Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea.
Epidemiol Psychiatr Sci. 2020 Oct 20;29:e176. doi: 10.1017/S2045796020000876.
To investigate the association between parity and the risk of incident dementia in women.
We pooled baseline and follow-up data for community-dwelling women aged 60 or older from six population-based, prospective cohort studies from four European and two Asian countries. We investigated the association between parity and incident dementia using Cox proportional hazards regression models adjusted for age, educational level, hypertension, diabetes mellitus and cohort, with additional analysis by dementia subtype (Alzheimer dementia (AD) and non-Alzheimer dementia (NAD)).
Of 9756 women dementia-free at baseline, 7010 completed one or more follow-up assessments. The mean follow-up duration was 5.4 ± 3.1 years and dementia developed in 550 participants. The number of parities was associated with the risk of incident dementia (hazard ratio (HR) = 1.07, 95% confidence interval (CI) = 1.02-1.13). Grand multiparity (five or more parities) increased the risk of dementia by 30% compared to 1-4 parities (HR = 1.30, 95% CI = 1.02-1.67). The risk of NAD increased by 12% for every parity (HR = 1.12, 95% CI = 1.02-1.23) and by 60% for grand multiparity (HR = 1.60, 95% CI = 1.00-2.55), but the risk of AD was not significantly associated with parity.
Grand multiparity is a significant risk factor for dementia in women. This may have particularly important implications for women in low and middle-income countries where the fertility rate and prevalence of grand multiparity are high.
探讨生育次数与女性发生痴呆的风险之间的关联。
我们汇集了来自四个欧洲国家和两个亚洲国家的六项基于人群的前瞻性队列研究中 60 岁及以上的社区居住女性的基线和随访数据。我们使用 Cox 比例风险回归模型，根据年龄、教育水平、高血压、糖尿病和队列调整生育次数与痴呆发生的相关性，通过痴呆亚型（阿尔茨海默病痴呆（AD）和非阿尔茨海默病痴呆（NAD））进行了进一步分析。
在基线时无痴呆的 9756 名女性中，有 7010 名完成了一次或多次随访评估。平均随访时间为 5.4±3.1 年，550 名参与者发生了痴呆。生育次数与发生痴呆的风险相关（风险比（HR）=1.07，95%置信区间（CI）=1.02-1.13）。与 1-4 次生育相比，多胎生育（5 次或更多次生育）使痴呆的风险增加了 30%（HR=1.30，95%CI=1.02-1.67）。每增加一次生育，NAD 的风险增加 12%（HR=1.12，95%CI=1.02-1.23），多胎生育增加 60%（HR=1.60，95%CI=1.00-2.55），但 AD 的风险与生育次数无显著相关性。
多胎生育是女性痴呆的一个重要危险因素。这对于生育率和多胎生育率较高的中低收入国家的女性来说可能具有特别重要的意义。
