Female reproductive factors and the risk of dementia: a nationwide cohort study
Background and purpose The aim was to investigate whether female reproductive factors are associated with dementia. Methods In all, 4 696 633 post‐menopausal women without dementia were identified using the Korean National Health Insurance System database. Data on reproductive factors were collected...
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| Veröffentlicht in: | European journal of neurology 2020-08, Vol.27 (8), p.1448-1458 |
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| container_title | European journal of neurology |
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| creator | Yoo, J. E. Shin, D. W. Han, K. Kim, D. Won, H.‐S. Lee, J. Kim, S. Y. Nam, G. E. Park, H. S. |
| description | Background and purpose
The aim was to investigate whether female reproductive factors are associated with dementia.
Methods
In all, 4 696 633 post‐menopausal women without dementia were identified using the Korean National Health Insurance System database. Data on reproductive factors were collected using a self‐administered questionnaire. Dementia was determined using dementia diagnosis codes and anti‐dementia drug prescription. Cox proportional hazards regression was conducted to assess the hazard ratio (HR) for dementia according to reproductive factors.
Results
During a median follow‐up of 5.74 years, there were 212 227 new cases of all‐cause dementia (4.5%), 162 901 cases of Alzheimer’s disease (3.5%) and 24 029 cases of vascular dementia (0.5%). The HR of dementia was 1.15 [95% confidence interval (CI) 1.03–1.16] for menarcheal age ≥17 years compared with menarcheal age 13–14 years, 0.79 (0.77–0.81) for menopausal age ≥55 years compared with menopausal age |
| doi_str_mv | 10.1111/ene.14315 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2402425760</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2424640372</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3535-3980234f19680f78aec035b2652df6a6aead080c99dbe45e01cce84b4d2f66153</originalsourceid><addsrcrecordid>eNp10E9LwzAYBvAgipvTg19AAl700C3_13qTsakw3EXPJUvess62mUnr2Lc3uulB8L3khfx4eHkQuqRkSOOMoIEhFZzKI9SnQqUJ5Zwex51LmkhKaA-dhbAmhLAxI6eoxxnPVJayPlrMoNYVYA8b72xn2vIDcKFN63zAurG4XcXPMrxhV2ALNTRtqe-wxo1uS9dsSwvYuJXzLQ5tZ3fn6KTQVYCLwztAr7Ppy-QxmS8enib388RwyWXCs5QwLgqaqZQU41SDIVwumZLMFkorDdqSlJgss0sQEgg1BlKxFJYVSlHJB-hmnxvPfu8gtHldBgNVpRtwXciZIEwwOVYk0us_dO0638TromJCCcLHLKrbvTLeheChyDe-rLXf5ZTkXy3nseX8u-Vorw6J3bIG-yt_ao1gtAfbsoLd_0n59Hm6j_wEgAeE3g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2424640372</pqid></control><display><type>article</type><title>Female reproductive factors and the risk of dementia: a nationwide cohort study</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Yoo, J. E. ; Shin, D. W. ; Han, K. ; Kim, D. ; Won, H.‐S. ; Lee, J. ; Kim, S. Y. ; Nam, G. E. ; Park, H. S.</creator><creatorcontrib>Yoo, J. E. ; Shin, D. W. ; Han, K. ; Kim, D. ; Won, H.‐S. ; Lee, J. ; Kim, S. Y. ; Nam, G. E. ; Park, H. S.</creatorcontrib><description>Background and purpose
The aim was to investigate whether female reproductive factors are associated with dementia.
Methods
In all, 4 696 633 post‐menopausal women without dementia were identified using the Korean National Health Insurance System database. Data on reproductive factors were collected using a self‐administered questionnaire. Dementia was determined using dementia diagnosis codes and anti‐dementia drug prescription. Cox proportional hazards regression was conducted to assess the hazard ratio (HR) for dementia according to reproductive factors.
