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Orchard ER, Chopra S, Ooi LQR, Chen P, An L, Jamadar SD, Yeo BTT, Rutherford HJV, Holmes AJ. Protective role of parenthood on age-related brain function in mid- to late-life. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.03.592382. [PMID: 38746272 PMCID: PMC11092769 DOI: 10.1101/2024.05.03.592382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
The experience of parenthood can profoundly alter one's body, mind, and environment, yet we know little about the long-term associations between parenthood and brain function and aging in adulthood. Here, we investigate the link between number of children parented (parity) and age on brain function in 19,964 females and 17,607 males from the UK Biobank. In both females and males, increased parity was positively associated with functional connectivity, particularly within the somato/motor network. Critically, the spatial topography of parity-linked effects was inversely correlated with the impact of age on functional connectivity across the brain for both females and males, suggesting that a higher number of children is associated with patterns of brain function in the opposite direction to age-related alterations. These results indicate that the changes accompanying parenthood may confer benefits to brain health across the lifespan, highlighting the importance of future work to understand the associated mechanisms.
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Tu L, Lv X, Yuan C, Chen H, Yu X, Wang H, Zhang Q. Sex differences in cognitive function trajectories and their determinants in older adults: Evidence from the Chinese longitudinal healthy longevity survey. Int J Geriatr Psychiatry 2024; 39:e6072. [PMID: 38488836 DOI: 10.1002/gps.6072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES To examine sex differences in the cognitive trajectories of a nationally representative sample of older people living in China and to explore potential determinants of these trajectories. METHODS The study included 2230 women and 2171 men who were cognitively healthy and aged over 60 at the first observation from the Chinese Longitudinal Healthy Longevity Survey based on the 2008-2018 cohort. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 10 years in each gender. Logistic regression was used to investigate associations between baseline characteristics (age, education, fertility history, sleep length, physical activity, and health status and behaviors) and trajectory classes. RESULTS Three trajectories (labeled stable, slow decline, and rapid decline) were identified according to the changes in MMSE scores for both women and men. For the women, both the slow and rapid decline groups accounted for a larger proportion (14.7% and 11.0%, respectively) than the male decline groups (8.1% and 6.6%, respectively), and the women had a lower baseline MMSE score with a faster decline. In the multivariable logistic regression analyses, older age, less education, older age at first birth, poorer functional abilities, hearing impairment, and lower baseline MMSE scores were significantly associated with cognitive decline in both the female and male groups compared to the stable group. For the women, sleeping over 9 h was also associated with a rapid cognitive decline trajectory, while current exercise and being overweight/obese were protective factors against cognitive decline. CONCLUSIONS The women had an overall more serious cognitive decline than men. The potential determinants of cognitive decline identified in this study could be considered for developing specific intervention strategies aimed at promoting a healthy brain and preventing cognitive decline in different sexes, especially in low-income and developing countries.
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Affiliation(s)
- Lihui Tu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiaozhen Lv
- Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Changzheng Yuan
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hui Chen
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xin Yu
- Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Huali Wang
- Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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3
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Stickel AM, Tarraf W, Kuwayama S, Wu B, Sundermann EE, Gallo LC, Lamar M, Daviglus M, Zeng D, Thyagarajan B, Isasi CR, Lipton RB, Cordero C, Perreira KM, Gonzalez HM, Banks SJ. Connections between reproductive health and cognitive aging among women enrolled in the HCHS/SOL and SOL-INCA. Alzheimers Dement 2024; 20:1944-1957. [PMID: 38160447 PMCID: PMC10947951 DOI: 10.1002/alz.13575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/01/2023] [Accepted: 11/13/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Reproductive health history may contribute to cognitive aging and risk for Alzheimer's disease, but this is understudied among Hispanic/Latina women. METHODS Participants included 2126 Hispanic/Latina postmenopausal women (44 to 75 years) from the Study of Latinos-Investigation of Neurocognitive Aging. Survey linear regressions separately modeled the associations between reproductive health measures (age at menarche, history of oral contraceptive use, number of pregnancies, number of live births, age at menopause, female hormone use at Visit 1, and reproductive span) with cognitive outcomes at Visit 2 (performance, 7-year change, and mild cognitive impairment [MCI] prevalence). RESULTS Younger age at menarche, oral contraceptive use, lower pregnancies, lower live births, and older age at menopause were associated with better cognitive performance. Older age at menarche was protective against cognitive change. Hormone use was linked to lower MCI prevalence. DISCUSSION Several aspects of reproductive health appear to impact cognitive aging among Hispanic/Latina women.
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Affiliation(s)
- Ariana M. Stickel
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare SciencesWayne State UniversityDetroitMichiganUSA
| | - Sayaka Kuwayama
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Benson Wu
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Erin E. Sundermann
- Department of PsychiatryUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Linda C. Gallo
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Melissa Lamar
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoCollege of MedicineChicagoIllinoisUSA
- Rush Alzheimer's Disease Research Center and the Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Martha Daviglus
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoCollege of MedicineChicagoIllinoisUSA
| | - Donglin Zeng
- Department of BiostatisticsUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and PathologyUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Carmen R. Isasi
- Department of Epidemiology & Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Richard B. Lipton
- Department of Epidemiology & Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | | | - Krista M. Perreira
- Department of Social MedicineUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Hector M. Gonzalez
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Sarah J. Banks
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
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Angel JL, López-Ortega M, Chiu CT, Rote SM, Cantu P, Antequera F, Chen CA. Loss of Autonomy: Likely Dementia and Living Arrangement Transitions Among Mexicans and Mexican Americans. THE GERONTOLOGIST 2024; 64:gnad083. [PMID: 37392451 PMCID: PMC10825852 DOI: 10.1093/geront/gnad083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To examine the role of probable dementia on changes in living arrangements and mortality among very old Mexicans and Mexican Americans in 2 different nations. RESEARCH DESIGN AND METHODS We employ the Hispanic Established Population for the Epidemiologic Study of the Elderly and the Mexican Health and Aging Study, 2 comparable longitudinal data sets, to identify predictors of changes in living arrangements using multinomial logistic regression, controlling for cognitive status, demographic characteristics, and resources. RESULTS In Mexico, women with dementia who lived alone at baseline were more likely to become part of an extended family household than men with similar levels of cognitive impairment. A similar pattern emerges for the oldest Mexican-American women. Spousal loss increases the likelihood of living alone for women in the United States regardless of dementia. Although dementia elevates the risk of mortality for men living alone in the United States, in both countries, women in their 90s who lived alone with dementia had a lower risk of mortality relative to men. DISCUSSION AND IMPLICATIONS Longer life spans increase the risk of living alone with dementia in both countries, especially for women. Older individuals in both countries face financial hardships. Mexicans have limited formal options in dementia care. Mexican Americans with dementia continue to live alone despite low income although, unlike the Mexicans, they have access to Medicaid long-term care. For Mexico and the United States, the growing number of older individuals with dementia represents a growing public health concern.
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Affiliation(s)
- Jacqueline L Angel
- LBJ School of Public Affairs and Center on Aging and Population Sciences, The University of Texas at Austin, Austin, Texas, USA
| | | | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | - Sunshine M Rote
- Kent School of Social Work and Family Science, University of Louisville, Louisville, Kentucky, USA
| | - Phillip Cantu
- Department of Internal Medicine—Geriatrics, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Felipe Antequera
- LBJ School of Public Affairs, The University of Texas at Austin, Austin, Texas, USA
| | - Ching-An Chen
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
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Zhang S, Yang H, Li Z, Zhang S, Wu Y. A study of the effect of number of children on depression among rural older women: empirical evidence from China. J Biosoc Sci 2024; 56:182-206. [PMID: 37718633 DOI: 10.1017/s0021932023000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
The association between early reproductive events and health status in later life has always been of interest across disciplines. The purpose of this study was to investigate whether there was an association between the number of children born in the early years of elderly women and their depression in later life based on a sample of older women aged 65 years and above with at least one child in rural China. Data from the Chinese Longitudinal Healthy Longevity Survey in 2018, this study used the ordinary least square method to conduct empirical research. This study has found a significant correlation between an increase in the number of children and depression in older rural women. When considering the sex of the child, the number of daughters had a greater and more significant impact on depression. Number of children may exacerbate depression of older women through declining self-rated health and reduced social activity, while increased inter-generational support alleviated depression. The association between number of children born and depression also existed in urban older women, though not significant. Therefore, it is suggested to accelerate the improvement of supporting policies related to childbirth, developing a healthy and scientific fertility culture, and improving rural maternal and child health services. Women should be assisted in balancing their roles in the family and in society, and in particular in sharing the burden of caring for children. Targeted efforts to increase old-age protection for older people.
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Affiliation(s)
- Shuo Zhang
- School of Sociology and Population Studies, Renmin University of China, Beijing, China
| | - Hualei Yang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Zhiyun Li
- School of Politics and Public Administration, Qingdao University, Qingdao, China
| | - Siqing Zhang
- School of Government, Nanjing University, Nanjing, China
| | - Yuanyang Wu
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
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Fischer M, Lövdén M, Nilsson T, Seblova D. Very Early-Life Risk Factors for Developing Dementia: Evidence From Full Population Registers. J Gerontol B Psychol Sci Soc Sci 2023; 78:2131-2140. [PMID: 37756487 PMCID: PMC10699746 DOI: 10.1093/geronb/gbad142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVES Very early-life conditions are recognized as critical for healthy brain development. This study assesses early-life risk factors for developing dementia. In the absence of historical medical birth records, we leverage an alternative full population approach using demographic characteristics obtained from administrative data to derive proxy indicators for birth complications and unfavorable birth outcomes. We use proxy variables to investigate the impact of early-life risk factors on dementia risk. METHODS We use administrative individual-level data for full cohorts born 1932-1950 in Sweden with multigenerational linkages. Records on hospitalization and mortality are used to identify dementia cases. We derive 3 birth risk factors based on demographic characteristics: advanced maternal age, narrow sibling spacing, and twin births, and apply survival analysis to evaluate long-term effects on dementia risk. We control for confounding using multiple indicators for socio-economic status (SES), including parental surnames, and by implementing a sibling design. As comparison exposure, we add low education from the 1970 Census. RESULTS The presence of at least 1 birth risk factor increases dementia risk (HR = 1.059; 95% CI: 1.034, 1.085). The occurrence of twin births poses a particularly heightened risk (HR = 1.166; 95% CI: 1.084, 1.255). DISCUSSION Improvements to the very early-life environment hold significant potential to mitigate dementia risk. A comparison to the influence of low education on dementia (the largest known modifiable risk factor) suggests that demographic birth characteristics are of relevant effect sizes. Our findings underscore the relevance of providing assistance for births experiencing complications and adverse health outcomes to reduce dementia cases.
