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Pregnancy history and cognitive aging among older women

the Rancho Bernardo Study

Ilango, Sindana D., MPH1; McEvoy, Linda K., PhD2,3; Laughlin, Gail A., PhD2; Bergstrom, Jaclyn, MS2; Barrett-Connor, Elizabeth, MD2; Kritz-Silverstein, Donna, PhD2

doi: 10.1097/GME.0000000000001318
Original Study: PDF Only

Objective: The aim of the study was to examine the association of pregnancy history with trajectories of cognitive function in older women.

Methods: Participants were 1,025 women (mean age = 73.1 ± 9.6 y) enrolled in the Rancho Bernardo Study who attended a clinic visit between 1988 and 1992, when pregnancy history (ever pregnant, number of pregnancies, ages at first and last pregnancy) was recorded and cognitive function was assessed with a battery of four tests repeated up to 7 times through 2016. Linear mixed-effects regression models were used to examine the association between pregnancy history and longitudinal change in cognitive function.

Results: Overall, 77% of women had at least one pregnancy; number of pregnancies ranged from 1 to 14 (mean = 2.9 ± 1.7). Ages at first and last pregnancy ranged from 16 to 44 years (mean = 24.9 ± 4.7) and 16 to 49 years (mean = 30.7 ± 5.5), respectively. Of 16 associations tested (4 pregnancy exposures by 4 cognitive tests), one was statistically significant without correction for multiple comparisons. Women who reported ever being pregnant recalled 0.12 fewer words on the Buschke Selective Reminding Test for every year increase in age than women who had never been pregnant (P = 0.05). No other significant associations of pregnancy history with cognitive decline were observed.

Conclusions: Our results show no clinically meaningful long-term influence of pregnancy history on age-related change in cognitive function. These reassuring findings suggest childbearing decisions and timing will not affect cognitive function in older age.

1San Diego State University/University of California San Diego Joint Doctoral Program in Public Health (Epidemiology), San Diego, CA

2Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA

3Department of Radiology, University of California San Diego, La Jolla, CA.

Address correspondence to: Donna Kritz-Silverstein, PhD, Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Drive, MC 0725, La Jolla, CA 92093-0725. E-mail:; Sindana Ilango at

Received 28 September, 2018

Revised 22 January, 2019

Accepted 22 January, 2019

Funding/support: Data collection for the Rancho Bernardo Study was supported by the National Institute on Alcohol Abuse and Alcoholism (R01 AA021187), National Institute of Aging (AG007181 and AG028507), and the National Institute of Diabetes and Digestive and Kidney Diseases (DK031801).

Financial disclosure/conflicts of interest: None reported.

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© 2019 by The North American Menopause Society.