Association of the number of pregnancies and births with cognitive performance in older postmenopausal women: a cross-sectional study

Abstract Objective Cognitive impairment in the elderly is a serious public health problem. However, the effect of the number of pregnancies and births in the early years of life on cognitive function in postmenopausal women remains controversial. This study aims to investigate the relationship between these two factors. Methods We used the National Health and Nutrition Examination Survey 2011-2014 data on women aged ≥60 years. This study included sociodemographic data, history of estrogen use, and contraceptive use as confounding variables. The combined scores of the Consortium to Establish a Registry for Alzheimer's Disease Word Learning (CERAD-WL), delayed word recall (CERAD-DR), the Animal Fluency test (AF), and the Digit Symbol Substitution Test (DSST) were used to assess the cognitive performance of participants. Hierarchical multiple regression analysis explored the relationship between the number of pregnancies and births and cognitive function. Results The study screened 1,259 postmenopausal women and found that 24.3% had low cognitive performance. The study found a significant increase in low cognitive performance among older adults, Mexican Americans, those with a lower education level and poverty-income ratio, those who were widowed, and those with diabetes and hypertension ( P < 0.001). In the multiple regression analysis, the number of pregnancies remained a significant determinant of cognitive performance ( B = −0.188, P < 0.001). Conclusions The number of pregnancies was associated with cognitive performance in a population of postmenopausal women in the United States. A lower number of pregnancies is associated with better cognitive performance.