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Affiliation(s)
- Martin Fischer
- Department of Clinical Sciences/Faculty of Medicine, Lund University, Malmö, Skåne County, Sweden
- RWI—Leibniz Institute for Economic Research, Essen, Germany
| | - Martin Lövdén
- Department of Psychology, University of Gothenburg, Gothenburg, Västra Götaland County, Sweden
| | - Therese Nilsson
- Department of Economics, Lund University, Lund, Skåne County, Sweden
- Research Institute of Industrial Economics (IFN), Stockholm, Stockholm County, Sweden
| | - Dominika Seblova
- Department of Epidemiology, Second Medical Faculty, Charles University Prague, Prague, Czech Republic
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Weng Y, Yang X. Fertility behaviors and mid-late-life health status in China: From a life-course perspective. Soc Sci Med 2023; 338:116314. [PMID: 37890281 DOI: 10.1016/j.socscimed.2023.116314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 10/04/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023]
Abstract
Despite extensive research on the impact of fertility behaviors on mid-late-life health, conclusions remain inconsistent, and understanding is limited regarding the role of fertility-correlated life events in this causality. This study uses the 2018 wave and life-history information of the China Health and Retirement Longitudinal Study (CHARLS) dataset to explore how the number of children born (NCB) and age at first birth (AFB) influence later-life health. It also examines the effects of early-life educational attainment and mid-late-life caregiving on later-life health from a life-course perspective. Health measures include the Health Deficit Index (HDI), Activities of Daily Living (ADL), and Mini-Mental State Examination (MMSE). Results from the instrumental variables (IV) approach indicate that higher NCB predicts worse health, while later AFB predicts better later-life health. These findings remain robust with different measures of fertility behaviors, and in models that control for cohort and community fixed-effects. However, introducing education variables could disrupt the causality between fertility behaviors and later-life health, but not with caregiving variables. This suggests a potential "horse race" effect between education and fertility behaviors, both of which significantly influence later-life health. Therefore, understanding this causality and formulating policy for an aging society from a life-course perspective is essential.
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Affiliation(s)
- Yulei Weng
- School of Economics and Management, Northwest University, Xi'an, Shaanxi, 710127, China.
| | - Xiaocong Yang
- School of Public Administration, Guangzhou University, Guangzhou, Guangdong, 510006, China; The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3053, Australia.
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8
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Thomeer MB, Reczek R, Ross C, Bijou C. Sequencing of Births by Wantedness: Implications for Changes in Mid-Life Health Among Aging NLSY79 Women. J Gerontol B Psychol Sci Soc Sci 2023; 78:1881-1891. [PMID: 37526336 PMCID: PMC10645314 DOI: 10.1093/geronb/gbad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVES As life course frameworks highlight and gerontological studies confirm, the health implications of early birth timing (e.g., adolescent births) and unplanned births (e.g., unwanted or mistimed births) extend years after those births into mid and later life. Yet past research often overlooks the considerable diversity in sequencing and timing of unplanned births even within the same individual (e.g., having both wanted and unwanted births), which are likely fundamental for women's long-term health trajectories. We develop a holistic understanding of birth timing and wantedness to provide insight into when and how childbearing histories matter for aging women's health. METHODS We use sequence analysis with hierarchical cluster method and estimate regression models using the 1979 National Longitudinal Survey of Youth (N = 3,231) to examine how timing and patterning of births by wantedness are associated with changes in physical and mental health from ages 40 to 50. RESULTS We identify 7 clusters of childbearing sequences. Of those 7 clusters, respondents with sequences characterized by wanted births in their 20s and 30s had the smallest declines in health in mid-life, whereas respondents with sequences with mainly unwanted births at any age or with mainly mistimed births beginning in adolescence had the greatest health declines. Adjusting for social and economic variables accounted for some, but not all, health differences across childbearing clusters. DISCUSSION This project demonstrates the need for comprehensive life course perspectives on long-term health implications of birth wantedness and timing, recognizing diversity within and between individuals.
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Affiliation(s)
- Mieke Beth Thomeer
- Department of Sociology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Rin Reczek
- Department of Sociology, The Ohio State University, Columbus, Ohio, USA
- Institute for Population Research, The Ohio State University, Columbus, Ohio, USA
| | - Clifford Ross
- Department of Sociology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christina Bijou
- Department of Sociology, The Ohio State University, Columbus, Ohio, USA
- Institute for Population Research, The Ohio State University, Columbus, Ohio, USA
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Du Y, Luo Y, Zheng X, Liu J. Number of children and cognitive function among Chinese menopausal women: The mediating role of depressive symptoms and social participation. J Affect Disord 2023; 340:758-765. [PMID: 37591349 DOI: 10.1016/j.jad.2023.08.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 07/27/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVES This study examined the association between number of children and cognitive function and its possible hormone and psychosocial pathways in Chinese menopausal women. METHODS We analyzed data from the China Health and Retirement Longitudinal Study (CHALRS), including 4803 menopausal women. Ordinary least squares (OLS) regression modeling and structural equation modeling (SEM) were applied to explore the association between number of children and cognitive function and the potential mechanisms. RESULTS Overall, the median number of biological children was three among participants. The cognitive function score decreased significantly with increasing numbers of children [β = -0.547, 95 % confidence interval (CI): -0.677, -0.416]. There was a significant interaction between number of children and residence (P = 0.003). Compared with older women with three or less children, women with more than three children had worse cognitive function (β = -0.798, 95 % CI: -1.081, -0.514). Mediation analysis verified that depressive symptoms and social participation partially mediate the associations between the number of children and cognitive function. LIMITATIONS First, because of the cross-sectional design, our study was unable to make causal inferences. Second, information about endogenous estrogen exposure was not collected in CHARLS. Third, recall bias may exist due to the use of self-reported data. CONCLUSION Our results indicated that a higher number of children is associated with an increased risk for cognitive impairment. We suggest paying special attention to mental and social health among women with multiple children (>3).
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Affiliation(s)
- Yushan Du
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Jufen Liu
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
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Rentscher KE, Klopack ET, Crimmins EM, Seeman TE, Cole SW, Carroll JE. Social relationships and epigenetic aging in older adulthood: Results from the Health and Retirement Study. Brain Behav Immun 2023; 114:349-359. [PMID: 37683960 PMCID: PMC10650967 DOI: 10.1016/j.bbi.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 08/18/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023] Open
Abstract
Growing evidence suggests that social relationship quality can influence age-related health outcomes, although how the quality of one's relationships directly relates to the underlying aging process is less clear. We hypothesized that the absence of close relationships as well as lower support and higher strain within existing relationships would be associated with an accelerated epigenetic aging profile among older adults in the Health and Retirement Study. Adults (N = 3,647) aged 50-100 years completed ratings of support and strain in relationships with their spouse, children, other family members, and friends. They also provided a blood sample that was used for DNA methylation profiling to calculate a priori-specified epigenetic aging measures: Horvath, Hannum, PhenoAge, GrimAge, and Dunedin Pace of Aging methylation (DunedinPoAm38). Generalized linear models that adjusted for chronological age, sex, and race/ethnicity and applied a false discovery rate correction revealed that the absence of marital and friend relationships related to an older GrimAge and faster DunedinPoAm38. Among those with existing relationships, lower support from a spouse, child, other family, and friends and higher strain with friends related to an older PhenoAge and GrimAge and faster DunedinPoAm38. In secondary analyses that further adjusted for socioeconomic and lifestyle factors, lower support from other family members and friends was associated with greater epigenetic aging. Findings suggest that the absence of close relationships and lower support within existing relationships-particularly with family members and friends-relate to accelerated epigenetic aging in older adulthood, offering one mechanism through which social relationships might influence risk for age-related declines and disease.
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Affiliation(s)
- Kelly E Rentscher
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA; Norman Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Eric T Klopack
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Eileen M Crimmins
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Teresa E Seeman
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Steve W Cole
- Norman Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Judith E Carroll
- Norman Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, USA
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11
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DiBiase RM, Gottesman RF, Tom SE, Walker KA, Mosley T, Lutsey PL, Miller EC. Parity and Risk of Dementia in Women: The Atherosclerosis Risk in Communities Study. J Womens Health (Larchmt) 2023; 32:1031-1040. [PMID: 37615600 PMCID: PMC10541925 DOI: 10.1089/jwh.2023.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Objective: Reproductive factors, including parity, may contribute to dementia risk, due to hormonal, physiological, social, and demographic factors. We hypothesized that higher parity would be associated with increased dementia risk. Materials and Methods: We utilized data from the Atherosclerosis Risk in Communities (ARIC) community-based cohort study. Participants were recruited in 1987-1989 and followed through 2017. Participants, all born between 1921 and 1945, were from four U.S. communities in Forsyth County, NC; Jackson, MS; Minneapolis, MN; and Washington County, MD. We included all female participants seen at ARIC visit three or five for whom parity and dementia outcomes were available (N = 7,921). The primary exposure was self-reported number of live births. Our primary outcome was dementia, diagnosed via neurocognitive assessments, informant interviews, and expert adjudication. We created Cox proportional hazards models to evaluate the association between parity and incident dementia, adjusting for demographic factors, education level, apolipoprotein E allele status, and vascular risk factors. We tested for interactions by race and birth cohort. Results: The adjusted hazard ratio was 0.82 (95% confidence intervals [CI] 0.69-0.99) for dementia in women with 0-1 births and 0.85 (95% CI 0.72-0.99) for women with 5+ births, compared to women with 2 births (reference group). This association was present in women born from 1924 to 1934, but not in women born in 1935 or later (p-interaction <0.001). Conclusion: We found an inverted U-shaped association of parity with dementia risk. This effect was modified by birth cohort, suggesting that the association may depend on demographic and sociocultural factors.
