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

Jong Bin Bae; Darren M. Lipnicki; Ji Won Han; Perminder S. Sachdev; Tae Hui Kim; Kyung Phil Kwak; Bong Jo Kim; Shin Gyeom Kim; Jeong Lan Kim; Seok Woo Moon; Joon Hyuk Park; Seung Ho Ryu; Jong Chul Youn; Dong Young Lee; Dong Woo Lee; Seok Bum Lee; Jung Jae Lee; Jin Hyeong Jhoo; Juan J. Llibre-Rodriguez; Jorge J. Llibre-Guerra; Adolfo J. Valhuerdi-Cepero; Karen Ritchie; Marie Laure Ancelin; Isabelle Carriere; Ingmar Skoog; Jenna Najar; Therese Rydberg Sterner; Nikolaos Scarmeas; Mary Yannakoulia; Efthimios Dardiotis; Kenichi Meguro; Mari Kasai; Kei Nakamura; Steffi Riedel-Heller; Susanne Roehr; Alexander Pabst; Martin Van Boxtel; Sebastian Köhler; Ding Ding; Qianhua Zhao; Xiaoniu Liang; Marcia Scazufca; Antonio Lobo; Concepción De-La-Cámara; Elena Lobo; Ki Woong Kim; 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; 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; Richard Mayeux; Nicole Schupf; Ronald Petersen; Richard Lipton; Edwin S. Lowe; Louisa Jorm

doi:10.1186/s12916-020-01671-1

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

Jong Bin Bae, Darren M. Lipnicki, Ji Won Han, Perminder S. Sachdev, Tae Hui Kim, Kyung Phil Kwak, Bong Jo Kim, Shin Gyeom Kim, Jeong Lan Kim, Seok Woo Moon, Joon Hyuk Park, Seung Ho Ryu, Jong Chul Youn, Dong Young Lee, Dong Woo Lee, Seok Bum Lee, Jung Jae Lee, Jin Hyeong Jhoo, Juan J. Llibre-Rodriguez, Jorge J. Llibre-GuerraAdolfo J. Valhuerdi-Cepero, Karen Ritchie, Marie Laure Ancelin, Isabelle Carriere, Ingmar Skoog, Jenna Najar, Therese Rydberg Sterner, Nikolaos Scarmeas, Mary Yannakoulia, Efthimios Dardiotis, Kenichi Meguro, Mari Kasai, Kei Nakamura, Steffi Riedel-Heller, Susanne Roehr, Alexander Pabst, Martin Van Boxtel, Sebastian Köhler, Ding Ding, Qianhua Zhao, Xiaoniu Liang, Marcia Scazufca, Antonio Lobo, Concepción De-La-Cámara, Elena Lobo, Ki Woong Kim, 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, 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, Richard Mayeux, Nicole Schupf, Ronald Petersen, Richard Lipton, Edwin S. Lowe, Louisa Jorm

Neurology

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

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.

Original language	English (US)
Article number	210
Journal	BMC Medicine
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s12916-020-01671-1
State	Published - Aug 5 2020

Keywords

Alzheimer's disease
Dementia
Parity
Risk factors
Women

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12916-020-01671-1

Cite this

Bae, J. B., Lipnicki, D. M., Han, J. W., Sachdev, P. S., Kim, T. H., Kwak, K. P., Kim, B. J., Kim, S. G., Kim, J. L., Moon, S. W., Park, J. H., Ryu, S. H., Youn, J. C., Lee, D. Y., Lee, D. W., Lee, S. B., Lee, J. J., Jhoo, J. H., Llibre-Rodriguez, J. J., ... Jorm, L. (2020). Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study. BMC Medicine, 18(1), Article 210. https://doi.org/10.1186/s12916-020-01671-1

