Zhou Rui, Liu Hua-Min, Zou Lian-Wu, Wei Hong-Xia, Huang Yi-Ning, Zhong Qi, Gu Shan-Yuan, Chen Ming-Feng, Wang Shao-Li, Sun Hai-Xia, Wu Xian-Bo
Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China.
Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, China.
Front Aging Neurosci. 2022 May 4;14:864128. doi: 10.3389/fnagi.2022.864128. eCollection 2022.
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.
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.
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 ( < 0.01). Similarly, a parity of 1-3 and ≥4 was related to slower cognitive decline (β = 0.164, 0.292, respectively, < 0.05).
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.
关于生育次数与轻度认知障碍（MCI）或痴呆风险之间关联的证据并不一致，且生育次数与认知功能纵向变化之间的关系尚不清楚。我们在一大群老年女性中对这些问题进行了调查，这些女性被密切监测MCI和可能的痴呆症的发展情况。
利用女性健康倡议记忆研究，纳入了7100名绝经后女性（平均年龄70.1±3.8岁），她们有基线生育次数（定义为足月妊娠次数）的信息、1996 - 2007年的整体认知测量（改良简易精神状态检查评分）以及1996 - 2016年的认知障碍（经中央判定的MCI和痴呆诊断）。使用多变量线性混合效应模型分析整体认知的变化率。使用Cox回归模型评估不同生育次数组中MCI/痴呆的风险。
平均随访10.5年期间，共确定了465例MCI/痴呆新病例。与未生育女性相比，生育次数为1 - 3次和≥4次的女性患MCI/痴呆的风险较低。风险比分别为0.75（0.56 - 0.99）和0.71（0.53 - 0.96）（P<0.01）。同样，生育次数为1 - 3次和≥4次与认知功能下降较慢有关（β分别为0.164、0.292，P<0.05）。
生育次数较多可降低老年女性未来患MCI/痴呆的风险，并减缓认知功能下降速度。未来需要开展研究以确定生育次数如何影响女性晚年的认知功能。