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Affiliation(s)
- Rebecca M. DiBiase
- Department of Neurology, McGaw Medical Center of Northwestern University, Chicago, Illinois, USA
| | - Rebecca F. Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, Maryland, USA
| | - Sarah E. Tom
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Keenan A. Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, Maryland, USA
| | - Thomas Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Pamela L. Lutsey
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Eliza C. Miller
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
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12
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Naz MSG, Rahnemaei FA, Tehrani FR, Sayehmiri F, Ghasemi V, Banaei M, Ozgoli G. Possible cognition changes in women with polycystic ovary syndrome: a narrative review. Obstet Gynecol Sci 2023; 66:347-363. [PMID: 37376796 PMCID: PMC10514592 DOI: 10.5468/ogs.22165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/15/2022] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Nowadays, polycystic ovary syndrome (PCOS) and cognitive dysfunction are major health problems among female. This narrative review aimed to investigate cognitive dysfunction in female with PCOS. English and Persian articles published in PubMed, Scopus, Web of Science, Google Scholar, PsycINFO, Scientific Information Database, and Cochrane Database of Systematic Reviews until May 2022 were searched. Sixteen studies involving 850 female with PCOS and 974 controls were assessed. In these studies, the association between biochemical factors and symptoms of PCOS and memory, attention, executive functioning, information processing speed, and visuospatial skills was evaluated. The literature review revealed the possible cognitive changes in female with PCOS. This study summarized the different aspects of cognitive function in female with PCOS due to medication, psychological problems (mood disorders caused by disease symptoms and complications), and biochemical markers, such as metabolic and sex hormone abnormalities. Considering the existing scientific gap regarding the possibility of cognitive complications in female with PCOS, further biological studies should be conducted to evaluate the potential mechanisms involved.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Fatemeh Alsadat Rahnemaei
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht,
Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Fatemeh Sayehmiri
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Vida Ghasemi
- Department of Nursing, Asadabad School of Medical Sciences, Asadabad,
Iran
| | - Mojdeh Banaei
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas,
Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
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13
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Zhang Y, Fletcher J, Lu Q, Song J. Gender differences in the association between parity and cognitive function: Evidence from the UK biobank. Soc Sci Med 2023; 320:115649. [PMID: 36709690 PMCID: PMC9974636 DOI: 10.1016/j.socscimed.2022.115649] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/05/2023]
Abstract
While much previous work linking fertility history with late-life cognition has focused on a narrow set of cognitive measures and/or has used modest sample sizes in the analysis, our paper expands the size and scope of these linkages by analyzing cognitive function across five domains and precisely estimating gendered patterns between men and women. Results point to important gendered associations between parity and cognition: having children is likely associated with better cognitive function for fathers in all five domains. However, mothers show worse cognitive function in some domains (i.e., numeric memory, prospective memory, and fluid intelligence) than childless women. We explore the possibility of confounding in these associations and rule out the effects of genetic cognitive ability on fertility. We also find that adding controls for educational attainment differ by gender-strengthening associations between parity and cognition for men and largely eliminating them for women. The findings support previous work done on how life course contexts may link to the risk of dementia or cognitive impairment, highlighting parity as potential protective or risk factors to parents' cognitive health. The use of five cognitive domains yields variations in results, giving implications on measure selection of cognitive function and calling for replicated work covering more cognitive domains.
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Affiliation(s)
- Yan Zhang
- Center for Demography of Health and Aging, University of Wisconsin, Madison, United States.
| | - Jason Fletcher
- Center for Demography of Health and Aging, University of Wisconsin, Madison, United States.
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, United States.
| | - Jie Song
- Department of Statistics, University of Wisconsin, Madison, United States.
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14
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Orchard ER, Rutherford HJV, Holmes AJ, Jamadar SD. Matrescence: lifetime impact of motherhood on cognition and the brain. Trends Cogn Sci 2023; 27:302-316. [PMID: 36609018 PMCID: PMC9957969 DOI: 10.1016/j.tics.2022.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 01/06/2023]
Abstract
Profound environmental, hormonal, and neurobiological changes mark the transition to motherhood as a major biosocial life event. Despite the ubiquity of motherhood, the enduring impact of caregiving on cognition and the brain across the lifespan is not well characterized and represents a unique window of opportunity to investigate human neural and cognitive development. By integrating insights from the human and animal maternal brain literatures with theories of cognitive ageing, we outline a framework for understanding maternal neural and cognitive changes across the lifespan. We suggest that the increased cognitive load of motherhood provides an initial challenge during the peripartum period, requiring continuous adaptation; yet when these demands are sustained across the lifespan, they result in increased late-life cognitive reserve.
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Affiliation(s)
- Edwina R Orchard
- Yale Child Study Center, School of Medicine, Yale University, New Haven, CT, USA; Department of Psychology, Faculty of Arts and Sciences, Yale University, New Haven, CT, USA.
| | | | - Avram J Holmes
- Department of Psychology, Faculty of Arts and Sciences, Yale University, New Haven, CT, USA
| | - Sharna D Jamadar
- Turner Institute of Brain and Mental Health & Monash Biomedical Imaging, Monash University, Melbourne, Australia
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15
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Khate K, Chaudhary V, Longkumer I, Saraswathy KN, Devi NK. Gender-specific association of blood lipids and reproductive trajectory with cognitive impairment: A community based cross-sectional study from India. Front Psychol 2023; 14:1107152. [PMID: 36923148 PMCID: PMC10008908 DOI: 10.3389/fpsyg.2023.1107152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/08/2023] [Indexed: 03/01/2023] Open
Abstract
Background Abnormal blood lipid levels in the general population and adverse reproductive events among women have been associated with cognitive impairment (CI). However, their relationship has not been extensively studied in community settings. Hence, this study aims to explore the association of CI with blood lipid levels in both sexes and reproductive events/trajectory among women. Methods A cross-sectional study was conducted among a North Indian rural population. A total of 808 adults were recruited through door-to-door household survey. Data on socio-demographic variables, reproductive profile of women, and cognitive impairment status were collected. Fasting blood sample was collected to estimate serum lipid profile. Multivariate logistic regression was performed to test for association. Results The study demonstrated a lack of association between lipid profile and cognitive impairment among males. Surprisingly, low HDL-C among females was found to be protective against moderate/severe cognitive impairment (value of p = 0.049). Further, menopausal women and those having five or higher live births were found to be at higher risk of CI than pre-menopausal women and those with 1-2 live births, respectively. Conclusion The present study hints toward a gender-specific association of blood lipid levels with CI. Further, higher live births and menopause appear to be important risk factors for CI among women.
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Affiliation(s)
- Kevingu Khate
- Department of Anthropology, University of Delhi, New Delhi, India
| | - Vineet Chaudhary
- Department of Anthropology, University of Delhi, New Delhi, India
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16
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Chen M, Guo J, Lin Y, Xu J, Hu Y, Yang L, Xu X, Zhu L, Zhou J, Zhang Z, Li H, Lin S, Wu S. Life-course fertility and multimorbidity among middle-aged and elderly women in China: Evidence from China health and retirement longitudinal study. Front Public Health 2023; 11:1090549. [PMID: 36891346 PMCID: PMC9986627 DOI: 10.3389/fpubh.2023.1090549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
Background Multimorbidity has become an important public health problem in China, especially among middle-aged and elderly women. Few studies have been reported on the association between multimorbidity and female fertility, which is an important stage in the life course. This study aimed to explore the association between multimorbidity and fertility history among middle-aged and elderly women in China. Methods Data from 10,182 middle-aged and elderly female participants in the China Health and Retirement Longitudinal Study (CHARLS) in 2018 were used in this study. Multimorbidity was defined as the presence of at least two or more chronic conditions. Logistic regression analysis, negative binomial regression analysis, and restrictive cubic splines (RCSs) were used to analyze the relationship between female fertility history and multimorbidity or the number of chronic conditions. Multivariable linear regression was used to analyze the relationship between female fertility history and multimorbidity pattern factor scores. Results The results of this study showed that high parity and early childbearing were significantly associated with an increased risk of multimorbidity and an increased number of chronic conditions among middle-aged and elderly women in China. Late childbearing was significantly associated with reduced risk of multimorbidity and lessened diseases. Parity and age of first childbirth were significantly correlated with the odds of multimorbidity. The association between fertility history and multimorbidity was found to be influenced by age and urban-rural dual structure. Women with high parity tend to have higher factor scores of cardiac-metabolic, visceral-arthritic, and respiratory-psychiatric patterns. Women with early childbearing tended to have higher factor scores of the visceral-arthritic pattern and those with late childbearing tended to have lower factor scores of the cardiac-metabolic pattern. Conclusion Fertility history has a significant effect on multimorbidity in the middle and later lives of Chinese women. This study is of great importance for reducing the prevalence of multimorbidity among Chinese women through their life course and promoting health during their middle and later lives.
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Affiliation(s)
- Mingjun Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jianhui Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yawen Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jialiang Xu
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yuduan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Le Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xingyan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Li Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jungu Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zhiyu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Huangyuan Li
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Shaowei Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Siying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
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17
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Wolfova K, Wu D, Weiss J, Cermakova P, Kohler HP, Skirbekk VF, Stern Y, Gemmill A, Tom SE. Sons and parental cognition in mid-life and older adulthood. J Psychiatr Res 2022; 156:284-290. [PMID: 36279678 PMCID: PMC10103684 DOI: 10.1016/j.jpsychires.2022.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022]
Abstract
Prior research suggests a relationship between number of sons and maternal long-term health outcomes, including dementia. We assessed the relationship between having sons and parental cognitive aging. Specifically, we investigated the relationship between having at least 1 son and parental baseline cognition level and rate of cognitive decline, accounting for life course sociodemographic characteristics in a cohort of 13 222 adults aged ≥50 years from the US Health and Retirement Study. We included only participants with at least one child. We further explored whether this relationship varies by parental sex and whether the magnitude of the relationship increases with each additional son. Cognition was assessed biennially for a maximum of nine times as a sum of scores from immediate and delayed 10-noun free recall tests, a serial 7s subtraction test, and a backwards counting test. Associations were evaluated using linear mixed-effects models, stepwise adjusting for sociodemographic and health-related factors. In our analytic sample of parents, a total of 82.3% of respondents had at least 1 son and 61.6% of respondents were female. Parents of at least 1 son had a faster rate of cognitive decline in comparison to parents without any son. Our results also suggest that cognitive decline was faster among parents of multiple sons, compared to parents with only daughters. Thus, the results support the theory that having sons might have a long-term negative effect on parental cognition.
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Affiliation(s)
- Katrin Wolfova
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Prague, 100 00, Czech Republic; National Institute of Mental Health, Klecany, 250 67, Czech Republic; Department of Neurology, Columbia University, 10032, New York, USA
| | - Di Wu
- Department of Biostatistics, Columbia University, 10032, New York, USA
| | - Jordan Weiss
- Department of Demography, UC Berkeley, Berkeley, CA, 94720, USA
| | - Pavla Cermakova
- National Institute of Mental Health, Klecany, 250 67, Czech Republic; Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, 150 06, Czech Republic
| | - Hans-Peter Kohler
- Department of Sociology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Vegard Fykse Skirbekk
- Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo, 0473, Norway
| | - Yaakov Stern
- Department of Neurology, Columbia University, 10032, New York, USA
| | - Alison Gemmill
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 21205, Maryland, USA
| | - Sarah E Tom
- Department of Neurology, Columbia University, 10032, New York, USA; Department of Epidemiology, Columbia University, 10032, New York, USA.
