Abstract
INTRODUCTION: Few studies have concurrently examined the biological and social reproductive factors in relation to women's cognitive aging. METHODS: We analyzed 8577 women and 7872 men ≥45 years of age from the China Health and Retirement Longitudinal Study. Biological reproductive factors included reproductive span, age at menarche, and age at menopause; social reproductive factors included number of children and age at first live birth. Multivariable regression models were sequentially adjusted for age, childhood cognition proxy, education, and current health and lifestyle factors. RESULTS: Longer reproductive span was associated with better cognitive performance in women, whereas a higher number of children were linked to poorer cognition in both sexes, particularly in women. These associations remained robust after full adjustment, compared with age at menarche, age at menopause, and age at first birth. CONCLUSION: Integrating biological and social reproductive factors provides insights into sex-specific cognitive aging patterns and may inform tailored dementia prevention strategies. HIGHLIGHTS: A longer reproductive span was linked to better cognition in older Chinese women. More children were linked to poorer cognition in both sexes, especially in women. Reproductive span and number of children showed robust associations with late-life cognition, stronger than other reproductive factors.