Multiparity, Brain Atrophy, and Cognitive Decline

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

doi:10.3389/fnagi.2020.00159

Multiparity, Brain Atrophy, and Cognitive Decline

Front Aging Neurosci. 2020 Jun 3:12:159. doi: 10.3389/fnagi.2020.00159. eCollection 2020.

Authors

Joon Hyung Jung¹, Ga Won Lee², Jun Ho Lee³, Min Soo Byun⁴, Dahyun Yi⁵, So Yeon Jeon⁶, Gi Jung Jung², Haejung Joung², Seong A Shin⁷, Yu Kyeong Kim⁷, Koung Mi Kang⁸, Chul-Ho Sohn⁸, Dong Young Lee^{1

2

5}

Affiliations

¹ Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.
² Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.
³ Department of Neuropsychiatry, National Center for Mental Health, Seoul, South Korea.
⁴ Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
⁵ Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, South Korea.
⁶ Department of Neuropsychiatry, Chungnam National University Hospital, Daejeon, South Korea.
⁷ Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea.
⁸ Department of Radiology, Seoul National University Hospital, Seoul, South Korea.

Abstract

Background: Multiparity - grand multiparity (i.e., five or more childbirths) in particular - has been reported to have an association with increased risk of Alzheimer's disease (AD) dementia or related cognitive decline in women. However, the pathological links underlying this relationship are still unknown. This study was conducted to examine the relationships of multiparity with cerebral amyloid-beta (Aβ) deposition, brain atrophy, and white matter hyperintensities (WMHs).

Methods: In this study, total of 237 older women with 148 cognitively normal and 89 mild cognitive impairment from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease (KBASE) were included. Participants underwent clinical and neuropsychological assessments in addition to ¹¹C-labeled Pittsburgh Compound B positron emission tomography, and magnetic resonance imaging. The associations of parity with Aβ deposition, hippocampal volume, cortical volume, WMH volume and mini-mental status examination (MMSE) score were examined.

Results: Participants with grand multiparity showed significantly reduced adjusted hippocampal volume, spatial pattern of atrophy for recognition of AD volume and spatial pattern of atrophy for recognition of brain aging volume even after controlling for potential confounders. Furthermore, MMSE score was also significantly lower in this group. In contrast, grand multiparity did not show any association with global Aβ retention, Aβ positivity rate, or WMH volume, regardless of covariates.

Conclusion: Our findings suggest that grand multiparity contributes to cognitive decline or increased dementia risk in older women by aggravating amyloid-independent hippocampal or cortical atrophy.

Keywords: Alzheimer’s disease; beta-amyloid; childbirth; hippocampus; multiparity; neurodegeneration.