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18
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Yang HL, Zhang SQ, Zhang S, Wu YY, Luo RD. Fertility experiences and later-life cognitive function among older adults in China. Am J Hum Biol 2022; 34:e23786. [PMID: 35929732 DOI: 10.1002/ajhb.23786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/02/2022] [Accepted: 07/16/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES The relationship between fertility history and human health has long fascinated scholars; however, whether there is a link between number of children and cognitive function in older adults remains unclear. We investigated the associations between parity and the timing of first and last births with the cognitive function of older adults over 65. METHODS The mini-mental state examination (MMSE) was selected as a tool to measure cognitive function. We analyzed data on 5847 older adults in rural and urban communities in China from the 2018 Chinese Longitudinal Healthy Longevity Survey using ordinary least squares. To further explore the transmission mechanism, we also conducted a mediating effect analysis. RESULTS We found a negative association between number of children and cognitive function in older adults. Compared with older adults with four children, the MMSE scores of older adults with more than five children decreased significantly, and the score of older adults with zero to three children increased. Further, a late age at first birth (≥35) and a late age at last birth (≥35) were negatively associated with cognitive function. We also found that the associations between parity and cognition might be partly explained by variations in health. CONCLUSION Our analyses provided evidence from China to support the link between fertility history and cognitive function that has been observed in previous international studies: We suggest that high parity (≥5) is negatively associated with cognitive function.
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Affiliation(s)
- Hua-Lei Yang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Si-Qing Zhang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Shuo Zhang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Yuan-Yang Wu
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Run-Dong Luo
- School of Business, Shandong University, Weihai, China
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19
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Xue K, Nie Y, Wang Y, Hu Z. Number of Births and Later-Life Depression in Older Adults: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11780. [PMID: 36142053 PMCID: PMC9517263 DOI: 10.3390/ijerph191811780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Previous studies on the number of births and the health of the elderly have been highly focused on physical health and used samples from developed countries. Therefore, this study aimed to explore the effect of the lifetime number of births on depression in Chinese older adults. We used panel data for men and women aged 50 and over from the 2013-2018 China Health and Retirement Longitudinal Study. Depressive symptoms were assessed through a short form of the Center for Epidemiologic Studies Depression Scale. We found that depression levels in women were significantly higher than in men, with a mean difference of 2.44 (p < 0.001). The model estimation results indicated that the number of births affected depression in older adults, and its increase could exacerbate depression in older adults. The number of births significantly impacted depression among the elderly aged 50-69. Furthermore, there was a negative relationship between the proportion of sons and older adults' depression, which was significant in older males; the number of abortions may exacerbate depression in older adults, especially in females.
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Affiliation(s)
- Kaiyun Xue
- College of Economics and Management, Northwest A&F University, Yangling, Xianyang 712100, China
| | - Yafeng Nie
- School of Economics, Jinan University, Guangzhou 510632, China
| | - Yue Wang
- College of Economics and Management, Northwest A&F University, Yangling, Xianyang 712100, China
| | - Zhen Hu
- College of Economics and Management, Northwest A&F University, Yangling, Xianyang 712100, China
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20
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Saillant K, Intzandt B, Bérubé B, Sanami S, Gauthier C, Bherer L. Mastering the Relationship between the Body and the Brain? The Case of a Female Master Athlete. Exp Aging Res 2022; 49:372-388. [PMID: 35950796 DOI: 10.1080/0361073x.2022.2109340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Physical inactivity significantly increases risk of cardiovascular diseases, which are highly prevalent in aging. Conversely, higher levels of physical activity in aging have been associated with benefits for physical and cognitive health and is hypothesized to prevent and reduce development of cardiovascular risk factors. However, those older adults with the highest activity levels (i.e., Master Athletes [MA]) are relatively understudied, and even fewer studies involve female MA. OBJECTIVE The aim of this study was to compare the physiological, physical, and cognitive profiles of an 83-year-old track-and-field MA runner to a sample of inactive age-matched females. RESULTS Results revealed the MA had a high peak oxygen uptake and had superior performance on visuospatial memory tasks compared to her inactive counterparts. Cerebral blood flow was slightly elevated in the MA, but lower cerebrovascular reactivity was revealed compared to the other female included in the magnetic resonance imaging portion. CONCLUSION Our results suggest that high levels of physical activity have benefits on multiple aspects of an aging female's life and that more studies should include MA, as well as a spectrum of cardiorespiratory fitness to further understand the role of physical activity in female aging.
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Affiliation(s)
- Kathia Saillant
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada.,Research Center of the Montreal Heart Institute, Montréal, Québec, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Brittany Intzandt
- Research Center of the Montreal Heart Institute, Montréal, Québec, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada.,School of Graduate Studies, Concordia University, Montréal, Québec, Canada.,PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - Béatrice Bérubé
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada.,Research Center of the Montreal Heart Institute, Montréal, Québec, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Safa Sanami
- Research Center of the Montreal Heart Institute, Montréal, Québec, Canada.,PERFORM Centre, Concordia University, Montréal, Québec, Canada.,Physics Department, Concordia University, Montréal, Québec, Canada
| | - Claudine Gauthier
- Research Center of the Montreal Heart Institute, Montréal, Québec, Canada.,PERFORM Centre, Concordia University, Montréal, Québec, Canada.,Physics Department, Concordia University, Montréal, Québec, Canada
| | - Louis Bherer
- Research Center of the Montreal Heart Institute, Montréal, Québec, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada.,Department of Medicine, Université de Montréal, Montréal, Québec, Canada
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21
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Barral S, Andersen SL, Perls TT, Bae H, Sebastiani P, Christensen K, Thyagarajan B, Lee J, Schupf N. Association between late maternal age and age-related endophenotypes in the Long Life Family Study. Neurosci Lett 2022; 784:136737. [PMID: 35709880 PMCID: PMC11061875 DOI: 10.1016/j.neulet.2022.136737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/02/2022] [Accepted: 06/10/2022] [Indexed: 11/28/2022]
Abstract
Extended maternal age has been suggested as marker of delayed age-associated disabilities. We use the Long Life Family Study (LLFS) offspring generation to investigate the association between extended maternal age at last childbirth and healthy-aging endophenotypes. We hypothesize that women with extended maternal age at last childbirth will exhibit healthier endophenotype profiles compared to younger mothers. The association between maternal age and age-related endophenotypes previously derived in LLFS was assessed using Generalized Estimating Equations to adjust for relatedness. The quartiles of the maternal age at last childbirth were modeled as the independent variables. Univariate analyses tested the association between maternal age at last childbirth and age at clinical assessment, education, field center, Apolipoprotein E (APOE) genotype, depression, stress, smoking and successful pregnancies. Only the variables significantly associated in the univariate analyses were considered in secondary multivariate analyses. Univariate analyses showed that compared to older mothers (age at last birth ≥35), mothers 30 years old or younger at last childbirth are less educated (12 ± 3 years versus 13 ± 3 years) and have a higher frequency of smoking (9% versus 3% for maternal age ≥35). Results showed that older mothers (age at last birth ≥31-34 or ≥ 35) demonstrated significantly better cognitive profiles (p = 0.017 and p = 0.021 respectively) compared with mothers with last childbirth age ≤30. Later maternal age among women from long-life families is associated with a better cognitive profile, supporting the hypothesis that later age at childbirth may be a marker for healthy aging.
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Affiliation(s)
- Sandra Barral
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA; G.H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA; The Department of Neurology, Columbia University Medical Center, New York, NY, USA.
| | - Stacy L Andersen
- Boston University School of Medicine, Department of Medicine, Boston, MA, USA
| | - Thomas T Perls
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Harold Bae
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University Corvallis, OR, USA
| | - Paola Sebastiani
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Kaare Christensen
- University of Southern Denmark, Odense, Denmark, Department of Epidemiology, Biostatistics and Biodemography, Odense, Denmark
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Joseph Lee
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA; G.H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA; The Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Nicole Schupf
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA; G.H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA; The Department of Neurology, Columbia University Medical Center, New York, NY, USA; The Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
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22
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Zhang Y. Fertility History and Risk of Cognitive Impairment Among Older Parents in the United States. J Gerontol B Psychol Sci Soc Sci 2022; 77:2326-2337. [PMID: 35796743 PMCID: PMC9799211 DOI: 10.1093/geronb/gbac091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES I work from a gendered life-course perspective to examine the association between older parents' fertility history (i.e., timing and parity) and their risk of cognitive impairment in the United States. METHODS I analyze nationally representative data from 9 waves over 16 years of the Health and Retirement Study (2000-2016). The sample includes 14,543 respondents (6,108 men and 8,435 women) aged 50 and older at the baseline survey. I examine the relationship between parity, age at first birth, and age at last birth with risk of cognitive impairment using nonlinear discrete-time hazard models. RESULTS Adjusting for the effects of full covariates, there are U-shaped relationships between women's age at last birth and risk of cognitive impairment and between women's parity and risk of cognitive impairment. In the sensitivity tests, the relationships remain robust when sampling weights are applied, or mortality selection is corrected. DISCUSSION Fertility timing and parity are likely factors associated with the risk of cognitive impairment for older women. Understanding fertility history and its impact on cognition can help identify the most vulnerable subpopulations, so that more effective interventions can be made to improve cognitive functioning among older adults.
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Affiliation(s)
- Yan Zhang
- Address correspondence to: Center for Demography of Health and Aging, University of Wisconsin–Madison, Madison, Wisconsin, USA. E-mail:
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23
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Kashtanova DA, Taraskina AN, Erema VV, Akopyan AA, Ivanov MV, Strazhesko ID, Akinshina AI, Yudin VS, Makarov VV, Kraevoy SA, Korolev DE, Tarasova IV, Beloshevskaya OA, Mkhitaryan EA, Tkacheva ON, Yudin SM. Analyzing Successful Aging and Longevity: Risk Factors and Health Promoters in 2020 Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138178. [PMID: 35805838 PMCID: PMC9266557 DOI: 10.3390/ijerph19138178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022]
Abstract
Geriatric syndromes (GSs) and aging-associated diseases (AADs) are common side effects of aging. They are affecting the lives of millions of older adults and placing immense pressure on healthcare systems and economies worldwide. It is imperative to study the factors causing these conditions and develop a holistic framework for their management. The so-called long-lived individuals—people over the age of 90 who managed to retain much of their health and functionality—could be holding the key to understanding these factors and their health implications. We analyzed the health status and lifestyle of the long-lived individuals and identified risk factors for GSs. Family history greatly contributes to the health and prevention of cognitive decline in older adults. Lifestyle and certain socioeconomic factors such as education, the age of starting to work and retiring, job type and income level, physical activity, and hobby were also associated with certain GSs. Moreover, the levels of total protein, albumin, alpha-1 globulins, high-density lipoprotein, free triiodothyronine, and 25-hydroxyvitamin D were direct indicators of the current health status. The proposed mathematical model allows the prediction of successful aging based on family history, social and economic factors, and life-long physical activity (f1 score = 0.72, AUC = 0.68, precision = 0.83 and recall = 0.64).
