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Body mass index in midlife and risk of Alzheimer disease and vascular dementia.
Curr Alzheimer Res. 2007 Apr; 4(2):103-9.CA

Abstract

Prior work has suggested that obesity and overweight as measured by body mass index (BMI) increases risk of dementia. It is unknown if there is a difference in the risk of developing Alzheimer disease (AD) versus vascular dementia (VaD) associated with high body weight. The goal of this study was to examine the association between midlife BMI and risk of both AD and VaD an average of 36 years later in a large (N= 10,136) and diverse cohort of members of a health care delivery system. Participants aged 40-45 participated in health exams between 1964 and 1968. AD and VaD diagnoses were obtained from Neurology visits between January 1, 1994 and June 15, 2006. Those with diagnoses of general dementia from primary care providers were excluded from the study. BMI was analyzed in WHO categories of underweight, overweight and obese, as well as in subdivisions of WHO categories. All models were fully adjusted for age, education, race, sex, marital status, smoking, hyperlipidemia, hypertension, diabetes, ischemic heart disease and stroke. Cox proportional hazard models showed that compared to those with a normal BMI (18.5-24.9), those obese (BMI > or = 30) at midlife had a 3.10 fold increase in risk of AD (fully adjusted model, Hazard Ratio=3.10, 95% CI 2.19-4.38), and a five fold increase in risk of VaD (fully adjusted model, HR=5.01, 95% CI 2.98-8.43) while those overweight (BMI > or = 25 and <30) had a two fold increase in risk of AD and VaD (fully adjusted model, HR=2.09, 95% CI 1.69-2.60 for AD and HR=1.95, 95% CI 1.29-2.96 for VaD). These data suggest that midlife BMI is strongly predictive of both AD and VaD, independent of stroke, cardiovascular and diabetes co morbidities. Future studies need to unveil the mechanisms between adiposity and excess risk of AD and VaD.

Authors+Show Affiliations

Whitmer RA
Kaiser Permanente Division of Research, Etiology and Prevention, 2000 Broadway, Oakland, CA 94612, USA. Rachel.whitmer@kp.org
Gunderson EP
No affiliation info available
Quesenberry CP
No affiliation info available
Zhou J
No affiliation info available
Yaffe K
No affiliation info available

MeSH

AdultAlzheimer DiseaseBody Mass IndexBody WeightDementia, VascularFemaleHumansIncidenceMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesRisk

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17430231

Citation

Whitmer, Rachel A., et al. "Body Mass Index in Midlife and Risk of Alzheimer Disease and Vascular Dementia." Current Alzheimer Research, vol. 4, no. 2, 2007, pp. 103-9.
Whitmer RA, Gunderson EP, Quesenberry CP, et al. Body mass index in midlife and risk of Alzheimer disease and vascular dementia. Curr Alzheimer Res. 2007;4(2):103-9.
Whitmer, R. A., Gunderson, E. P., Quesenberry, C. P., Zhou, J., & Yaffe, K. (2007). Body mass index in midlife and risk of Alzheimer disease and vascular dementia. Current Alzheimer Research, 4(2), 103-9.
Whitmer RA, et al. Body Mass Index in Midlife and Risk of Alzheimer Disease and Vascular Dementia. Curr Alzheimer Res. 2007;4(2):103-9. PubMed PMID: 17430231.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body mass index in midlife and risk of Alzheimer disease and vascular dementia. AU - Whitmer,Rachel A, AU - Gunderson,Erica P, AU - Quesenberry,Charles P,Jr AU - Zhou,Jufen, AU - Yaffe,Kristine, PY - 2007/4/14/pubmed PY - 2007/7/11/medline PY - 2007/4/14/entrez SP - 103 EP - 9 JF - Current Alzheimer research JO - Curr Alzheimer Res VL - 4 IS - 2 N2 - Prior work has suggested that obesity and overweight as measured by body mass index (BMI) increases risk of dementia. It is unknown if there is a difference in the risk of developing Alzheimer disease (AD) versus vascular dementia (VaD) associated with high body weight. The goal of this study was to examine the association between midlife BMI and risk of both AD and VaD an average of 36 years later in a large (N= 10,136) and diverse cohort of members of a health care delivery system. Participants aged 40-45 participated in health exams between 1964 and 1968. AD and VaD diagnoses were obtained from Neurology visits between January 1, 1994 and June 15, 2006. Those with diagnoses of general dementia from primary care providers were excluded from the study. BMI was analyzed in WHO categories of underweight, overweight and obese, as well as in subdivisions of WHO categories. All models were fully adjusted for age, education, race, sex, marital status, smoking, hyperlipidemia, hypertension, diabetes, ischemic heart disease and stroke. Cox proportional hazard models showed that compared to those with a normal BMI (18.5-24.9), those obese (BMI > or = 30) at midlife had a 3.10 fold increase in risk of AD (fully adjusted model, Hazard Ratio=3.10, 95% CI 2.19-4.38), and a five fold increase in risk of VaD (fully adjusted model, HR=5.01, 95% CI 2.98-8.43) while those overweight (BMI > or = 25 and <30) had a two fold increase in risk of AD and VaD (fully adjusted model, HR=2.09, 95% CI 1.69-2.60 for AD and HR=1.95, 95% CI 1.29-2.96 for VaD). These data suggest that midlife BMI is strongly predictive of both AD and VaD, independent of stroke, cardiovascular and diabetes co morbidities. Future studies need to unveil the mechanisms between adiposity and excess risk of AD and VaD. SN - 1567-2050 UR - https://www.unboundmedicine.com/medline/citation/17430231/Body_mass_index_in_midlife_and_risk_of_Alzheimer_disease_and_vascular_dementia_ DB - PRIME DP - Unbound Medicine ER -