You Wenpeng
School of Biomedicine The University of Adelaide Adelaide South Australia Australia.
Health Sci Rep. 2025 Aug 6;8(8):e71145. doi: 10.1002/hsr2.71145. eCollection 2025 Aug.
Reproductive history, including age at first childbirth, may be associated with female dementia prevalence and sex disparities. This study investigates the relationship between reproductive timing and dementia outcomes, emphasizing socioeconomic and cultural influences, particularly in low- and middle-income countries (LMICs) where disparities in healthcare and education may exacerbate risks.
Country-level ecological analysis was conducted using data from 204 countries. Variables were sourced from international databases, including the Institute for Health Metrics and Evaluation (IHME), the United Nations, and the World Bank. The primary outcomes were female dementia prevalence and sex disparity in dementia prevalence. Predictor variables included age at first childbirth, ageing in females, economic affluence, genetic predisposition, and urban living. Statistical methods included scatterplots, correlation analyses, partial correlations, stepwise multiple regression, and principal component analysis.
Later age at first childbirth was strongly associated with increased female dementia prevalence (² = 0.7314, = 126) and greater sex disparity in dementia outcomes (² = 0.6362, = 126). Subgroup analyses revealed stronger associations in LMICs than in high-income countries. Economic affluence was positively associated with both later age at first childbirth and higher female dementia prevalence. Other variables, such as ageing and genetic predisposition, also showed independent associations.
Delayed age at first childbirth is significantly associated with higher female dementia prevalence and sex disparities, particularly in LMICs. These findings highlight the need for individual-level, longitudinal studies to explore potential causal pathways and to inform sex-sensitive public health strategies for dementia prevention across diverse global contexts.
生殖史，包括首次生育年龄，可能与女性痴呆症患病率及性别差异有关。本研究调查生殖时间与痴呆症结局之间的关系，强调社会经济和文化影响，尤其是在低收入和中等收入国家（LMICs），那里医疗保健和教育方面的差异可能会加剧风险。
利用来自204个国家的数据进行国家级生态分析。变量来自国际数据库，包括健康指标与评估研究所（IHME）、联合国和世界银行。主要结局是女性痴呆症患病率及痴呆症患病率的性别差异。预测变量包括首次生育年龄、女性老龄化、经济富裕程度、遗传易感性和城市生活。统计方法包括散点图、相关性分析、偏相关性分析、逐步多元回归和主成分分析。
首次生育年龄较晚与女性痴呆症患病率增加（r² = 0.7314，n = 126）及痴呆症结局中更大的性别差异（r² = 0.6362，n = 126）密切相关。亚组分析显示，与高收入国家相比，低收入和中等收入国家的相关性更强。经济富裕程度与首次生育年龄较晚及女性痴呆症患病率较高均呈正相关。其他变量，如老龄化和遗传易感性，也显示出独立的相关性。
首次生育年龄延迟与女性痴呆症患病率较高及性别差异显著相关，尤其是在低收入和中等收入国家。这些发现凸显了开展个体层面纵向研究的必要性，以探索潜在的因果途径，并为全球不同背景下预防痴呆症的性别敏感型公共卫生策略提供依据。
