Title
Reproductive period, endogenous estrogen exposure and dementia incidence among women in Latin America and China; A 10/66 population-based cohort study
Date Issued
01 February 2018
Access level
open access
Resource Type
journal article
Author(s)
Prince M.J.
Acosta D.
Huang Y.
Jimenez-Velazquez I.Z.
Llibre Rodriguez J.J.
Salas A.
Sosa A.L.
Chua K.C.
Dewey M.E.
Liu Z.
Mayston R.
Valhuerdi A.
Instituto de la Memoria y Desordenes Relacionados
Publisher(s)
Public Library of Science
Abstract
Background Exposure to endogenous estrogen may protect against dementia, but evidence remains equivocal. Such effects may be assessed more precisely in settings where exogenous estrogen administration is rare. We aimed to determine whether reproductive period (menarche to menopause), and other indicators of endogenous estrogen exposure are inversely associated with dementia incidence. Methods Population-based cohort studies of women aged 65 years and over in urban sites in Cuba, Dominican Republic, Puerto Rico and Venezuela, and rural and urban sites in Peru, Mexico and China. Sociodemographic and risk factor questionnaires were administered to all participants, including ages at menarche, birth of first child, and menopause, and parity, with ascertainment of incident 10/66 dementia, and mortality, three to five years later. Results 9,428 women participated at baseline, with 72–98% responding by site. The ‘at risk’ cohort comprised 8,466 dementia-free women. Mean age varied from 72.0 to 75.4 years, lower in rural than urban sites and in China than in Latin America. Mean parity was 4.1 (2.4–7.2 by site), generally higher in rural than urban sites. 6,854 women with baseline reproductive period data were followed up for 26,463 person years. There were 692 cases of incident dementia, and 895 dementia free deaths. Pooled meta-analysed fixed effects, per year, for reproductive period (Adjusted Sub-Hazard Ratio [ASHR] 1.001, 95% CI 0.988–1.015) did not support any association with dementia incidence, with no evidence for effect modification by APOE genotype. No association was observed between incident dementia and; ages at menarche, birth of first child, and menopause: nulliparity; or index of cumulative endogenous estrogen exposure. Greater parity was positively associated with incident dementia (ASHR 1.030, 95% CI 1.002–1.059, I2 = 0.0%). Conclusions We found no evidence to support the theory that natural variation in cumulative exposure to endogenous oestrogens across the reproductive period influences dementia incidence in late life.
Volume
13
Issue
2
Language
English
OCDE Knowledge area
Neurología clínica
Salud pública, Salud ambiental
Scopus EID
2-s2.0-85042687964
PubMed ID
Source
PLoS ONE
ISSN of the container
19326203
Sponsor(s)
Funded by Wellcome Trust (GR066133 – Prevalence phase in Cuba; GR080002- Incidence phase in Peru, Mexico, Cuba, Dominican Republic, Venezuela and China and data analysis across all centres) - https://wellcome.ac.uk/ (to MJP), World Health Organization (Prevalence phase in Dominican Republic and China) - http://www.who. int/en/ (to MJP), US Alzheimer’s Association (IIRG – 04 – 1286 – Prevalence phase in Peru, and Mexico) - https://www.alz.org/research/ alzheimers_grants/ (to MJP), FONACIT/ CDCH/ UCV (data collection in Venezuela) - http://fonacit. gob.ve/ (to AS), Puerto Rico Legislature (data collection in Puerto Rico to IZJV), European Research Council (ERC-2013-ADG 340755 LIFE2YEARS1066 – work on current analysis) - https://erc.europa.eu/ (to MJP). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Sources of information:
Directorio de Producción Científica
Scopus