Reproductive health history and later life cognition in African Caribbean women

Abstract

Introduction: Dementia prevalence is higher in women, in particular those of African ancestry. Reproductive health may influence dementia risk, yet data from the Caribbean are lacking. We assessed the association of reproductive health with cognition in the Tobago Women's Health Study.

Methods: This population-based study recruited middle to older aged women from the Caribbean Island of Tobago. Cognitive performance was assessed using the Digit Symbol Substitution Test (DSST). Seven indicators of reproductive health were collected via interviews. Multivariable regression models estimated the association between reproductive indicators and DSST score.

Results: Among 776 women (mean age 55.8 ± 8.9 years), the mean number of live births was 2.83 ± 2.4, and 22% experienced at least one pregnancy complication. Later age at first live birth (mean age 22.7 ± 5.4 years) was significantly associated with higher DSST score (β = 0.35, p < 0.001), independent of other reproductive factors.

Discussion: Older age at the time of first live birth appears protective for cognitive function among African Caribbean women.

Highlights: Later age at first birth is linked to better cognitive function, independent of other reproductive, demographic, and health factors. This study provides novel insights into cognitive aging among African Caribbean women, an understudied population, addressing a critical gap in research on reproductive history and cognition. This study highlights the need for further research on the longitudinal association between reproductive history and cognition, particularly in African Caribbean women.

Keywords: African Caribbean women; Digit Symbol Substitution Test; age at first birth; cognition; dementia; reproductive health; women's health.