Highlights
- •Reproductive history was associated with cognitive impairment.
- •A longer reproductive period was associated with a lower risk of cognitive impairment.
- •The findings suggest that longer exposure to endogenous estrogen may have a protective effect against cognitive impairment.
Abstract
Objective
While exposure to endogenous estrogen may be associated with better cognitive performance,
it is still unclear whether it has an association with mild cognitive impairment (MCI)
or dementia. The aim of this study was to clarify the effects of reproductive history,
as a surrogate marker of exposure to endogenous estrogen, on the risk of cognitive
impairment (MCI or dementia) in women.
Study design
A total of 747 women aged 40–59 years in the Saku area (Nagano Prefecture) were followed
as part of the Japan Public Health Center-based Prospective (JPHC) Study, which started
in 1990. Participants had undergone a mental health examination in 2014–2015.
Main outcome measures
We used multiple logistic regression to analyze the association between reproductive
history, obtained at baseline and 10-year follow-up, with current cognitive impairment
diagnosed by a trained psychiatrist, adjusting for various lifestyle factors.
Results
Among 670 eligible women, current cognitive impairment was diagnosed in 227, 196 of
whom had MCI and 31 dementia. A longer reproductive period had a significantly inverse
association with cognitive impairment (P-trend = 0.032). In particular, women with
a reproductive period ≥38 years compared with ≤33 years had a significantly lower
risk of cognitive impairment (multivariable adjusted odds ratio=0.62, 95% confidence
interval=0.40–0.96).
Conclusions
A longer reproductive period was associated with a lower risk of cognitive impairment,
which suggests that a longer exposure to endogenous estrogen may have a protective
effect against cognitive impairment.
Keywords
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Article info
Publication history
Published online: July 01, 2019
Accepted:
June 29,
2019
Received in revised form:
April 17,
2019
Received:
December 25,
2018
Identification
Copyright
© 2019 Published by Elsevier B.V.
