Abstract P423: Lactation Duration is Associated With Favorable Cognitive Function in Women During Midlife: The 30-year Cardia Study

Abstract

Introduction: Lactation has been associated with lower incidence of the metabolic syndrome, type 2 diabetes, hypertension, and early atherosclerosis in women across the childbearing years. The lower risk of cardiometabolic diseases related to higher lifetime lactation may also extend to levels of cognitive function during midlife. Hypothesis: We tested the hypothesis that lactation duration is associated with better cognitive function in women during midlife independent of antecedent risk factors, as well as obesity, diabetes, and hypertension. Methods: We included 904 women aged 18-30 years at baseline (1985-86) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study without no diabetes before ≥1 birth(s) after baseline, reported lactation duration for each post-baseline birth, and had 6 measures of cognitive function assessed at Year 30 (2015-16) including the Rey Auditory Verbal Learning Test (RAVLT), Digit Symbol Substitution Test (DSST), Stroop Test, Montreal Cognitive Assessment (MoCA), Letter Fluency Test, and Category Fluency Test. Linear regression models estimated mean (95%CI) cognition scores by lactation duration (none, >0 to 6 mos, > 6 to <12 mos, ≥12 mos) adjusted for race, age, BMI, blood pressure, parity, and follow up covariates (Table 1). Results: Among parous women (46% black, 54% white) at 30-year follow up, average age was 54 yrs and 47% had obesity, 61% delivered ≥2 births since baseline, 29% used anti-hypertensive medications and 16% developed overt diabetes. Black women were less likely to report >6 mos of total lactation for all births than white women (23% vs. 58%). Unadjusted and fully adjusted mean scores for 3 cognitive function measures had graded direct associations with increasing lactation duration; specifically, the RAVLT, MoCA and Category Fluency Test scores (all p-trend < 0.01). Conclusions: In this prospective study, longer lactation duration was associated with more favorable cognition scores among women during midlife.