Multiparity, Brain Atrophy, and Cognitive Decline.

Joon Hyung Jung,Gi Jung Jung,Koung Mi Kang,Min Soo Byun,Dahyun Yi,Haejung Joung,Chul-Ho Sohn,Jun Ho Lee,Ga Won Lee,Yu Kyeong Kim,Dong Young Lee,Seong A Shin,So Yeon Jeon

doi:10.3389/fnagi.2020.00159

Abstract

BackgroundMultiparity – grand multiparity (i.e., five or more childbirths) in particular – has been reported to have an association with increased risk of Alzheimer’s disease (AD) dementia or related cognitive decline in women. However, the pathological links underlying this relationship are still unknown. This study was conducted to examine the relationships of multiparity with cerebral amyloid-beta (Aβ) deposition, brain atrophy, and white matter hyperintensities (WMHs).MethodsIn this study, total of 237 older women with 148 cognitively normal and 89 mild cognitive impairment from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE) were included. Participants underwent clinical and neuropsychological assessments in addition to 11C-labeled Pittsburgh Compound B positron emission tomography, and magnetic resonance imaging. The associations of parity with Aβ deposition, hippocampal volume, cortical volume, WMH volume and mini-mental status examination (MMSE) score were examined.ResultsParticipants with grand multiparity showed significantly reduced adjusted hippocampal volume, spatial pattern of atrophy for recognition of AD volume and spatial pattern of atrophy for recognition of brain aging volume even after controlling for potential confounders. Furthermore, MMSE score was also significantly lower in this group. In contrast, grand multiparity did not show any association with global Aβ retention, Aβ positivity rate, or WMH volume, regardless of covariates.ConclusionOur findings suggest that grand multiparity contributes to cognitive decline or increased dementia risk in older women by aggravating amyloid-independent hippocampal or cortical atrophy.

Highlights

The incidence and prevalence of Alzheimer’s disease (AD) dementia are higher in women than in men (Li and Singh, 2014)
apolipoprotein E ε4 (APOE4) positivity, cognitive status, global Aβ deposition, Aβ positivity, and white matter hyperintensity (WMH) volume were comparable between the two groups
We found that grand multiparity was associated with reduced brain volume, hippocampal volume, but not with Aβ pathology or WMHs, in non-demented older women

Summary

Introduction

The incidence and prevalence of Alzheimer’s disease (AD) dementia are higher in women than in men (Li and Singh, 2014). Several epidemiological studies reported that the number of childbirths or parity was related to increased risk of AD dementia or related cognitive decline (Colucci et al, 2006; Li et al, 2016; Jang et al, 2018). Grand multiparity has been linked to increased risk of cardiovascular disease, cerebral infarction (Klingberg et al, 2017), and diabetes mellitus (Nicholson et al, 2006), which could influence risk of dementia or AD-related cognitive decline (Kalaria, 2000), as well as preeclampsia and other obstetric complications (Babinszki et al, 1999; Roman et al, 2004). Multiparity – grand multiparity (i.e., five or more childbirths) in particular – has been reported to have an association with increased risk of Alzheimer’s disease (AD) dementia or related cognitive decline in women. This study was conducted to examine the relationships of multiparity with cerebral amyloid-beta (Aβ) deposition, brain atrophy, and white matter hyperintensities (WMHs)

Methods

Results

Discussion

Conclusion