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Affiliation(s)
- Daria A. Kashtanova
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency 10 Bld., 1 Pogodinskaya Str., Moscow 119121, Russia; (A.N.T.); (V.V.E.); (M.V.I.); (A.I.A.); (V.S.Y.); (V.V.M.); (S.A.K.); (S.M.Y.)
- Correspondence:
| | - Anastasiia N. Taraskina
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency 10 Bld., 1 Pogodinskaya Str., Moscow 119121, Russia; (A.N.T.); (V.V.E.); (M.V.I.); (A.I.A.); (V.S.Y.); (V.V.M.); (S.A.K.); (S.M.Y.)
| | - Veronika V. Erema
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency 10 Bld., 1 Pogodinskaya Str., Moscow 119121, Russia; (A.N.T.); (V.V.E.); (M.V.I.); (A.I.A.); (V.S.Y.); (V.V.M.); (S.A.K.); (S.M.Y.)
| | - Anna A. Akopyan
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, Bld. 16, 1st Leonova Street, Moscow 129226, Russia; (A.A.A.); (I.D.S.); (D.E.K.); (I.V.T.); (O.A.B.); (E.A.M.); (O.N.T.)
| | - Mikhail V. Ivanov
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency 10 Bld., 1 Pogodinskaya Str., Moscow 119121, Russia; (A.N.T.); (V.V.E.); (M.V.I.); (A.I.A.); (V.S.Y.); (V.V.M.); (S.A.K.); (S.M.Y.)
| | - Irina D. Strazhesko
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, Bld. 16, 1st Leonova Street, Moscow 129226, Russia; (A.A.A.); (I.D.S.); (D.E.K.); (I.V.T.); (O.A.B.); (E.A.M.); (O.N.T.)
| | - Alexandra I. Akinshina
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency 10 Bld., 1 Pogodinskaya Str., Moscow 119121, Russia; (A.N.T.); (V.V.E.); (M.V.I.); (A.I.A.); (V.S.Y.); (V.V.M.); (S.A.K.); (S.M.Y.)
| | - Vladimir S. Yudin
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency 10 Bld., 1 Pogodinskaya Str., Moscow 119121, Russia; (A.N.T.); (V.V.E.); (M.V.I.); (A.I.A.); (V.S.Y.); (V.V.M.); (S.A.K.); (S.M.Y.)
| | - Valentin V. Makarov
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency 10 Bld., 1 Pogodinskaya Str., Moscow 119121, Russia; (A.N.T.); (V.V.E.); (M.V.I.); (A.I.A.); (V.S.Y.); (V.V.M.); (S.A.K.); (S.M.Y.)
| | - Sergey A. Kraevoy
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency 10 Bld., 1 Pogodinskaya Str., Moscow 119121, Russia; (A.N.T.); (V.V.E.); (M.V.I.); (A.I.A.); (V.S.Y.); (V.V.M.); (S.A.K.); (S.M.Y.)
| | - Denis E. Korolev
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, Bld. 16, 1st Leonova Street, Moscow 129226, Russia; (A.A.A.); (I.D.S.); (D.E.K.); (I.V.T.); (O.A.B.); (E.A.M.); (O.N.T.)
| | - Irina V. Tarasova
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, Bld. 16, 1st Leonova Street, Moscow 129226, Russia; (A.A.A.); (I.D.S.); (D.E.K.); (I.V.T.); (O.A.B.); (E.A.M.); (O.N.T.)
| | - Olga A. Beloshevskaya
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, Bld. 16, 1st Leonova Street, Moscow 129226, Russia; (A.A.A.); (I.D.S.); (D.E.K.); (I.V.T.); (O.A.B.); (E.A.M.); (O.N.T.)
| | - Elen A. Mkhitaryan
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, Bld. 16, 1st Leonova Street, Moscow 129226, Russia; (A.A.A.); (I.D.S.); (D.E.K.); (I.V.T.); (O.A.B.); (E.A.M.); (O.N.T.)
| | - Olga N. Tkacheva
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, Bld. 16, 1st Leonova Street, Moscow 129226, Russia; (A.A.A.); (I.D.S.); (D.E.K.); (I.V.T.); (O.A.B.); (E.A.M.); (O.N.T.)
| | - Sergey M. Yudin
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency 10 Bld., 1 Pogodinskaya Str., Moscow 119121, Russia; (A.N.T.); (V.V.E.); (M.V.I.); (A.I.A.); (V.S.Y.); (V.V.M.); (S.A.K.); (S.M.Y.)
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Bonsang E, Skirbekk V. Does Childbearing Affect Cognitive Health in Later Life? Evidence From an Instrumental Variable Approach. Demography 2022; 59:975-994. [PMID: 35471229 PMCID: PMC10539463 DOI: 10.1215/00703370-9930490] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cognitive decline is a widespread concern as populations grow older. However, population aging is partly driven by a decrease in fertility, and family size may influence cognitive functioning in later life. Prior studies have shown that fertility history is associated with late-life cognition, but whether the relationship is causal remains unclear. We use an instrumental variable approach and data from the Survey of Health, Ageing, and Retirement in Europe to examine whether having three or more versus two children affects late-life cognition. Parents often prefer to have at least one son and one daughter. We thus exploit the sex composition of the first two children as a source of exogenous variation in the probability of having three or more children. Results indicate that having three or more versus two children has a negative effect on late-life cognition. This effect is strongest in Northern Europe, perhaps because higher fertility decreases financial resources yet does not improve social resources in this region. Future studies should address the potential effects of childlessness or having one child on late-life cognition and explore the mediating mechanisms.
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Affiliation(s)
- Eric Bonsang
- LEDA, CNRS, IRD, Université Paris-Dauphine, Université PSL, Paris, France
- Netspar, Tilburg, the Netherlands
| | - Vegard Skirbekk
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Columbia Aging Centre, Columbia University, New York, NY, USA
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Zhou R, Liu HM, Zou LW, Wei HX, Huang YN, Zhong Q, Gu SY, Chen MF, Wang SL, Sun HX, Wu XB. Associations of Parity With Change in Global Cognition and Incident Cognitive Impairment in Older Women. Front Aging Neurosci 2022; 14:864128. [PMID: 35601623 PMCID: PMC9114765 DOI: 10.3389/fnagi.2022.864128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background The evidence of the association between parity and risk of mild cognitive impairment (MCI) or dementia is mixed, and the relationship between parity and longitudinal cognitive changes is less clear. We investigated these issues in a large population of older women who were carefully monitored for development of MCI and probable dementia. Methods Using the Women’s Health Initiative Memory Study, 7,100 postmenopausal women (mean age 70.1 ± 3.8 years) with information on baseline parity (defined as the number of term pregnancies), measures of global cognition (Modified Mini-Mental State Examination score) from 1996–2007, and cognitive impairment (centrally adjudicated diagnoses of MCI and dementia) from 1996–2016 were included. Multivariable linear mixed-effects models were used to analyze the rate of changes in global cognition. Cox regression models were used to evaluate the risk of MCI/dementia across parity groups. Results Over an average of 10.5 years, 465 new cases of MCI/dementia were identified. Compared with nulliparous women, those with a parity of 1–3 and ≥4 had a lower MCI/dementia risk. The HRs were 0.75 (0.56–0.99) and 0.71 (0.53–0.96), respectively (P < 0.01). Similarly, a parity of 1–3 and ≥4 was related to slower cognitive decline (β = 0.164, 0.292, respectively, P < 0.05). Conclusion Higher parity attenuated the future risk for MCI/dementia and slowed the rates of cognitive decline in elderly women. Future studies are needed to determine how parity affects late-life cognitive function in women.
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Affiliation(s)
- Rui Zhou
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China
| | - Hua-Min Liu
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China
| | - Lian-Wu Zou
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, China
| | - Hong-Xia Wei
- Department of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China
| | - Yi-Ning Huang
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China
| | - Qi Zhong
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China
| | - Shan-Yuan Gu
- Inpatient Department, Baiyun Jingkang Hospital, Guangzhou, China
| | - Ming-Feng Chen
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, China
| | - Shao-Li Wang
- Clinical Laboratory, Baiyun Jingkang Hospital, Guangzhou, China
| | - Hai-Xia Sun
- Department of Geriatrics, The 74th Army Hospital of the Chinese People’s Liberation Army, Guangzhou, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China
- *Correspondence: Xian-Bo Wu,
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Xi H, Gan J, Liu S, Wang F, Chen Z, Wang XD, Shi Z, Ji Y. Reproductive factors and cognitive impairment in natural menopausal women: A cross-sectional study. Front Endocrinol (Lausanne) 2022; 13:893901. [PMID: 35979434 PMCID: PMC9376623 DOI: 10.3389/fendo.2022.893901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Little information on rural older women in northern China has been reported, apart from three studies in southern and eastern China in the past decade. This study aims to evaluate the relationships between reproductive factors and the risk of cognitive impairment, including mild cognitive impairment (MCI) and dementia, in Chinese women with natural menopause. METHODS The cross-sectional study was conducted in 112 community primary healthcare centers in rural northern China between April 2019 and January 2020. A total of 4,275 women aged ≥65 years who had natural menopause were included. Reproductive factors as well as the reproductive period (= age at menopause - age at menarche) were recorded. The relationships between reproductive factors and cognitive impairment were evaluated by correlation and logistic regression analysis. RESULTS Overall, 28.6% and 11.4% of women were diagnosed with MCI or dementia, respectively. In natural menopause women, the age at menopause (adjusted r = 0.070, p < 0.001), reproductive period (adjusted r = 0.053, p = 0.001), and number of pregnancies (adjusted r = -0.042, p = 0.007) and parities (adjusted r = -0.068, p < 0.001) were correlated with Mini-Mental State Examination (Chinese version) scores, and with similar findings concerning MCI and dementia with Lewy bodies (DLB). Greater age at menopause and a long reproductive period significantly decreased the risk of MCI and Alzheimer's disease (AD), and more parities significantly increased the risks of MCI (odds ratio (OR) = 1.111, 95% confidence interval (CI): 1.039-1.187, p = 0.002), dementia (OR = 1.162, 95% CI: 1.061-1.271, p = 0.001), particular AD (OR = 1.131, 95% CI: 1.010-1.266, p = 0.032), DLB (OR = 1.238, 95% CI: 1.003-1.528, p = 0.047), and vascular dementia (VaD) (OR = 1.288, 95% CI: 1.080-1.536, p = 0.005). CONCLUSIONS The prevalence rates of MCI and dementia were 28.6% and 11.4% in older women. Greater age at menarche, young age at menopause, shorter reproductive period, and larger numbers of pregnancies/parities were correlated with poor cognition and significantly increased the risks of MCI and dementia, particularly AD, DLB, and VaD.
