3
Subgroup analysis of the associations between parity groups and incident MCI/dementia. aMaximum of likelihood ratios test was used to detect the significance of the interaction effect. Models were adjusted for age, race, educational level, employment status, family income, marital status, social support construct scores, age at menopause, BMI, smoking status, alcohol consumption, physical activities, hypertension, DM, CVD, depression, lipid-lowering medication history, and hormone therapy treatment assignment.
See this image and copyright information in PMC

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