@article{3104043,
    title = "Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study",
    author = "Bae, J.B. and Lipnicki, D.M. and Han, J.W. and Sachdev, P.S. and Kim, T.H. and Kwak, K.P. and Kim, B.J. and Kim, S.G. and Kim, J.L. and Moon, S.W. and Park, J.H. and Ryu, S.-H. and Youn, J.C. and Lee, D.Y. and Lee, D.W. and Lee, S.B. and Lee, J.J. and Jhoo, J.H. and Llibre-Rodriguez, J.J. and Llibre-Guerra, J.J. and Valhuerdi-Cepero, A.J. and Ritchie, K. and Ancelin, M.-L. and Carriere, I. and Skoog, I. and Najar, J. and Sterner, T.R. and Scarmeas, N. and Yannakoulia, M. and Dardiotis, E. and Meguro, K. and Kasai, M. and Nakamura, K. and Riedel-Heller, S. and Roehr, S. and Pabst, A. and Van Boxtel, M. and Köhler, S. and Ding, D. and Zhao, Q. and Liang, X. and Scazufca, M. and Lobo, A. and De-La-Cámara, C. and Lobo, E. and Kim, K.W. and Makkar, S.R. and Crawford, J.D. and Thalamuthu, A. and Kochan, N.A. and Leung, Y. and Lo, J.W. and Turana, Y. and Castro-Costa, E. and Larijani, B. and Nabipour, I. and Rockwood, K. and Shifu, X. and Lipton, R.B. and Katz, M.J. and Preux, P.-M. and Guerchet, M. and Lam, L. and Ninimiya, T. and Walker, R. and Hendrie, H. and Guaita, A. and Chen, L.-K. and Shahar, S. and Dominguez, J. and Krishna, M. and Ganguli, M. and Anstey, K.J. and Crowe, M. and Haan, M.N. and Kumagai, S. and Ng, T.P. and Brodaty, H. and Mayeux, R. and Schupf, N. and Petersen, R. and Lipton, R. and Lowe, E.S. and Jorm, L.",
    journal = "BMC Medicine",
    year = "2020",
    volume = "18",
    number = "1",
    publisher = "BioMed Central Ltd.",
    issn = "1741-7015",
    doi = "10.1186/s12916-020-01671-1",
    keywords = "adult;  age;  Article;  Asia;  childbirth;  cohort analysis;  controlled study;  dementia;  diabetes mellitus;  disease association;  educational status;  Europe;  female;  high risk population;  human;  hypertension;  major clinical study;  multiinfarct dementia;  nullipara;  parity;  population research;  primipara;  prospective study;  risk factor;  South and Central America;  dementia;  genetics;  middle aged;  parity;  pathology, Cohort Studies;  Dementia;  Female;  Humans;  Middle Aged;  Parity;  Risk Factors",
    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. © 2020 The Author(s)."
}