Results
During a median follow‐up of 5.74 years, there were 212 227 new cases of all‐cause dementia (4.5%), 162 901 cases of Alzheimer’s disease (3.5%) and 24 029 cases of vascular dementia (0.5%). The HR of dementia was 1.15 [95% confidence interval (CI) 1.03–1.16] for menarcheal age ≥17 years compared with menarcheal age 13–14 years, 0.79 (0.77–0.81) for menopausal age ≥55 years compared with menopausal age <40 years, and 0.81 (0.79–0.82) for fertility duration ≥40 years compared with fertility duration <30 years. Whilst being of parity one (HR 0.89, 95% CI 0.85–0.94) and breastfeeding <6 months (HR 0.92, 95% CI 0.88–0.95) was associated with lower risk of dementia, being of parity two or more (HR 1.04, 95% CI 0.99–1.05) and breastfeeding ≥12 months (HR 1.14, 95% CI 1.01–1.07) was associated with a higher risk of dementia than women without parity or breastfeeding history. Use of hormone replacement therapy and oral contraceptives independently reduced the dementia risk by 15% and 10%, respectively.
Conclusions
Female reproductive factors are independent risk factors for dementia incidence, with higher risk associated with shorter lifetime endogenous estrogen exposure.</description><identifier>ISSN: 1351-5101</identifier><identifier>EISSN: 1468-1331</identifier><identifier>DOI: 10.1111/ene.14315</identifier><identifier>PMID: 32396982</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>Age ; Alzheimer's disease ; Breast feeding ; Breastfeeding & lactation ; Cohort analysis ; Confidence intervals ; Contraceptives ; Dementia ; Dementia disorders ; duration of fertility ; Estrogens ; Fertility ; Hazard assessment ; Health risk assessment ; Hormone replacement therapy ; menarche ; Menopause ; Neurodegenerative diseases ; Oral contraceptives ; Parity ; Risk analysis ; Risk factors ; Statistical analysis ; Vascular dementia</subject><ispartof>European journal of neurology, 2020-08, Vol.27 (8), p.1448-1458</ispartof><rights>2020 European Academy of Neurology</rights><rights>2020 European Academy of Neurology.</rights><rights>Copyright © 2020 European Academy of Neurology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3535-3980234f19680f78aec035b2652df6a6aead080c99dbe45e01cce84b4d2f66153</citedby><cites>FETCH-LOGICAL-c3535-3980234f19680f78aec035b2652df6a6aead080c99dbe45e01cce84b4d2f66153</cites><orcidid>0000-0001-8128-8920</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fene.14315$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fene.14315$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32396982$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoo, J. E.</creatorcontrib><creatorcontrib>Shin, D. W.</creatorcontrib><creatorcontrib>Han, K.</creatorcontrib><creatorcontrib>Kim, D.</creatorcontrib><creatorcontrib>Won, H.‐S.</creatorcontrib><creatorcontrib>Lee, J.</creatorcontrib><creatorcontrib>Kim, S. Y.</creatorcontrib><creatorcontrib>Nam, G. E.</creatorcontrib><creatorcontrib>Park, H. S.</creatorcontrib><title>Female reproductive factors and the risk of dementia: a nationwide cohort study</title><title>European journal of neurology</title><addtitle>Eur J Neurol</addtitle><description>Background and purpose
The aim was to investigate whether female reproductive factors are associated with dementia.
Methods
In all, 4 696 633 post‐menopausal women without dementia were identified using the Korean National Health Insurance System database. Data on reproductive factors were collected using a self‐administered questionnaire. Dementia was determined using dementia diagnosis codes and anti‐dementia drug prescription. Cox proportional hazards regression was conducted to assess the hazard ratio (HR) for dementia according to reproductive factors.
