August 14, 2018; 91 (7) Article
Differential effects of completed and incomplete pregnancies on the risk of Alzheimer disease
Hyesue Jang, Jong Bin Bae, Efthimios Dardiotis, Nikolaos Scarmeas, Perminder S. Sachdev, Darren M. Lipnicki, Ji Won Han, Tae Hui Kim, Kyung Phil Kwak, Bong Jo Kim, Shin Gyeom Kim, Jeong Lan Kim, Seok Woo Moon, Joon Hyuk Park, Seung-Ho Ryu, Jong Chul Youn, Dong Young Lee, Dong Woo Lee, Seok Bum Lee, Jung Jae Lee, Jin Hyeong Jhoo, Mary Yannakoulia, Mary H. Kosmidis, Giorgos M. Hadjigeorgiou, Paraskevi Sakka, Ki Woong Kim
First published July 18, 2018, DOI: https://doi.org/10.1212/WNL.0000000000006000
Hyesue Jang
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Jong Bin Bae
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Efthimios Dardiotis
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Nikolaos Scarmeas
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Perminder S. Sachdev
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Darren M. Lipnicki
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Ji Won Han
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Tae Hui Kim
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Kyung Phil Kwak
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Bong Jo Kim
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Shin Gyeom Kim
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Jeong Lan Kim
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Seok Woo Moon
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Joon Hyuk Park
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Seung-Ho Ryu
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Jong Chul Youn
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Dong Young Lee
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Dong Woo Lee
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Seok Bum Lee
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Jung Jae Lee
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Jin Hyeong Jhoo
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Mary Yannakoulia
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Mary H. Kosmidis
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Giorgos M. Hadjigeorgiou
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Paraskevi Sakka
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Ki Woong Kim
From the Department of Brain and Cognitive Sciences (H.J., K.W.K.), Seoul National University College of Natural Sciences; Department of Psychiatry (J.B.B., J.W.H., D.Y.L., K.W.K.), Seoul National University, College of Medicine; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Neurology (E.D.), Faculty of Medicine, University of Thessaly, Larissa; Department of Social Medicine, Psychiatry and Neurology (N.S.), National and Kapodistrian University of Athens, Greece; Department of Neurology (N.S.), Columbia University, New York, NY; Centre for Healthy Brain Ageing (P.S.S., D.M.L.) and Dementia Collaborative Research Centre (P.S.S.), University of New South Wales, Sydney, Australia; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeongju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University, School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry (J.L.K.), School of Medicine, Chungnam National University, Daejeon; Department of Psychiatry (S.W.M.), School of Medicine, Konkuk University and Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Psychiatry, School of Medicine (S.-H.R.), Konkuk University and Konkuk University Medical Center, Seoul; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; Department of Psychiatry (J.H.J.), Kangwon National University, School of Medicine, Chuncheon, South Korea; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens; Laboratory of Cognitive Neuroscience (M.H.K.), School of Psychology, Aristotle University of Thessaloniki; School of Medicine (G.M.H.), University of Thessaly, Larissa; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Marousi, Greece; and Department of Neurology (G.M.H), Medical School, University of Cyprus, Nicosia, Cyprus.
Differential effects of completed and incomplete pregnancies on the risk of Alzheimer disease
Hyesue Jang, Jong Bin Bae, Efthimios Dardiotis, Nikolaos Scarmeas, Perminder S. Sachdev, Darren M. Lipnicki, Ji Won Han, Tae Hui Kim, Kyung Phil Kwak, Bong Jo Kim, Shin Gyeom Kim, Jeong Lan Kim, Seok Woo Moon, Joon Hyuk Park, Seung-Ho Ryu, Jong Chul Youn, Dong Young Lee, Dong Woo Lee, Seok Bum Lee, Jung Jae Lee, Jin Hyeong Jhoo, Mary Yannakoulia, Mary H. Kosmidis, Giorgos M. Hadjigeorgiou, Paraskevi Sakka, Ki Woong Kim
Neurology Aug 2018, 91 (7) e643-e651; DOI: 10.1212/WNL.0000000000006000
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Abstract
Objective To investigate the effects of completed pregnancy with childbirth and incomplete pregnancy without childbirth on the late-life cognition and the risk of Alzheimer disease (AD) in women.
Methods Using the pooled data of 3,549 women provided by 2 population-based cohort studies, we conducted logistic regression analyses to examine retrospectively the associations of completed and incomplete pregnancy with the risks of mild cognitive impairment and AD. For women without dementia, we also conducted analyses of covariance to examine the associations of completed and incomplete pregnancy with Mini-Mental State Examination (MMSE) score.
Results Grand multiparous women who experienced ≥5 completed pregnancies showed an ≈1.7-fold higher risk of AD than those who experienced 1 to 4 completed pregnancies (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.04–2.72), while those who had incomplete pregnancies showed half the level of AD risk compared with those who never experienced an incomplete pregnancy (OR 0.43, 95% CI 0.24–0.76 for 1 incomplete pregnancy; OR 0.56, 95% CI 0.34–0.92 for ≥2 incomplete pregnancies). In women without dementia, the grand multiparous had worse MMSE scores than those with 1 to 4 completed pregnancies (p < 0.001), while those who experienced ≥1 incomplete pregnancies had better MMSE scores than those who never experienced an incomplete pregnancy (p = 0.008).
Conclusions Grand multiparity was associated with high risk of AD, while incomplete pregnancy was associated with low risk of AD in late life.
Glossary
- AD=
- Alzheimer disease;
- CIRS=
- Cumulative Illness Rating Scale;
- COSMIC=
- Cohort Studies of Memory in an International Consortium;
- CPREG=
- completed pregnancy with childbirth;
- HELIAD=
- Hellenic Longitudinal Investigation of Aging and Diet;
- HRT=
- hormone replacement therapy;
- IPREG=
- incomplete pregnancy without childbirth;
- KLOSCAD=
- Korean Longitudinal Study on Cognitive Aging and Dementia;
- MCI=
- mild cognitive impairment;
- MMSE=
- Mini-Mental State Examination
Footnotes
↵* These authors contributed equally to this work.
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
CME Course: NPub.org/cmelist
- Received December 30, 2017.
- Accepted in final form May 17, 2018.
- © 2018 American Academy of Neurology
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