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      Associations of Parity With Change in Global Cognition and Incident Cognitive Impairment in Older Women

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          Abstract

          Background

          The evidence of the association between parity and risk of mild cognitive impairment (MCI) or dementia is mixed, and the relationship between parity and longitudinal cognitive changes is less clear. We investigated these issues in a large population of older women who were carefully monitored for development of MCI and probable dementia.

          Methods

          Using the Women’s Health Initiative Memory Study, 7,100 postmenopausal women (mean age 70.1 ± 3.8 years) with information on baseline parity (defined as the number of term pregnancies), measures of global cognition (Modified Mini-Mental State Examination score) from 1996–2007, and cognitive impairment (centrally adjudicated diagnoses of MCI and dementia) from 1996–2016 were included. Multivariable linear mixed-effects models were used to analyze the rate of changes in global cognition. Cox regression models were used to evaluate the risk of MCI/dementia across parity groups.

          Results

          Over an average of 10.5 years, 465 new cases of MCI/dementia were identified. Compared with nulliparous women, those with a parity of 1–3 and ≥4 had a lower MCI/dementia risk. The HRs were 0.75 (0.56–0.99) and 0.71 (0.53–0.96), respectively ( P < 0.01). Similarly, a parity of 1–3 and ≥4 was related to slower cognitive decline (β = 0.164, 0.292, respectively, P < 0.05).

          Conclusion

          Higher parity attenuated the future risk for MCI/dementia and slowed the rates of cognitive decline in elderly women. Future studies are needed to determine how parity affects late-life cognitive function in women.

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          Most cited references54

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          Tracking pathophysiological processes in Alzheimer's disease: an updated hypothetical model of dynamic biomarkers.

          In 2010, we put forward a hypothetical model of the major biomarkers of Alzheimer's disease (AD). The model was received with interest because we described the temporal evolution of AD biomarkers in relation to each other and to the onset and progression of clinical symptoms. Since then, evidence has accumulated that supports the major assumptions of this model. Evidence has also appeared that challenges some of our assumptions, which has allowed us to modify our original model. Refinements to our model include indexing of individuals by time rather than clinical symptom severity; incorporation of interindividual variability in cognitive impairment associated with progression of AD pathophysiology; modifications of the specific temporal ordering of some biomarkers; and recognition that the two major proteinopathies underlying AD biomarker changes, amyloid β (Aβ) and tau, might be initiated independently in sporadic AD, in which we hypothesise that an incident Aβ pathophysiology can accelerate antecedent limbic and brainstem tauopathy. Copyright © 2013 Elsevier Ltd. All rights reserved.
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            The Modified Mini-Mental State (3MS) examination.

            E Teng, H Chui (1987)
            The Mini-Mental State (MMS) examination is a widely used screening test for dementia. The Modified Mini-Mental State (3MS) incorporates four added test items, more graded scoring, and some other minor changes. These modifications are designed to sample a broader variety of cognitive functions, cover a wider range of difficulty levels, and enhance the reliability and the validity of the scores. The 3MS retains the brevity, ease of administration, and objective scoring of the MMS but broadens the range of scores from 0-30 to 0-100. Greater sensitivities of the 3MS over the MMS are demonstrated with the pentagon item drawn by 249 patients. A summary form for administration and scoring that can generate both the MMS and the 3MS scores is provided so that the examiner can maintain continuity with existing data and can obtain a more informative assessment.
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              Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study

              China has a large population of older people, but has not yet undertaken a comprehensive study on the prevalence, risk factors, and management of both dementia and mild cognitive impairment (MCI).
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                Author and article information

                Contributors
                Journal
                Front Aging Neurosci
                Front Aging Neurosci
                Front. Aging Neurosci.
                Frontiers in Aging Neuroscience
                Frontiers Media S.A.
                1663-4365
                04 May 2022
                2022
                : 14
                : 864128
                Affiliations
                [1] 1Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University , Guangzhou, China
                [2] 2Department of Psychiatry, Baiyun Jingkang Hospital , Guangzhou, China
                [3] 3Department of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University , Guangzhou, China
                [4] 4Inpatient Department, Baiyun Jingkang Hospital , Guangzhou, China
                [5] 5Clinical Laboratory, Baiyun Jingkang Hospital , Guangzhou, China
                [6] 6Department of Geriatrics, The 74th Army Hospital of the Chinese People’s Liberation Army , Guangzhou, China
                Author notes

                Edited by: M. Florencia Iulita, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, Spain

                Reviewed by: Anna Brugulat-Serrat, BarcelonaBeta Brain Research Center, Spain; Molly Fox, University of California, Los Angeles, United States

                *Correspondence: Xian-Bo Wu, wuxb1010@ 123456smu.edu.cn

                These authors have contributed equally to this work and share first authorship

                This article was submitted to Alzheimer’s Disease and Related Dementias, a section of the journal Frontiers in Aging Neuroscience

                Article
                10.3389/fnagi.2022.864128
                9114765
                35601623
                c469d60a-a083-4c30-90d2-e91514aea1e4
                Copyright © 2022 Zhou, Liu, Zou, Wei, Huang, Zhong, Gu, Chen, Wang, Sun and Wu.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 28 January 2022
                : 28 March 2022
                Page count
                Figures: 3, Tables: 3, Equations: 0, References: 54, Pages: 11, Words: 7753
                Categories
                Neuroscience
                Original Research

                Neurosciences
                cognitive decline,cognitive impairment,dementia,epidemiology,parity
                Neurosciences
                cognitive decline, cognitive impairment, dementia, epidemiology, parity

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