Is there an association between reproductive history and cognitive impairment Critically appraised topic

Background and Aim : Diseases related to cognitive impairment, especially dementia and its mostcommon cause Alzheimer’s disease (AD), are becoming prominent health threats and affect enormoussocial burden. It is estimated that more than 35.6 million people lived with dementia worldwide in 2010;this number will be doubled by 2030 and tripled by 2050. Extensive evidences illustrate thatpostmenopausal women carry an increased risk of developing AD than age-matched men, probably due tothe marked reduction of estrogen level that occurs following the menopause. The purpose of this study wasto investigate the relationship between cognitive impairment and reproductive historyMethods : : at first, PECO wrote the question in the practice. )P: Postmenopausal woman،E: ReproductiveHistory،C:-،O: Cognitive impairment (.In that study, the researcher first searched using Syntax in theGoogle Scholar search engine, specifically in Persian databases such as SID, Magiran, In addition to theEnglish databases such as PubMed, Scopus, Science Direct, Web of Science and Springer. )Syntax: ocp ororal contraceptive (2398). Reproductive History AND cognition (2376). Pregnancy AND cognition (211).Menopause AND Cognition (514). Contraceptive AND Cognitive impairment (161). Systematic reviewand Meta-analysis AND Reproductive History AND Cognitive impairment (0). Cognition ANDContraceptive (201). Cognition AND menarche (71. ( Afterwards, the articles were categorized from 2000to 2018 and they were reviewed, as well. After deleting duplicates and reviewing title, abstract and full text,one article was selected to announce the final resultResults : The length of reproductive period was inversely associated with the risk of cognitive impairment(OR=0.974). Odds ratio (OR) of cognitive impairment had the value of 1.316 for women with 5 or moretimes of full-term pregnancies. Women without incomplete pregnancy had a significant higher risk ofcognitive impairment (OR = 1.194). Oral contraceptive use (OR = 0.489) intrauterine device (IUD) use(OR = 0.684) were associated with significantly reduced risk of cognitive impairment .Levels of evidence3A. Evaluation: the strength of the article was large community-based sample of postmenopausal womenand Confounder’s adjusted. the Limitation of the article was: Genetic factors like family history, which cancause cognitive impairment, No specific information was available for the type and duration of oralcontraception and IUD, Disregarding the dimensions of cognitive impairment and According to theguideline which was published by Who, both of the BMI and dyslipidemia are also considered asconfounders, however, there are neglected in this study.Conclusion : Reproductive history (Reproductive period ،Number of incomplete pregnancies. Number offull-term pregnancies ،Oral contraceptives ،IUD) has a significant relationship with cognitive impairment

Keywords:

Reproductive History , cognitive impairment , cognition , oral contraceptive