Results
During a median follow‐up of 5.74 years, there were 212 227 new cases of all‐cause dementia (4.5%), 162 901 cases of Alzheimer’s disease (3.5%) and 24 029 cases of vascular dementia (0.5%). The HR of dementia was 1.15 [95% confidence interval (CI) 1.03–1.16] for menarcheal age ≥17 years compared with menarcheal age 13–14 years, 0.79 (0.77–0.81) for menopausal age ≥55 years compared with menopausal age <40 years, and 0.81 (0.79–0.82) for fertility duration ≥40 years compared with fertility duration <30 years. Whilst being of parity one (HR 0.89, 95% CI 0.85–0.94) and breastfeeding <6 months (HR 0.92, 95% CI 0.88–0.95) was associated with lower risk of dementia, being of parity two or more (HR 1.04, 95% CI 0.99–1.05) and breastfeeding ≥12 months (HR 1.14, 95% CI 1.01–1.07) was associated with a higher risk of dementia than women without parity or breastfeeding history. Use of hormone replacement therapy and oral contraceptives independently reduced the dementia risk by 15% and 10%, respectively.
Conclusions
Female reproductive factors are independent risk factors for dementia incidence, with higher risk associated with shorter lifetime endogenous estrogen exposure.</description><subject>Age</subject><subject>Alzheimer's disease</subject><subject>Breast feeding</subject><subject>Breastfeeding & lactation</subject><subject>Cohort analysis</subject><subject>Confidence intervals</subject><subject>Contraceptives</subject><subject>Dementia</subject><subject>Dementia disorders</subject><subject>duration of fertility</subject><subject>Estrogens</subject><subject>Fertility</subject><subject>Hazard assessment</subject><subject>Health risk assessment</subject><subject>Hormone replacement therapy</subject><subject>menarche</subject><subject>Menopause</subject><subject>Neurodegenerative diseases</subject><subject>Oral contraceptives</subject><subject>Parity</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Vascular dementia</subject><issn>1351-5101</issn><issn>1468-1331</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp10E9LwzAYBvAgipvTg19AAl700C3_13qTsakw3EXPJUvess62mUnr2Lc3uulB8L3khfx4eHkQuqRkSOOMoIEhFZzKI9SnQqUJ5Zwex51LmkhKaA-dhbAmhLAxI6eoxxnPVJayPlrMoNYVYA8b72xn2vIDcKFN63zAurG4XcXPMrxhV2ALNTRtqe-wxo1uS9dsSwvYuJXzLQ5tZ3fn6KTQVYCLwztAr7Ppy-QxmS8enib388RwyWXCs5QwLgqaqZQU41SDIVwumZLMFkorDdqSlJgss0sQEgg1BlKxFJYVSlHJB-hmnxvPfu8gtHldBgNVpRtwXciZIEwwOVYk0us_dO0638TromJCCcLHLKrbvTLeheChyDe-rLXf5ZTkXy3nseX8u-Vorw6J3bIG-yt_ao1gtAfbsoLd_0n59Hm6j_wEgAeE3g</recordid><startdate>202008</startdate><enddate>202008</enddate><creator>Yoo, J. E.</creator><creator>Shin, D. W.</creator><creator>Han, K.</creator><creator>Kim, D.</creator><creator>Won, H.‐S.</creator><creator>Lee, J.</creator><creator>Kim, S. Y.</creator><creator>Nam, G. E.</creator><creator>Park, H. S.</creator><general>John Wiley & Sons, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8128-8920</orcidid></search><sort><creationdate>202008</creationdate><title>Female reproductive factors and the risk of dementia: a nationwide cohort study</title><author>Yoo, J. E. ; Shin, D. W. ; Han, K. ; Kim, D. ; Won, H.‐S. ; Lee, J. ; Kim, S. Y. ; Nam, G. E. ; Park, H. S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3535-3980234f19680f78aec035b2652df6a6aead080c99dbe45e01cce84b4d2f66153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Alzheimer's disease</topic><topic>Breast feeding</topic><topic>Breastfeeding & lactation</topic><topic>Cohort analysis</topic><topic>Confidence intervals</topic><topic>Contraceptives</topic><topic>Dementia</topic><topic>Dementia disorders</topic><topic>duration of fertility</topic><topic>Estrogens</topic><topic>Fertility</topic><topic>Hazard assessment</topic><topic>Health risk assessment</topic><topic>Hormone replacement therapy</topic><topic>menarche</topic><topic>Menopause</topic><topic>Neurodegenerative diseases</topic><topic>Oral contraceptives</topic><topic>Parity</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Statistical analysis</topic><topic>Vascular dementia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoo, J. E.