Bae, JB, Lipnicki, DM, Han, JW, Sachdev, PS, Kim, TH, Kwak, KP, Kim, BJ, Kim, SG, Kim, JL, Moon, SW, Park, JH, Ryu, SH, Youn, JC, Lee, DY, Lee, DW, Lee, SB, Lee, JJ, Jhoo, JH, Llibre-Rodriguez, JJ, Llibre-Guerra, JJ, Valhuerdi-Cepero, AJ, Ritchie, K, Ancelin, ML, Carriere, I, Skoog, I, Najar, J, Sterner, TR, Scarmeas, N, Yannakoulia, M, Dardiotis, E, Meguro, K, Kasai, M, Nakamura, K, Riedel-Heller, S, Roehr, S, Pabst, A, Van Boxtel, M, Köhler, S, Ding, D, Zhao, Q, Liang, X, Scazufca, M, Lobo, A, De-La-Cámara, C, Lobo, E, Kim, KW, Makkar, SR, Crawford, JD, Thalamuthu, A, Kochan, NA, Leung, Y, Lo, JW, Turana, Y, Castro-Costa, E, Larijani, B, Nabipour, I, Rockwood, K, Shifu, X, Lipton, RB, Katz, MJ, Preux, PM, Guerchet, M, Lam, L, Ninimiya, T, Walker, R, Hendrie, H, Guaita, A, Chen, LK, Shahar, S, Dominguez, J, Krishna, M, Ganguli, M, Anstey, KJ, Crowe, M, Haan, MN, Kumagai, S, Ng, TP, Brodaty, H, Mayeux, R, Schupf, N, Petersen, R, Lipton, R, Lowe, ES & Jorm, L 2020, 'Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study', BMC Medicine, vol. 18, no. 1, 210. https://doi.org/10.1186/s12916-020-01671-1

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

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",

author = "Bae, {Jong Bin} and Lipnicki, {Darren M.} and Han, {Ji Won} and Sachdev, {Perminder S.} and Kim, {Tae Hui} and Kwak, {Kyung Phil} and Kim, {Bong Jo} and Kim, {Shin Gyeom} and Kim, {Jeong Lan} and Moon, {Seok Woo} and Park, {Joon Hyuk} and Ryu, {Seung Ho} and Youn, {Jong Chul} and Lee, {Dong Young} and Lee, {Dong Woo} and Lee, {Seok Bum} and Lee, {Jung Jae} and Jhoo, {Jin Hyeong} and Llibre-Rodriguez, {Juan J.} and Llibre-Guerra, {Jorge J.} and Valhuerdi-Cepero, {Adolfo J.} and Karen Ritchie and Ancelin, {Marie Laure} and Isabelle Carriere and Ingmar Skoog and Jenna Najar and Sterner, {Therese Rydberg} and Nikolaos Scarmeas and Mary Yannakoulia and Efthimios Dardiotis and Kenichi Meguro and Mari Kasai and Kei Nakamura and Steffi Riedel-Heller and Susanne Roehr and Alexander Pabst and {Van Boxtel}, Martin and Sebastian K{\"o}hler and Ding Ding and Qianhua Zhao and Xiaoniu Liang and Marcia Scazufca and Antonio Lobo and Concepci{\'o}n De-La-C{\'a}mara and Elena Lobo and Kim, {Ki Woong} and Makkar, {Steve R.} and Crawford, {John D.} and Anbupalam Thalamuthu and Kochan, {Nicole A.} and Yvonne Leung and Lo, {Jessica W.} and Yuda Turana and Erico Castro-Costa and Bagher Larijani and Iraj Nabipour and Kenneth Rockwood and Xiao Shifu and Lipton, {Richard B.} and Katz, {Mindy J.} and Preux, {Pierre Marie} and Ma{\"e}lenn Guerchet and Linda Lam and Toshiharu Ninimiya and Richard Walker and Hugh Hendrie and Antonio Guaita and Chen, {Liang Kung} and Suzana Shahar and Jacqueline Dominguez and Murali Krishna and Mary Ganguli and Anstey, {Kaarin J.} and Michael Crowe and Haan, {Mary N.} and Shuzo Kumagai and Ng, {Tze Pin} and Henry Brodaty and Richard Mayeux and Nicole Schupf and Ronald Petersen and Richard Lipton and Lowe, {Edwin S.} and Louisa Jorm",

note = "Publisher Copyright: {\textcopyright} 2020 The Author(s).",

year = "2020",

month = aug,

day = "5",

doi = "10.1186/s12916-020-01671-1",

language = "English (US)",

volume = "18",

journal = "BMC Medicine",

issn = "1741-7015",

publisher = "BioMed Central",

number = "1",

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TY - JOUR

T1 - Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study

AU - Bae, Jong Bin

AU - Lipnicki, Darren M.

