Evidence map›Paper›PMID 41499366›Full record

ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2026

Pregnancy and breastfeeding are associated with less later-life cognitive decline in a longitudinal, prospective cohort.

Molly M Fox, Jennifer E Bramen, Dayoon Kwon, Mark A Espeland, Yijia Sun, Li Zhang, Aladdin H Shadyab, Ramon Casanova, JoAnn E Manson, Marcus Y Chang and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Molly M FoxDepartment of Anthropology, University of California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0001-9219-8971
Jennifer E BramenPacific Neuroscience Institute and Foundation, Providence Saint John's Health Center, Santa Monica, California, USA.
Dayoon KwonDepartment of Epidemiology, University of California, Los Angeles, California, USA.
Mark A EspelandDepartment of Internal Medicine, Wake Forest University School of Medicine, One Medical Center Drive, Winston-Salem, North Carolina, USA.
Yijia SunDepartment of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles, California, USA.
Li ZhangDepartment of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles, California, USA.
Aladdin H ShadyabHerbert Wertheim School of Public Health and Human Longevity Science, Department of Medicine, University of California San Diego, La Jolla, California, USA.
Ramon CasanovaDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.
JoAnn E MansonDepartment of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Marcus Y ChangDepartment of Anthropology, University of California, Los Angeles, California, USA.
Verna R PorterPacific Neuroscience Institute and Foundation, Providence Saint John's Health Center, Santa Monica, California, USA.
Leslie V FarlandDepartment of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA.
Qian XiaoDepartment of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Robert A WildDepartment of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA.
Prabha SiddarthDepartment of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA.
Carolyn J CrandallDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, California, USA.

Funding

WOMEN'S HEALTH INITIATIVE - CLINICAL COORDINATING CENTER: TASK AREA B - LONG LIFE STUDY VISIT 2 LIMITED HOME VISIT75N92021D00001 · NHLBI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI ANDERSON, GARNET L. · 2021 to 2025
$52.0M
Wake Forest University School of Medicine Alzheimer's Disease Research CenterP30AG072947 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI SUZANNE CRAFT · 2021 to 2026
$24.3M
USC/UCLA Center on Biodemography &Population HealthP30AG017265 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI JENNIFER A AILSHIRE · 1999 to 2026
$17.9M
WOMEN'S HEALTH INITIATIVE (WHI) REGIONAL CENTER (RC): TASK AREA A AND A275N92021D00002 · NHLBI · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI WACTAWSKI-WENDE, JEAN · 2021 to 2025
$6.9M
WOMEN'S HEALTH INITIATIVE (WHI) REGIONAL CENTER (RC) - TO EXERCISE OPTION PERIOD ONE (1) AND REVISE CONTRACT ARTICLES.75N92021D00004 · NHLBI · STANFORD UNIVERSITY · PI STEFANICK, MARCIA · 2021 to 2025
$6.5M
WOMEN'S HEALTH INITIATIVE (WHI) REGIONAL CENTER (RC) - TO EXERCISE OPTION PERIOD ONE (1) AND REVISE CONTRACT ARTICLES.75N92021D00003 · NHLBI · OHIO STATE UNIVERSITY · PI JACKSON, REBECCA · 2021 to 2025
$5.0M
WOMEN'S HEALTH INITIATIVE (WHI) REGIONAL CENTER (RC) - TO EXERCISE OPTION PERIOD ONE (1) AND REVISE CONTRACT ARTICLES.75N92021D00005 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI VITOLINS, MARA · 2021 to 2025
$4.2M
How women’s reproductive life-history relates to cognitive decline and neuropathology in Alzheimer’s disease and related dementiasR21AG079093 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI FOX, MOLLY MAURER · 2023 to 2024
$381k
Social adversity, gestational stress physiology, and birth outcomes in Hispanic AmericansR03DK125524 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI FOX, MOLLY MAURER · 2020 to 2021
$234k
NHLBI NIH HHS 75N92021D00001NHLBI NIH HHS 75N92021D00002NIA NIH HHS P30 AG017265NIA NIH HHS P30 AG072947NIA NIH HHS R21 AG079093NIA NIH HHS R21AG079093NIDDK NIH HHS R03 DK125524NIDDK NIH HHS R03DK125524NIH HHSthe NIH R03DK125524the NIH R21AG079093WHI NIH HHS 75N92021D00003WHI NIH HHS 75N92021D00004WHI NIH HHS 75N92021D00005
6 · The paper itself

Abstract

introductionThe brains of female mammals evolved to undergo structural and functional changes during pregnancy and lactation, equipping them for motherhood. However, long-term cognitive health implications of these adaptations in women are poorly understood.

methodsIn the Women's Health Initiative (WHI) Memory Study (WHIMS; n = 7427) and WHI Study of Cognitive Aging (WHISCA; n = 2304), postmenopausal women completed reproductive history interviews, annual global cognitive assessment from mean age 70 for up to 13 years, and multi-domain cognitive testing for up to 8 years.

resultsEach additional month pregnant was associated with higher scores of global cognition. Each additional month of breastfeeding corresponded to higher scores of global cognition, verbal memory, and visual memory. We observed equivalent results for binary formulations of gravidity and breastfeeding. DISCUSSION: Low rates of fertility and breastfeeding may have implications for postmenopausal cognitive health at the population level. Next steps include examining mechanisms linking women's reproductive history with postmenopausal cognitive health. HIGHLIGHTS: Motherhood may leave an enduring mark on women's brains, shaping cognitive health. Over 7000 women were assessed annually from approximately age 70 for up to 13 years. Ever being pregnant and cumulative time pregnant were linked with better cognition. Ever having breastfed and more time breastfeeding were linked with better cognition. These results imply that declining fertility may affect cognitive aging in future generations.

Indexed as

Breast FeedingCognitive DysfunctionAgedCognitionCognitive AgingFemaleHumansLongitudinal StudiesMiddle AgedPostmenopausePregnancyProspective Studiescognitive aginggestationlactationlife course epidemiologylifespan risk factorsmommy brainmotherhoodpostmenopausal womenprotective factorsreproductive history

Identifiers

PMID41499366
PMCPMC12778429

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.