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Longer Reproductive Years Do No Protect Women Against Alzheimer
A DGReview of :"Reproductive Period and Risk of Dementia in Postmenopausal Women"
JAMA
03/20/2001
By Elda Hauschildt
A longer reproductive period in women who have natural menopause does not, as was expected, reduce their risk of dementia and Alzheimer disease.
Longer reproduction was theorised to help protect women as it indicates longer endogenous exposure to estrogen.
"A relationship between estrogen levels and dementia is biologically plausible," Dutch researchers suggest. That is partly because estrogen may improve cerebral blood flow and glucose metabolism and reduce the risk of cardiovascular disease.
A large, population-based study in the Netherlands was the first to examine the long-term effects of reproductive period length on risk of developing dementia and Alzheimer.
"Insofar as reproductive period is a marker of long-term exposure to endogenous estrogen, these findings do not support the hypothesis that high estrogen levels reduce risk of dementia," the researchers report.
In fact, they point out, "A longer reproductive period was associated with a higher risk of dementia in women with natural menopause, after adjustments for multiple confounding variables."
Their study was part of the Rotterdam Study, which examined a prospective cohort of 3,105 men and 4,878 women aged 55 years of older. Overall aim of Rotterdam was to assess the occurrence and determinants of chronic disease later in life.
A total of 3,601 women participated in the study of reproductive period and estrogen. All were aged 55 years and older and did not have dementia at baseline in 1990 to 1993.
Participants were re-examined in 1993/1994 and again in 1997/1999. They were monitored continuously for the development of dementia. Median follow-up was 6.3 years.
During follow-up, 199 women developed dementia. This included 159 who developed Alzheimer.
"After adjusting for age, dementia was not clearly associated with length of reproductive period," the researchers conclude.
"After adjusting for multiple co-variates, women with natural menopause and more reproductive years had an increased risk of dementia."
JAMA, 2001; 285: 1475-1481.
"Reproductive Period and Risk of Dementia in Postmenopausal Women"
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