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Affiliation(s)
- Haitao Xi
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jinghuan Gan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuai Liu
- Department of Neurology, Tianjin Dementia Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
| | - Fei Wang
- Department of Neurology, Yuncheng Central Hospital of Shanxi Province, Yuncheng, China
| | - Zhichao Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiao-Dan Wang
- Department of Neurology, Tianjin Dementia Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
| | - Zhihong Shi
- Department of Neurology, Tianjin Dementia Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
| | - Yong Ji
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Tianjin Dementia Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
- *Correspondence: Yong Ji,
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Lindseth LRS, de Lange AMG, van der Meer D, Agartz I, Westlye LT, Tamnes CK, Barth C. Associations between reproductive history, hormone use, APOE ε4 genotype and cognition in middle- to older-aged women from the UK Biobank. Front Aging Neurosci 2022; 14:1014605. [PMID: 36760712 PMCID: PMC9907169 DOI: 10.3389/fnagi.2022.1014605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/20/2022] [Indexed: 01/26/2023] Open
Abstract
Introduction Relative to men, women are at a higher risk of developing age-related neurocognitive disorders including Alzheimer's disease. While women's health has historically been understudied, emerging evidence suggests that reproductive life events such as pregnancy and hormone use may influence women's cognition later in life. Methods We investigated the associations between reproductive history, exogenous hormone use, apolipoprotein (APOE) ε4 genotype and cognition in 221,124 middle- to older-aged (mean age 56.2 ± 8.0 years) women from the UK Biobank. Performance on six cognitive tasks was assessed, covering four cognitive domains: episodic visual memory, numeric working memory, processing speed, and executive function. Results A longer reproductive span, older age at menopause, older age at first and last birth, and use of hormonal contraceptives were positively associated with cognitive performance later in life. Number of live births, hysterectomy without oophorectomy and use of hormone therapy showed mixed findings, with task-specific positive and negative associations. Effect sizes were generally small (Cohen's d < 0.1). While APOE ε4 genotype was associated with reduced processing speed and executive functioning, in a dose-dependent manner, it did not influence the observed associations between female-specific factors and cognition. Discussion Our findings support previous evidence of associations between a broad range of female-specific factors and cognition. The positive association between a history of hormonal contraceptive use and cognition later in life showed the largest effect sizes (max. d = 0.1). More research targeting the long-term effects of female-specific factors on cognition and age-related neurocognitive disorders including Alzheimer's disease is crucial for a better understanding of women's brain health and to support women's health care.
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Affiliation(s)
| | - Ann-Marie G. de Lange
- LREN, Department of Clinical Neurosciences, Centre for Research in Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Dennis van der Meer
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Ingrid Agartz
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Stockholm Health Care Services, Karolinska Institute, Stockholm County Council, Stockholm, Sweden
| | - Lars T. Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christian K. Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
| | - Claudia Barth
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- *Correspondence: Claudia Barth, ✉
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Miller EC, Wilczek A, Bello NA, Tom S, Wapner R, Suh Y. Pregnancy, preeclampsia and maternal aging: From epidemiology to functional genomics. Ageing Res Rev 2022; 73:101535. [PMID: 34871806 PMCID: PMC8827396 DOI: 10.1016/j.arr.2021.101535] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 11/15/2021] [Accepted: 12/01/2021] [Indexed: 01/03/2023]
Abstract
Women live longer than men but experience greater disability and a longer period of illness as they age. Despite clear sex differences in aging, the impact of pregnancy and its complications, such as preeclampsia, on aging is an underexplored area of geroscience. This review summarizes our current knowledge about the complex links between pregnancy and age-related diseases, including evidence from epidemiology, clinical research, and genetics. We discuss the relationship between normal and pathological pregnancy and maternal aging, using preeclampsia as a primary example. We review the results of human genetics studies of preeclampsia, including genome wide association studies (GWAS), and attempted to catalog genes involved in preeclampsia as a gateway to mechanisms underlying an increased risk of later life cardio- and neuro- vascular events. Lastly, we discuss challenges in interpreting the GWAS of preeclampsia and provide a functional genomics framework for future research needed to fully realize the promise of GWAS in identifying targets for geroprotective prevention and therapeutics against preeclampsia.
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Affiliation(s)
- Eliza C. Miller
- Department of Neurology, Division of Stroke and Cerebrovascular Disease, Columbia University Irving Medical Center, New York, NY, USA
| | - Ashley Wilczek
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - Natalie A. Bello
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Sarah Tom
- Department of Neurology, Division of Neurology Clinical Outcomes Research and Population Science and the Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Ronald Wapner
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA.
| | - Yousin Suh
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA; Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY, USA.
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Zhang Y, Fletcher J. Parental status in later life and parents' risk of cognitive impairment. SSM Popul Health 2021; 16:100968. [PMID: 34825046 PMCID: PMC8605109 DOI: 10.1016/j.ssmph.2021.100968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/29/2021] [Accepted: 11/12/2021] [Indexed: 11/30/2022] Open
Abstract
Parental status can influence parents’ well-being in significant ways, but little research has examined its impact on older adults’ cognitive health in the U.S. Using data from the National Health and Aging Trends Study (NHATS) 2011–2019, this study examines whether parental status is related to the risk of cognitive impairment among older adults in the U.S. We found that the presence of adult children (i.e., having at least one living adult child) was associated with a lower risk of cognitive impairment for older parents. Moreover, compared to childless older adults, older parents who had three and more children, who had adult daughter(s), and who had biological/adopted adult children displayed a significantly lower risk of cognitive impairment. This study highlights the importance of adult children as resources of support and caring that may benefit older parents’ cognitive health. The findings can help to identify the most vulnerable subpopulations among aging adults so that medical workers and policy makers can design effective strategies to protect cognitive function for those “at risk” older adults. Parental status is an important factor related to older adults’ cognitive health. Presence of adult children was associated with a lower risk of cognitive impairment than being childlessness. Having 3+ children, adult daughter(s), or biological children was associated with lower risk of cognitive impairment.
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Affiliation(s)
- Yan Zhang
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
| | - Jason Fletcher
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
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Gemmill A, Weiss J. The relationship between fertility history and incident dementia in the US Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2021; 77:1118-1131. [PMID: 34614155 DOI: 10.1093/geronb/gbab183] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES An emerging literature suggests that fertility history, which includes measures of parity and birth timing, may influence cognitive health in older ages, especially among women given their differential exposure to pregnancy and sex hormones. Yet, few studies have examined associations between measures of fertility history and incident dementia in population-based samples. METHODS We examined the associations between parity, younger age at first birth, and older age at last birth with incident dementia over a 16-year period in a prospective sample of 15,361 men and women aged 51-100 years at baseline drawn from the Health and Retirement Study. We used Cox regression and the Fine and Gray model to obtain cause-specific (csHRs) and subdistribution hazard ratios (sdHRs) for incident dementia from gender-stratified models in which we accounted for the semi-competing risk of death. RESULTS During the follow-up period (median 13.0 years), the crude incidence rate for dementia was 16.6 and 19.9 per 1,000 person-years for men and women, respectively. In crude models estimating csHRs, higher parity (vs. parity 2) and younger age at first birth were associated with increased risk of dementia for both genders. These associations did not persist after full covariate adjustment. Across all models in which we estimated sdHRs, we observed a positive relationship between older age at last birth and incident dementia for women only. DISCUSSION In this population-based, multi-ethnic cohort, we observed limited evidence for an association between measures of fertility history and incident dementia among men and women after adjusting for potential confounders.
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Affiliation(s)
- Alison Gemmill
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jordan Weiss
- Department of Demography, University of California, Berkeley, CA, USA
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Peterson A, Tom SE. A Lifecourse Perspective on Female Sex-Specific Risk Factors for Later Life Cognition. Curr Neurol Neurosci Rep 2021; 21:46. [PMID: 34227023 DOI: 10.1007/s11910-021-01133-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW The prevalence of Alzheimer's disease and related dementias is greater in women compared to men. We provide a review of female sex-specific risk factors across the lifecourse for cognition in older adulthood, highlighting areas that need further study. RECENT FINDINGS Pregnancy may affect late-life cognition, with adverse pregnancy outcomes associated with an increased risk of cognitive decline but parity providing a protective effect. Cumulative estrogen exposure, influenced by age of menarche, menopause, and exogenous estrogen use, may modify a woman's risk for dementia. Menopause transition-associated symptoms may impact cognitive health at the time of the symptoms, but long-term effects remain unknown. As compared to natural menopause, surgical menopause seems to increase the risk for cognitive impairment. Studies that have assessed the association between women's reproductive health and cognition have produced conflicting results. Future studies that address these inconsistencies among diverse populations are needed to better care for women throughout their lives.
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Affiliation(s)
- Amalia Peterson
- Department of Neurology, College of Physicians and Surgeons, Columbia University, 622 W. 168th Street, New York, NY, 10032, USA.
| | - Sarah E Tom
- Department of Neurology, College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Rote SM, Angel JL. Gender-Based Pathways to Cognitive Aging in the Mexican-Origin Population in the United States: The Significance of Work and Family. J Gerontol B Psychol Sci Soc Sci 2021; 76:e165-e175. [PMID: 33141216 DOI: 10.1093/geronb/gbaa189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study uses the life course perspective to explore the role of key midlife factors (occupation and number of children) for gender- and nativity-based pathways to cognitive aging for older Mexican Americans. METHOD Using the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE, 1993/1994-2016, n = 2,779), this study presents (a) cognitive impairment trajectories over 20 years of data and (b) multinomial logistic regression analyses of trajectory group membership by lifetime occupation and number of children, controlling for educational attainment. RESULTS For older Mexican American men, lifetime employment in agricultural occupations is associated with elevated risk for late-life cognitive impairment. Delayed risk for impairment is observed for U.S.-born men who were employed in factory work (e.g., production and repair) and in Mexican-born men who were employed in occupations with skilled or supervisory requirements. For all women, labor force participation, especially in skilled occupations, is related to a delayed risk of cognitive impairment. Number of children is unrelated to impairment for men; however, women with five or more children (compared to women with two to four children) are at risk for consistent and rapid cognitive impairment in late life. DISCUSSION Late-life cognitive health disparities that disproportionately impact the Mexican American population can be addressed by improving access to educational and occupational opportunities in early and midlife. This study points to key areas of intervention within work and the home for the Mexican-origin population.
