Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study

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-GuerraAdolfo 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 Kohler, Ding Ding, Qianhua Zhao, Xiaoniu Liang, Marcia Scazufca, Antonio Lobo, Concepcion De-la-Camara, Elena Lobo, Ki Woong Kim*, Cohort Studies of Memory in an International Consortium (COSMIC)

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.

Original languageEnglish
Article number210
Number of pages11
JournalBMC Medicine
Issue number1
Publication statusPublished - 5 Aug 2020


  • Dementia
  • Alzheimer's disease
  • Risk factors
  • Parity
  • Women


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