</creatorcontrib><creatorcontrib>Shin, D. W.</creatorcontrib><creatorcontrib>Han, K.</creatorcontrib><creatorcontrib>Kim, D.</creatorcontrib><creatorcontrib>Won, H.‐S.</creatorcontrib><creatorcontrib>Lee, J.</creatorcontrib><creatorcontrib>Kim, S. Y.</creatorcontrib><creatorcontrib>Nam, G. E.</creatorcontrib><creatorcontrib>Park, H. S.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoo, J. E.</au><au>Shin, D. W.</au><au>Han, K.</au><au>Kim, D.</au><au>Won, H.‐S.</au><au>Lee, J.</au><au>Kim, S. Y.</au><au>Nam, G. E.</au><au>Park, H. S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Female reproductive factors and the risk of dementia: a nationwide cohort study</atitle><jtitle>European journal of neurology</jtitle><addtitle>Eur J Neurol</addtitle><date>2020-08</date><risdate>2020</risdate><volume>27</volume><issue>8</issue><spage>1448</spage><epage>1458</epage><pages>1448-1458</pages><issn>1351-5101</issn><eissn>1468-1331</eissn><abstract>Background and purpose
The aim was to investigate whether female reproductive factors are associated with dementia.
Methods
In all, 4 696 633 post‐menopausal women without dementia were identified using the Korean National Health Insurance System database. Data on reproductive factors were collected using a self‐administered questionnaire. Dementia was determined using dementia diagnosis codes and anti‐dementia drug prescription. Cox proportional hazards regression was conducted to assess the hazard ratio (HR) for dementia according to reproductive factors.
Results
During a median follow‐up of 5.74 years, there were 212 227 new cases of all‐cause dementia (4.5%), 162 901 cases of Alzheimer’s disease (3.5%) and 24 029 cases of vascular dementia (0.5%). The HR of dementia was 1.15 [95% confidence interval (CI) 1.03–1.16] for menarcheal age ≥17 years compared with menarcheal age 13–14 years, 0.79 (0.77–0.81) for menopausal age ≥55 years compared with menopausal age <40 years, and 0.81 (0.79–0.82) for fertility duration ≥40 years compared with fertility duration <30 years. Whilst being of parity one (HR 0.89, 95% CI 0.85–0.94) and breastfeeding <6 months (HR 0.92, 95% CI 0.88–0.95) was associated with lower risk of dementia, being of parity two or more (HR 1.04, 95% CI 0.99–1.05) and breastfeeding ≥12 months (HR 1.14, 95% CI 1.01–1.07) was associated with a higher risk of dementia than women without parity or breastfeeding history. Use of hormone replacement therapy and oral contraceptives independently reduced the dementia risk by 15% and 10%, respectively.
Conclusions
Female reproductive factors are independent risk factors for dementia incidence, with higher risk associated with shorter lifetime endogenous estrogen exposure.</abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>32396982</pmid><doi>10.1111/ene.14315</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-8128-8920</orcidid></addata></record> |
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| ispartof | European journal of neurology, 2020-08, Vol.27 (8), p.1448-1458 |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Age Alzheimer's disease Breast feeding Breastfeeding & lactation Cohort analysis Confidence intervals Contraceptives Dementia Dementia disorders duration of fertility Estrogens Fertility Hazard assessment Health risk assessment Hormone replacement therapy menarche Menopause Neurodegenerative diseases Oral contraceptives Parity Risk analysis Risk factors Statistical analysis Vascular dementia |
| title | Female reproductive factors and the risk of dementia: a nationwide cohort study |
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