Higher dementia danger in ladies with extended fertility

Higher dementia risk in women with prolonged fertility

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Women with an extended reproductive interval had an elevated danger for dementia in outdated age, in contrast with those that have been fertile for a shorter interval, a population-based examine from the University of Gothenburg exhibits.

“Our results may explain why women have a higher risk of developing dementia and Alzheimer’s disease than men after age 85, and provide further support for the hypothesis that estrogen affect the risk of dementia among women,” says Jenna Najar, a medical physician and doctoral scholar at Sahlgrenska Academy who additionally works at AgeCap, the Center for Aging and Health on the University of Gothenburg.

The examine, now revealed within the journal Alzheimer’s & Dementia, covers 1,364 ladies who have been adopted between 1968 and 2012 within the inhabitants research collectively generally known as the “Prospective Population-based Study of Women in Gothenburg” (PPSW) and the “Gothenburg H70 Birth Cohort Studies in Sweden” (the H70 research). The “reproduction period” spans the years between menarche (onset of menstruation) and menopause, when menstruation ceases.

Of the ladies studied with a shorter reproductive interval (32.6 years or much less), 16 p.c (53 of 333 people) developed dementia. In the group of ladies who have been fertile an extended interval (38 years or extra), 24 p.c (88 of 364) developed dementia. The distinction was thus eight proportion factors.

The examine exhibits that danger for dementia and Alzheimer’s illness will increase successively for each extra yr that the lady stays fertile. The affiliation was strongest for these with dementia onset after age 85, and the impact was most strongly related to age at menopause.

Endogenous estrogen over time

These outcomes persevered after adjustment for different elements with an affect, comparable to academic attainment, bodily exercise, BMI, smoking, and heart problems. On the opposite hand, no affiliation was discovered between dementia danger and age at menarche, variety of pregnancies, length of breastfeeding, or exogenous estrogen taken within the type of hormonal alternative remedy (HRT) or oral contraceptives.

Several research have investigated how estrogen within the type of HRT impacts dementia danger. Some research present that dementia danger falls and others that it rises, particularly in ladies who take estrogen late in life.

In the present examine Jenna Najar has, as an alternative, investigated the long-term affiliation between elements associated to endogenous estrogen and dementia.

“What’s novel about this study, too, is that we’ve had access to information about several events in a woman’s life that can affect her estrogen levels. Examples are pregnancies, births, and breastfeeding. Being pregnant boosts estrogen levels tremendously; then they decline once the baby is born, and if women breastfeed the levels fall to extremely low levels. The more indicators we capture, the more reliable our results are,” Najar says.

Many elements concerned

Ingmar Skoog, professor of psychiatry at Sahlgrenska Academy, University of Gothenburg and head of AgeCap, led the examine.

“The varying results for estrogen may be due to it having a protective effect early in life but being potentially harmful once the disease has begun.”

At the identical time, Skoog factors out that the length of ladies’s fertile durations is one danger issue for dementia amongst many.

Most ladies whose menopause is delayed don’t develop dementia due to this issue alone. However, the examine might present a clue as to why ladies are at greater danger than males for dementia after age 85, the most typical age of onset. Alzheimer’s illness, alternatively, begins creating some 20 years earlier than signs of the dysfunction change into obvious.

“Most people affected are over 80 and female,” Najar says.

“As a result of global aging, the number of people affected by dementia will increase. To be able to implement preventive strategies, we need to identify people with an elevated risk of dementia.”


Fewer reproductive years in ladies linked to an elevated danger of dementia


More info:
Jenna Najar et al. Reproductive interval and dementia: A 44‐yr longitudinal inhabitants examine of Swedish ladies, Alzheimer’s & Dementia (2020). DOI: 10.1002/alz.12118

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