AU - Han, Ji Won

AU - Sachdev, Perminder S.

AU - Kim, Tae Hui

AU - Kwak, Kyung Phil

AU - Kim, Bong Jo

AU - Kim, Shin Gyeom

AU - Kim, Jeong Lan

AU - Moon, Seok Woo

AU - Park, Joon Hyuk

AU - Ryu, Seung Ho

AU - Youn, Jong Chul

AU - Lee, Dong Young

AU - Lee, Dong Woo

AU - Lee, Seok Bum

AU - Lee, Jung Jae

AU - Jhoo, Jin Hyeong

AU - Llibre-Rodriguez, Juan J.

AU - Llibre-Guerra, Jorge J.

AU - Valhuerdi-Cepero, Adolfo J.

AU - Ritchie, Karen

AU - Ancelin, Marie Laure

AU - Carriere, Isabelle

AU - Skoog, Ingmar

AU - Najar, Jenna

AU - Sterner, Therese Rydberg

AU - Scarmeas, Nikolaos

AU - Yannakoulia, Mary

AU - Dardiotis, Efthimios

AU - Meguro, Kenichi

AU - Kasai, Mari

AU - Nakamura, Kei

AU - Riedel-Heller, Steffi

AU - Roehr, Susanne

AU - Pabst, Alexander

AU - Van Boxtel, Martin

AU - Köhler, Sebastian

AU - Ding, Ding

AU - Zhao, Qianhua

AU - Liang, Xiaoniu

AU - Scazufca, Marcia

AU - Lobo, Antonio

AU - De-La-Cámara, Concepción

AU - Lobo, Elena

AU - Kim, Ki Woong

AU - Makkar, Steve R.

AU - Crawford, John D.

AU - Thalamuthu, Anbupalam

AU - Kochan, Nicole A.

AU - Leung, Yvonne

AU - Lo, Jessica W.

AU - Turana, Yuda

AU - Castro-Costa, Erico

AU - Larijani, Bagher

AU - Nabipour, Iraj

AU - Rockwood, Kenneth

AU - Shifu, Xiao

AU - Lipton, Richard B.

AU - Katz, Mindy J.

AU - Preux, Pierre Marie

AU - Guerchet, Maëlenn

AU - Lam, Linda

AU - Ninimiya, Toshiharu

AU - Walker, Richard

AU - Hendrie, Hugh

AU - Guaita, Antonio

AU - Chen, Liang Kung

AU - Shahar, Suzana

AU - Dominguez, Jacqueline

AU - Krishna, Murali

AU - Ganguli, Mary

AU - Anstey, Kaarin J.

AU - Crowe, Michael

AU - Haan, Mary N.

AU - Kumagai, Shuzo

AU - Ng, Tze Pin

AU - Brodaty, Henry

AU - Mayeux, Richard

AU - Schupf, Nicole

AU - Petersen, Ronald

AU - Lipton, Richard

AU - Lowe, Edwin S.

AU - Jorm, Louisa

PY - 2020/8/5

Y1 - 2020/8/5

N2 - 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.

AB - 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.

KW - Alzheimer's disease

KW - Dementia

KW - Parity

KW - Risk factors

KW - Women

UR - http://www.scopus.com/inward/record.url?scp=85089131489&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85089131489&partnerID=8YFLogxK

U2 - 10.1186/s12916-020-01671-1

DO - 10.1186/s12916-020-01671-1

M3 - Article

C2 - 32753059

AN - SCOPUS:85089131489

SN - 1741-7015

VL - 18

JO - BMC Medicine

JF - BMC Medicine

IS - 1

M1 - 210

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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