O-44 Reproductive health history and late life cognition in Tobagonian women
Author(s):
C Rosano , R Cvejkus , A I Acevedo-Fontánez , J M Zmuda , V Wheeler , I Miljkovic
Year of Presentation:
2024
Objective: Dementia prevalence is higher for women compared to men, with women of African ancestry being especially vulnerable. Emerging evidence suggests reproductive health may play a role in dementia risk, yet no data exists in the Caribbean region. We assessed the association of reproductive health with cognition in the Tobago Women Study.
Methods: Digit Symbol Substitution Test (DSST) and self-reported reproductive health data were obtained from 776 women aged 55.8+8.9 years in 2021-23, who reported having had at least one pregnancy. Multivariable regression models estimated the association between 5 indicators of reproductive health (age at first live birth, parity, pregnancy complications, age at menarche and menopause) and DSST score, adjusted for age and education level, and further adjusted for cardiometabolic conditions, due to their known association with DSST.
Results: Among 776 women, 43 did not have any live child birth, and the average parity was 2.83+2.4. A total of 172 of 776 (22%) women in this cohort had at least one pregnancy complication; five (5)% had pre-eclampsia, 2% had gestational diabetes and 16% had another, non-specified pregnancy complication. Age at first live birth was 22.6 (5.6), age at menarche and menopause were 12.7 (1.9) and 48.9 (5.8), respectively. Older age at first live birth was positively related with DSST (standardized beta: 0.145, p<0.001); this association remained independent of cardiometabolic conditions, parity and pregnancy complications. Conversely, parity, history of pregnancy complications, age at menarche or menopause were not associated with DSST after adjustment for cardiometabolic conditions.
Conclusion: In this population-based study of women of African ancestry, older age at the time of first live birth appears protective for cognitive function, independent of number of children or complications. Our results indicate potential novel strategies to protect women from dementia risk.