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Affiliation(s)
- Sunshine M Rote
- Kent School of Social Work, University of Louisville, Kentucky
| | - Jacqueline L Angel
- School of Public Affairs and Department of Sociology, The University of Texas at Austin
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Saenz JL, Díaz-Venegas C, Crimmins EM. Fertility History and Cognitive Function in Late Life: The Case of Mexico. J Gerontol B Psychol Sci Soc Sci 2021; 76:e140-e152. [PMID: 31603514 PMCID: PMC7955970 DOI: 10.1093/geronb/gbz129] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Mexico is aging rapidly, which makes identification of life-course factors influencing cognition a public health priority. We evaluate how the number of children one has relates to cognition in Mexico, a rapidly aging country that experienced fertility declines across recent cohorts of older people. METHOD We analyze older adults (age 50+, n = 11,380) from the 2015 Mexican Health and Aging Study. Respondents were categorized by number of children ever born (0-1, 2-3, 4-5, 6+). Using ordinary least squares regression, we estimate independent associations between fertility history and cognition accounting for demographic, socioeconomic, health, and psychosocial factors. RESULTS We observed an inverse U-shaped relationship between number of children (peaking at 2-3 children) and cognitive function, regardless of gender. In regression analyses adjusted for confounding variables, having 0-1 (vs 2-3 children) was associated with poorer cognitive function only for females. Regardless of gender, having 6+ (vs 2-3 children) was associated with poorer cognitive function. These associations remained significant even after accounting for socioeconomic, health, employment, and psychosocial factors. DISCUSSION Our results suggest fertility history may play a role in late-life cognitive health and provide evidence that both low and high fertility may relate to poorer cognitive function. We discuss differences by gender.
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Affiliation(s)
- Joseph L Saenz
- University of Southern California, Davis School of Gerontology, Los Angeles
| | | | - Eileen M Crimmins
- University of Southern California, Davis School of Gerontology, Los Angeles
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Hu Z, Wu Y, Yang H, Xie L, Zhang A, Lin X, Nie Y, Zhang X. Effects of Fertility Behaviors on Depression Among the Elderly: Empirical Evidence From China. Front Public Health 2021; 8:570832. [PMID: 33575236 PMCID: PMC7870999 DOI: 10.3389/fpubh.2020.570832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 12/30/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Increased population aging is associated with increased incidence of depression among the elderly. Existing studies have shown that ill-advised fertility behaviors during their youth also affect the health of the elderly. However, insufficient attention has been paid to depression among elderly in China. This paper focuses on how fertility behaviors affect senile depression among parents by examining the heterogeneity of such effects and tests the applicability of existing theoretical findings in a Chinese sample. Methods: The effects of fertility behaviors on depression among the elderly were investigated using the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative dataset. The effects of early-age fertility behaviors on the degree of depression among the elderly were investigated using ordinary least squares and ordered probit models that adjusted for demographic and socioeconomic factors. Results: (1) The age of first childbirth, childbearing period, and number of births were significantly and positively correlated with the degree of depression among the elderly (particularly rural persons aged 50–70 and older womens). (2) Elderly persons with sons had no better mental health status than those without sons, thus indicating the inapplicability of the traditional concept of “more sons are equal to more happiness” to the actual mental health situation of the elderly in China today. Conclusion: Overall, multiple, late, and boy-oriented childbearing and overly long childbearing periods had negative effects on mental health among Chinese elderly persons. This study tested the applicability of existing theoretical inferences and empirical conclusions in China, thereby further expanding the current literature regarding the effects of fertility behaviors on depression among the elderly.
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Affiliation(s)
- Zhen Hu
- School of Economics and Management, Northwest Agricultural and Forestry University, Xianyang, China
| | - Yuanyang Wu
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Hualei Yang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Lin Xie
- Institution of Population and Labor Economics, The Chinese Academy of Social Science, Beijing, China
| | - Anqi Zhang
- School of Public Economy and Management, Shanghai University of Finance and Economics, Shanghai, China
| | - Xueyu Lin
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Yafeng Nie
- School of Economics and Management, Northwest Agricultural and Forestry University, Xianyang, China
| | - Xiaoyu Zhang
- School of Economics and Management, Northwest Agricultural and Forestry University, Xianyang, China
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Read S, Comas-Herrera A, Grundy E. Social Isolation and Memory Decline in Later-life. J Gerontol B Psychol Sci Soc Sci 2020; 75:367-376. [PMID: 31781769 PMCID: PMC6963696 DOI: 10.1093/geronb/gbz152] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To investigate associations between level and changes in social isolation and in memory in older men and women. METHODS The sample included 6,123 women and 5,110 men aged 50+ from the English Longitudinal Study of Aging (ELSA). Extended latent change score models from six measurement occasions every 2 years from 2002 were used to investigate associations between social isolation and memory. Models were adjusted for age, socioeconomic position, and health. RESULTS Social isolation increased and memory decreased over time. Among men an initially high level of social isolation was associated with a somewhat greater decrease in memory. Among women a greater increase in social isolation predicted a greater decrease in memory and a larger change in social isolation was associated with further larger changes in isolation, although when social isolation reached a higher level it subsequently decreased. CONCLUSIONS Results suggest that the association between social isolation and memory decline arises because social isolation is associated with increased memory decline rather than poor memory leading to increases in social isolation. Men with high levels of social isolation and women with accumulated social isolation over time are especially affected as these patterns of isolation were associated with more profound memory decline.
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Affiliation(s)
- Sanna Read
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
| | - Adelina Comas-Herrera
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
| | - Emily Grundy
- Institute for Social and Economic Research, University of Essex, Colchester, UK
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Abstract
Evolutionary theories of senescence, such as the ‘disposable soma’ theory, propose that natural selection trades late survival for early fecundity. ‘Frailty’, a multidimensional measure of health status, may help to better define the long-term consequences of reproduction. We examined the relationship between parity and later life frailty (as measured by the Frailty Index) in a sample of 3,534 adults aged 65 years and older who participated in the English Longitudinal Study of Ageing. We found that the most parous adults were the most frail and that the parity-frailty relationship was similar for both sexes. Whilst this study provided some evidence for a ‘parity-frailty trade-off’, there was little support for our hypothesis that the physiological costs of childbearing influence later life frailty. Rather, behavioural and social factors associated with rearing many children may have contributed to the development of frailty in both sexes.
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Ning K, Zhao L, Franklin M, Matloff W, Batta I, Arzouni N, Sun F, Toga AW. Parity is associated with cognitive function and brain age in both females and males. Sci Rep 2020; 10:6100. [PMID: 32269255 PMCID: PMC7142076 DOI: 10.1038/s41598-020-63014-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 03/03/2020] [Indexed: 12/20/2022] Open
Abstract
Previous studies of the association between parity and long-term cognitive changes have primarily focused on women and have shown conflicting results. We investigated this association by analyzing data collected on 303,196 subjects from the UK Biobank. We found that in both females and males, having offspring was associated with a faster response time and fewer mistakes made in the visual memory task. Subjects with two or three children had the largest differences relative to those who were childless, with greater effects observed in men. We further analyzed the association between parity and relative brain age (n = 13,584), a brain image-based biomarker indicating how old one's brain structure appears relative to peers. We found that in both sexes, subjects with two or three offspring had significantly reduced brain age compared to those without offspring, corroborating our cognitive function results. Our findings suggest that lifestyle factors accompanying having offspring, rather than the physical process of pregnancy experienced only by females, contribute to these associations and underscore the importance of studying such factors, particularly in the context of sex.
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Affiliation(s)
- Kaida Ning
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, California, 90033, USA
- Molecular and Computational Biology Program, University of Southern California, Los Angeles, CA, 90089, USA
| | - Lu Zhao
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, California, 90033, USA
| | - Meredith Franklin
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90032, United States
| | - Will Matloff
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, California, 90033, USA
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, 90089, USA
| | - Ishaan Batta
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, California, 90033, USA
| | - Nibal Arzouni
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, California, 90033, USA
- Molecular and Computational Biology Program, University of Southern California, Los Angeles, CA, 90089, USA
| | - Fengzhu Sun
- Molecular and Computational Biology Program, University of Southern California, Los Angeles, CA, 90089, USA
| | - Arthur W Toga
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, California, 90033, USA.
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Einiö E, Goisis A, Myrskylä M. Is the relationship between men's age at first birth and midlife health changing? Evidence from two British cohorts. SSM Popul Health 2019; 8:100458. [PMID: 31388553 PMCID: PMC6676239 DOI: 10.1016/j.ssmph.2019.100458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/18/2019] [Accepted: 07/20/2019] [Indexed: 11/28/2022] Open
Abstract
Becoming a father, particularly for the first time, is a central transition in men's lives, and whether this transition takes place early or later in life may have important ramifications on the whole later life course. Previous research has shown that men who father their first child early in life have poorer later-life health than men who postpone having children. However, it is not known how selection by cognitive ability and other childhood characteristics confound the association between the timing of fatherhood and later-life health, or how the association is changing over time as parenthood is postponed to an older age. We investigate the association between men's age at the birth of their first child and midlife self-rated health in two British cohorts born in 1958 and 1970. The study employs logit models. Relative to men who had their first child when they were between 25 and 29 years old, men who had their first child before the age of 20 have the poorest health, followed by men who had a child when they were 20–24 years old. This result was observed in both cohorts. Childhood cognitive ability, which previous research has not analyzed, strongly contributed to this association, and to a greater extent than other childhood characteristics. For the 1970 cohort, those who became fathers at age 35 or older had the best health. This advantage was not found for the 1958 cohort. These findings suggest that the relationship between young age at fatherhood and midlife health is strongly confounded by cognitive ability, and that in recent cohorts a new pattern of advantage among older fathers has emerged. Early fatherhood shows associations with poorer self-rated health in midlife. Childhood cognitive ability strongly confounds this association. First-time fathers aged 35 years or older have the best health in the 1970 cohort. A similar health advantage in older fathers is not found in the 1958 cohort.
