• Jong Bin Bae, Darren M Lipnicki, Ji Won Han, Perminder S Sachdev, Tae Hui Kim, Kyung Phil Kwak, Bong Jo Kim, Shin Gyeom Kim, Jeong Lan Kim, Seok Woo Moon, Joon Hyuk Park, Seung-Ho Ryu, Jong Chul Youn, Dong Young Lee, Dong Woo Lee, Seok Bum Lee, Jung Jae Lee, Jin Hyeong Jhoo, Juan J Llibre-Rodriguez, Jorge J Llibre-Guerra, Adolfo J Valhuerdi-Cepero, Karen Ritchie, Marie-Laure Ancelin, Isabelle Carriere, Ingmar Skoog, Jenna Najar, Therese Rydberg Sterner, Nikolaos Scarmeas, Mary Yannakoulia, Efthimios Dardiotis, Kenichi Meguro, Mari Kasai, Kei Nakamura, Steffi Riedel-Heller, Susanne Roehr, Alexander Pabst, Martin van Boxtel, Sebastian Köhler, Ding Ding, Qianhua Zhao, Xiaoniu Liang, Marcia Scazufca, Antonio Lobo, Concepción De-la-Cámara, Elena Lobo, Ki Woong Kim, and for Cohort Studies of Memory in an International Consortium (COSMIC).
• Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
• Bmc Med. 2020 Aug 5; 18 (1): 210.

BackgroundDementia 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.MethodsWe 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.ResultsAcross 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.ConclusionParity is associated with women's risk of dementia, though this is not uniform across regions and dementia subtypes.

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