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 Köhler, Ding Ding, Qianhua Zhao, Xiaoniu Liang, Marcia Scazufca, Antonio Lobo, Concepción De-La-Cámara, Elena Lobo, Ki Woong Kim, Steve R. Makkar, John D. Crawford, Anbupalam Thalamuthu, Nicole A. Kochan, Yvonne Leung, Jessica W. Lo, Yuda Turana, Erico Castro-Costa, Bagher Larijani, Iraj Nabipour, Kenneth Rockwood, Xiao Shifu, Richard B. Lipton, Mindy J. Katz, Pierre Marie Preux, Maëlenn Guerchet, Linda Lam, Toshiharu Ninimiya, Richard Walker, Hugh Hendrie, Antonio Guaita, Liang Kung Chen, Suzana Shahar, Jacqueline Dominguez, Murali Krishna, Mary Ganguli, Kaarin J. Anstey, Michael Crowe, Mary N. Haan, Shuzo Kumagai, Tze Pin Ng, Henry Brodaty, Richard Mayeux, Nicole Schupf, Ronald Petersen, Richard Lipton, Edwin S. Lowe, Louisa Jorm

Research output: Contribution to journalArticlepeer-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 (US)
Article number210
JournalBMC Medicine
Issue number1
StatePublished - Aug 5 2020


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

ASJC Scopus subject areas

  • General Medicine


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