Division of Biological Anthropology, University of Cambridge, Cambridge, UK.
J Alzheimers Dis. 2013;37(4):809-21. doi: 10.3233/JAD-130152.
The effect of early and midlife factors on later-life cognitive function has attracted scientific and public interest in recent years, especially with respect to hormonal risk factors for dementia. There is substantial evidence for reproductive history affecting Alzheimer's disease (AD) etiology. Here, we demonstrate how breastfeeding history affects women's risk of AD. Reproductive history data was collected, and AD diagnostic interviews were performed, for a cohort of elderly British women. Using Cox proportional-hazard models, we find that longer breastfeeding duration corresponded to reduced risk of AD (p < 0.01, n = 81). Women who breastfed had lower AD risk than women who did not breastfeed (p = 0.017, n = 81). Breastfeeding practices are an important modifier of cumulative endogenous hormone exposure for mothers. Ovarian hormone deprivation and/or insulin sensitivity benefits of breastfeeding may be responsible for the observed reduction in AD risk. Future studies concerning hormone effects on AD risk should consider how reproductive history leads to variation in endogenous hormone exposure and how this may influence the relationship between hormones and AD.
近年来，早期和中年因素对晚年认知功能的影响引起了科学界和公众的兴趣，特别是与痴呆症的激素风险因素有关。有大量证据表明，生育史会影响阿尔茨海默病（AD）的病因。在这里，我们展示了哺乳史如何影响女性患 AD 的风险。我们为一群英国老年女性收集了生育史数据，并进行了 AD 诊断访谈。使用 Cox 比例风险模型，我们发现母乳喂养时间越长，AD 风险越低（p < 0.01，n = 81）。与未母乳喂养的女性相比，母乳喂养的女性患 AD 的风险更低（p = 0.017，n = 81）。母乳喂养的做法是母亲内源性激素暴露累积的重要调节剂。母乳喂养可能会降低卵巢激素剥夺和/或胰岛素敏感性的风险，这可能是导致 AD 风险降低的原因。未来关于激素对 AD 风险影响的研究应考虑生育史如何导致内源性激素暴露的变化，以及这如何影响激素与 AD 之间的关系。
