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Body adiposity in late life and risk of dementia or cognitive impairment in a longitudinal community-based study.

Abstract

BACKGROUND

The association between body adiposity at older ages and the development of cognitive impairment is unclear.

METHODS

The association of body mass index (BMI) and waist circumference in late life with incidence of cognitive impairment was prospectively examined in a cohort study of 1,351 Latinos, aged 60-101 and residents of the Sacramento, CA, area at study baseline. The status of dementia and "cognitive impairment but not demented" (CIND) was determined at baseline and at each of five follow-up examinations by a multistage assessment protocol. Incident cases of dementia and CIND were combined (dementia/CIND) for more than 8 years of follow-up. BMI was categorized as less than 25.0, 25.0-29.9 (overweight), and 30 kg/m(2) or greater (obese). Waist circumference was categorized into sex-specific tertiles.

RESULTS

Dementia/CIND was diagnosed in 110 (8.2%) participants. Compared with the lowest BMI category, overweight participants had a 48% decreased rate of dementia/CIND (adjusted hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.30-0.91) and obese participants had a 61% decreased rate of dementia/CIND (HR = 0.39, 95% CI: 0.20-0.78). Rates of dementia/CIND for the middle and high tertile of waist circumference, compared with the low tertile, were 80% and 90% higher, respectively (adjusted HR = 1.8, 95% CI: 1.1-3.1, and adjusted HR = 1.9, 95% CI: 0.91-3.8).

CONCLUSIONS

Abdominal fat in late life appears to confer an increased risk for dementia/CIND, whereas overall obesity appears to be protective. This may reflect age-related changes in body composition and the association of visceral fat with metabolic dysregulation.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology, University of Michigan, Ann Arbor, 48104, USA.

    Source

    MeSH

    Adiposity
    Aged
    Aging
    Body Mass Index
    California
    Cognition Disorders
    Dementia
    Female
    Follow-Up Studies
    Hispanic Americans
    Humans
    Male
    Middle Aged
    Prevalence
    Retrospective Studies
    Risk Factors
    Sex Factors
    Waist Circumference

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    19168781

    Citation

    West, Nancy A., and Mary N. Haan. "Body Adiposity in Late Life and Risk of Dementia or Cognitive Impairment in a Longitudinal Community-based Study." The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, vol. 64, no. 1, 2009, pp. 103-9.
    West NA, Haan MN. Body adiposity in late life and risk of dementia or cognitive impairment in a longitudinal community-based study. J Gerontol A Biol Sci Med Sci. 2009;64(1):103-9.
    West, N. A., & Haan, M. N. (2009). Body adiposity in late life and risk of dementia or cognitive impairment in a longitudinal community-based study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 64(1), pp. 103-9. doi:10.1093/gerona/gln006.
    West NA, Haan MN. Body Adiposity in Late Life and Risk of Dementia or Cognitive Impairment in a Longitudinal Community-based Study. J Gerontol A Biol Sci Med Sci. 2009;64(1):103-9. PubMed PMID: 19168781.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Body adiposity in late life and risk of dementia or cognitive impairment in a longitudinal community-based study. AU - West,Nancy A, AU - Haan,Mary N, Y1 - 2009/01/23/ PY - 2009/1/27/entrez PY - 2009/1/27/pubmed PY - 2009/4/15/medline SP - 103 EP - 9 JF - The journals of gerontology. Series A, Biological sciences and medical sciences JO - J. Gerontol. A Biol. Sci. Med. Sci. VL - 64 IS - 1 N2 - BACKGROUND: The association between body adiposity at older ages and the development of cognitive impairment is unclear. METHODS: The association of body mass index (BMI) and waist circumference in late life with incidence of cognitive impairment was prospectively examined in a cohort study of 1,351 Latinos, aged 60-101 and residents of the Sacramento, CA, area at study baseline. The status of dementia and "cognitive impairment but not demented" (CIND) was determined at baseline and at each of five follow-up examinations by a multistage assessment protocol. Incident cases of dementia and CIND were combined (dementia/CIND) for more than 8 years of follow-up. BMI was categorized as less than 25.0, 25.0-29.9 (overweight), and 30 kg/m(2) or greater (obese). Waist circumference was categorized into sex-specific tertiles. RESULTS: Dementia/CIND was diagnosed in 110 (8.2%) participants. Compared with the lowest BMI category, overweight participants had a 48% decreased rate of dementia/CIND (adjusted hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.30-0.91) and obese participants had a 61% decreased rate of dementia/CIND (HR = 0.39, 95% CI: 0.20-0.78). Rates of dementia/CIND for the middle and high tertile of waist circumference, compared with the low tertile, were 80% and 90% higher, respectively (adjusted HR = 1.8, 95% CI: 1.1-3.1, and adjusted HR = 1.9, 95% CI: 0.91-3.8). CONCLUSIONS: Abdominal fat in late life appears to confer an increased risk for dementia/CIND, whereas overall obesity appears to be protective. This may reflect age-related changes in body composition and the association of visceral fat with metabolic dysregulation. SN - 1758-535X UR - https://www.unboundmedicine.com/medline/citation/19168781/Body_adiposity_in_late_life_and_risk_of_dementia_or_cognitive_impairment_in_a_longitudinal_community_based_study_ L2 - https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/gln006 DB - PRIME DP - Unbound Medicine ER -