On the 21st of September we celebrate World Alzheimer’s day, a day that we concentrate our efforts on creating awareness of Alzheimer’s disease. This disease is among the most prevalent forms of dementia; a set of disorders that disrupt mental function. There are some interesting findings on how prolonged fertility and the number of children a woman has can impact Alzheimer and dementia in general.
Dementia is actually a general term -not a specific disease- describing the impaired ability to remember and think while on your everyday activities. It most often affects older people, but it is not a normal sign of aging. Of those at least 65 years of age, there are an estimated 5.0 million adults with dementia in 2014 and projected to be nearly 14 million by 2060.
Signs of dementia:
The risk of dementia increases of course because of age, but also because of family history, heart problems, brain injuries and race/ethnicity. Older African Americans are twice more likely to have dementia than whites. Hispanics 1.5 times more likely to have dementia than whites.
It is the most common cause of dementia, appearing in 60-80% of the cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease. Other symptoms like difficulty in walking or talking or personality changes come later as well. Family history is the most important risk factor. Having a first-degree relative with Alzheimer’s disease increases the risk of developing it by 10% to 30%.
Alzheimer’s unfortunately has no cure, but there is medication that can protect the brain or manage symptoms such as anxiety or behavior changes.
There are several studies which have concluded that prolonged fertility can increase the risk of dementia, compared to women who were fertile for a shorter period of time.
According to a population-based study in Gothenburg, Sweden, the reason why prolonged fertility maximizes chances of dementia in older women was estrogen exposure. Several observational studies have reported decreased dementia incidence among women taking exogenous estrogens. However, one study showed increased risk in women prescribed estrogen in late life. The Women’s Health Initiative Memory Study reported that women assigned exogenous estrogens had an increased risk of dementia, while others reported no association. There are different forms of endogenous estrogens. The reproductive period (time from menarche to menopause) comprises exposure of mainly estradiol and estrone. Pregnancy entails higher levels of estradiol, estrone, and estriol, whereas estrogen levels drop during the postnatal phase, particularly among women who breastfeed. Furthermore, exposure to exogenous estrogens may occur during the reproductive phase through use of oral contraceptives, or later in life as hormonal replacement therapy (HRT).
They also found that longer reproductive period and a later menopause were associated with increased risk of dementia and Alzheimer’s among women with natural menopause followed over 44 years. The risk was higher for those with onset of dementia and Alzheimer’s after the age of 85. At the same time, dementia risk was not found to be associated with age at menarche, number of pregnancies, months of breastfeeding, or exogenous estrogens.
According to the research, the mean length of reproductive period for women with natural menopause was 34.9 years and the mean age at menopause for women with natural menopause was 48.7 years.
The above findings were in line with findings from the Rotterdam Study, while the Kaiser Permanente Study had opposite results, and the 10/66 study reported no associations.
According to the Kaiser Permanente Study, while they reviewed the health records of 14,595 women who were aged 40 to 55 between 1964 and 1973,they found that those with three or more children had a 12% lower risk of dementia than women with one child.
One the other hand, a study of Bohn University in Germany examined the fertility and number of children in 106 women with a diagnosis of Alzheimer’s disease and compared it with that of 189 female subjects from two control groups with subjects without dementia. As additional control, the same comparisons were carried out for 40 male patients with Alzheimer’s disease and 105 male control subjects. What they did discover was that in female subjects, having children was found to be associated with a diagnosis of Alzheimer’s disease, but this was not the case in male subjects. The number of children did not seem to affect the risk of the disease, neither in female nor in male subjects. Natural exposure to estrogen seems to reduce the risk of Alzheimer’s disease in women.
Another study, from the University of California, found that women who experienced more months of pregnancy during their lives had a lower risk of Alzheimer’s disease.
From all the above, we can conclude that nothing is definite concerning the correlation between fertility and dementia/Alzheimer’s. What is definite is that factors such as the immune system, nutrition throughout a woman’s life, nutrition during pregnancy, and natural estrogen levels are all factors that can influence the appearance of the diseases. But not only them. Studies have shown that high blood pressure in middle age could make you more prone to dementia, and that diabetes also might have a detrimental effect.
The subject calls for further research and you shouldn’t worry much more than the usual if you have prolonged fertility, or later menopause or more that one offspring. What you should do is consult with your doctor in case of signs of dementia, no matter the age you are in.
For information about the available fertility treatments in Greece and how we can assist you during your fertility journey dm us or book a free call with our customer success manager.
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