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Affiliation(s)
- Elina Einiö
- Department of Social Research, University of Helsinki, P.O. Box 18, 00014, Finland.,Department of Social Policy, London School of Economics and Political Science, Old Building, Houghton St, London, WC2A 2AE, United Kingdom.,Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057, Rostock, Germany
| | - Alice Goisis
- Department of Social Policy, London School of Economics and Political Science, Old Building, Houghton St, London, WC2A 2AE, United Kingdom.,Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057, Rostock, Germany.,Centre for Longitudinal Studies, Department of Social Science, University College London, 55-59, Gordon Square, London, United Kingdom
| | - Mikko Myrskylä
- Department of Social Research, University of Helsinki, P.O. Box 18, 00014, Finland.,Department of Social Policy, London School of Economics and Political Science, Old Building, Houghton St, London, WC2A 2AE, United Kingdom.,Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057, Rostock, Germany
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Abstract
OBJECTIVE The aim of the study was to examine the association of pregnancy history with trajectories of cognitive function in older women. METHODS Participants were 1,025 women (mean age = 73.1 ± 9.6 y) enrolled in the Rancho Bernardo Study who attended a clinic visit between 1988 and 1992, when pregnancy history (ever pregnant, number of pregnancies, ages at first and last pregnancy) was recorded and cognitive function was assessed with a battery of four tests repeated up to 7 times through 2016. Linear mixed-effects regression models were used to examine the association between pregnancy history and longitudinal change in cognitive function. RESULTS Overall, 77% of women had at least one pregnancy; number of pregnancies ranged from 1 to 14 (mean = 2.9 ± 1.7). Ages at first and last pregnancy ranged from 16 to 44 years (mean = 24.9 ± 4.7) and 16 to 49 years (mean = 30.7 ± 5.5), respectively. Of 16 associations tested (4 pregnancy exposures by 4 cognitive tests), one was statistically significant without correction for multiple comparisons. Women who reported ever being pregnant recalled 0.12 fewer words on the Buschke Selective Reminding Test for every year increase in age than women who had never been pregnant (P = 0.05). No other significant associations of pregnancy history with cognitive decline were observed. CONCLUSIONS Our results show no clinically meaningful long-term influence of pregnancy history on age-related change in cognitive function. These reassuring findings suggest childbearing decisions and timing will not affect cognitive function in older age.
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Fertility History and Physical and Mental Health Changes in European Older Adults. EUROPEAN JOURNAL OF POPULATION-REVUE EUROPEENNE DE DEMOGRAPHIE 2018; 35:459-485. [PMID: 31372101 PMCID: PMC6639520 DOI: 10.1007/s10680-018-9489-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/04/2018] [Indexed: 02/07/2023]
Abstract
Previous studies have shown that aspects of reproductive history, such as earlier parenthood and high parity, are associated with poorer health in mid and later life. However, it is unclear which dimensions of health are most affected by reproductive history, and whether the pattern of associations varies for measures of physical, psychological and cognitive health. Such variation might provide more insight into possible underlying mechanisms. We use longitudinal data for men and women aged 50–79 years in ten European countries from the Survey of Health, Ageing and Retirement in Europe to analyse associations between completed fertility history and self-reported and observed health indicators measured 2–3 years apart (functional limitations, chronic diseases, grip strength, depression and cognition), adjusting for socio-demographic, and health factors at baseline. Using multiple imputation and pattern mixture modelling, we tested the robustness of estimates to missing data mechanisms. The results are partly consistent with previous studies and show that women who became mothers before age 20 had worse functional health at baseline and were more likely to suffer functional health declines. Parents of 4 or more children had worse physical, psychological and cognitive health at baseline and were more likely to develop circulatory disease over the follow-up period. Men who delayed fatherhood until age 35 or later had better health at baseline but did not experience significantly different health declines. This study improves our understanding of linkages between fertility histories and later life health and possible implications of changes in fertility patterns for population health. However, research ideally using prospective life course data is needed to further elucidate possible mechanisms, considering interactions with partnership histories, health behaviour patterns and socio-economic trajectories.
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Watts P, Webb E, Netuveli G. The role of sports clubs in helping older people to stay active and prevent frailty: a longitudinal mediation analysis. Int J Behav Nutr Phys Act 2017; 14:95. [PMID: 28705220 PMCID: PMC5512788 DOI: 10.1186/s12966-017-0552-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 07/07/2017] [Indexed: 01/17/2023] Open
Abstract
Background Frailty is a common syndrome in older adults characterised by increased vulnerability to adverse health outcomes as a result of decline in functional and physiological measures. Frailty predicts a range of poor health and social outcomes and is associated with increased risk of hospital admission. The health benefits of sport and physical activity and the health risks of inactivity are well known. However, less is known about the role of sports clubs and physical activity in preventing and managing frailty in older adults. The objective of this study is to examine the role of membership of sports clubs in promoting physical activity and reducing levels of frailty in older adults. Methods We used data from waves 1 to 7 of the English Longitudinal Study of Ageing (ELSA). Survey items on physical activity were combined to produce a measure of moderate or vigorous physical activity for each wave. Frailty was measured using an index of accumulated deficits. A total of sixty deficits, including symptoms, disabilities and diseases were recorded through self-report and tests. Direct and indirect relationships between sports club membership, levels of physical activity and frailty were examined using a cross-lagged panel model. Results We found evidence for an indirect relationship between sports club membership and frailty, mediated by physical activity. This finding was observed when examining time-specific indirect pathways and the total of all indirect pathways across seven waves of survey data (Est = −0.097 [95% CI = −0.124,-0.070], p = <0.001). Conclusions These analyses provide evidence to suggest that sports clubs may be useful in preventing and managing frailty in older adults, both directly and indirectly through increased physical activity levels. Sports clubs accessible to older people may improve health in this demographic by increasing activity levels and reducing frailty and associated comorbidities. There is a need for investment in these organisations to provide opportunities for older people to achieve the levels of physical activity necessary to prevent health problems associated with inactivity. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0552-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paul Watts
- School of Health, Sport and Bioscience, University of East London, Water Lane, London, E15 4LZ, UK
| | - Elizabeth Webb
- The International Centre for Lifecourse Studies in Society and Health, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Gopalakrishnan Netuveli
- Institute for Health and Human Development, University of East London, Water Lane, London, E15 4LZ, UK
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Comas-Herrera A, Knapp M, Wittenberg R, Banerjee S, Bowling A, Grundy E, Jagger C, Farina N, Lombard D, Lorenz K, McDaid D. MODEM: A comprehensive approach to modelling outcome and costs impacts of interventions for dementia. Protocol paper. BMC Health Serv Res 2017; 17:25. [PMID: 28077155 PMCID: PMC5225619 DOI: 10.1186/s12913-016-1945-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/10/2016] [Indexed: 12/02/2022] Open
Abstract
Background The MODEM project (A comprehensive approach to MODelling outcome and costs impacts of interventions for DEMentia) explores how changes in arrangements for the future treatment and care of people living with dementia, and support for family and other unpaid carers, could result in better outcomes and more efficient use of resources. Methods MODEM starts with a systematic mapping of the literature on effective and (potentially) cost-effective interventions in dementia care. Those findings, as well as data from a cohort, will then be used to model the quality of life and cost impacts of making these evidence-based interventions more widely available in England over the period from now to 2040. Modelling will use a suite of models, combining microsimulation and macrosimulation methods, modelling the costs and outcomes of care, both for an individual over the life-course from the point of dementia diagnosis, and for individuals and England as a whole in a particular year. Project outputs will include an online Dementia Evidence Toolkit, making evidence summaries and a literature database available free to anyone, papers in academic journals and other written outputs, and a MODEM Legacy Model, which will enable local commissioners of services to apply the model to their own populations. Discussion Modelling the effects of evidence-based cost-effective interventions and making this information widely available has the potential to improve the health and quality of life both of people with dementia and their carers, while ensuring that resources are used efficiently.
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Affiliation(s)
- Adelina Comas-Herrera
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
| | - Martin Knapp
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Raphael Wittenberg
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Sube Banerjee
- Centre for Dementia Studies at the Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton, UK
| | - Ann Bowling
- Faculty of Health Sciences at the University of Southampton, Southampton, UK
| | - Emily Grundy
- Department of Social Policy at the London School of Economics and Social Science, London, UK
| | - Carol Jagger
- Institute for Ageing and Health, Newcastle University, Newcastle, UK
| | - Nicolas Farina
- Centre for Dementia Studies at the Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton, UK
| | - Daniel Lombard
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Klara Lorenz
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - David McDaid
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
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Bowling A, Pikhartova J, Dodgeon B. Is mid-life social participation associated with cognitive function at age 50? Results from the British National Child Development Study (NCDS). BMC Psychol 2016; 4:58. [PMID: 27908287 PMCID: PMC5134123 DOI: 10.1186/s40359-016-0164-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/03/2016] [Indexed: 12/02/2022] Open
Abstract
Background Some studies have indicated that social engagement is associated with better cognitive outcomes. This study aimed to investigate associations between life-course social engagement (civic participation) and cognitive status at age 50, adjusting for social networks and support, behavioural, health, social and socio-economic characteristics. Methods The vehicle for the study was the National Child Development Study (1958 Birth Cohort Study), which is a general population sample in England, Scotland and Wales (9119: 4497 men and 4622 women) participating in nationally representative, prospective birth cohort surveys. The primary outcome variable was cognitive status at age 50, measured by memory test (immediate and delayed word recall test) and executive functioning test (word fluency and letter cancelation tests). The influence of hypothesised predictor variables was analysed using linear multiple regression analysis. Results Cognitive ability at age 11 (β = 0.19;95% CI = 0.17 to 0.21), participation in civic activities at ages 33 (0.12; 0.02 to 0.22) and 50 (0.13; 0.07 to 0.20), frequent engagement in physical activity (sport) (β from 0.15 to 0.18), achieving higher level qualifications (β from 0.23 to 1.08), and female gender (β = 0.49;95% CI = 0.38 to 0.60) were positively, significantly and independently associated with cognitive status at age 50. Having low socio-economic status at ages 11 (β from -0.22 to -0.27) and 42 (β from -0.28 to -0.38), and manifesting worse mental well-being at age 42 (β = -0.18; 95% CI = -0.33 to -0.02) were inversely associated with cognitive status at age 50. The proportion of explained variance in the multiple regression model (18%), while modest, is impressive given the multi-faceted causal nature of cognitive status. Conclusions The results indicate that modest associations between adult social engagement and cognitive function at age 50 persist after adjusting for covariates which included health, socio-economic status and gender, supporting theories of neuroplasticity. In addition to the continuing emphasis on physical activity, the encouragement of civic participation, at least as early as mid-life, should be a targeted policy to potentially promote and protect cognitive function in later mid-life. Electronic supplementary material The online version of this article (doi:10.1186/s40359-016-0164-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ann Bowling
- Faculty of Health Sciences, University of Southampton, Highfield Campus, Southampton, SO171BJ, UK.
| | - Jitka Pikhartova
- Faculty of Health Sciences, University of Southampton, Highfield Campus, Southampton, SO171BJ, UK.,Brunel University London, College of Health and Life Sciences, Department of Clinical Sciences, London, UK
| | - Brian Dodgeon
- Centre for Longitudinal Studies, UCL Institute of Education, 20 Bedford Way, London, WC1H 0AL20, UK
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