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Adiposity indicators and dementia over 32 years in Sweden.
Neurology 2009; 73(19):1559-66Neur

Abstract

BACKGROUND

High midlife and late-life adiposity may increase risk for dementia. Late-life decrease in body mass index (BMI) or body weight within several years of a dementia diagnosis has also been reported. Differences in study designs and analyses may provide different pictures of this relationship.

METHODS

Thirty-two years of longitudinal body weight, BMI, waist circumference, and waist-to-hip ratio (WHR) data, from the Prospective Population Study of Women in Sweden, were related to dementia. A representative sample of 1,462 nondemented women was followed from 1968 at ages 38-60 years, and subsequently in 1974, 1980, 1992, and 2000, using neuropsychiatric, anthropometric, clinical, and other measurements. Cox proportional hazards regression models estimated incident dementia risk by baseline factors. Logistic regression models including measures at each examination were related to dementia among surviving participants 32 years later.

RESULTS

While Cox models showed no association between baseline anthropometric factors and dementia risk, logistic models showed that a midlife WHR greater than 0.80 increased risk for dementia approximately twofold (odds ratio 2.22, 95% confidence interval 1.00-4.94, p = 0.049) among surviving participants. Evidence for reverse causality was observed for body weight, BMI, and waist circumference in years preceding dementia diagnosis.

CONCLUSIONS

Among survivors to age 70, high midlife waist-to-hip ratio may increase odds of dementia. Traditional Cox models do not evidence this relationship. Changing anthropometric parameters in years preceding dementia onset indicate the dynamic nature of this seemingly simple relationship. There are midlife and late-life implications for dementia prevention, and analytical considerations related to identifying risk factors for dementia.

Authors+Show Affiliations

Section for Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Sahlgrenska Academy, University of Gothenburg, Sweden. deborah.gustafson@neuro.gu.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19901247

Citation

Gustafson, D R., et al. "Adiposity Indicators and Dementia Over 32 Years in Sweden." Neurology, vol. 73, no. 19, 2009, pp. 1559-66.
Gustafson DR, Bäckman K, Waern M, et al. Adiposity indicators and dementia over 32 years in Sweden. Neurology. 2009;73(19):1559-66.
Gustafson, D. R., Bäckman, K., Waern, M., Ostling, S., Guo, X., Zandi, P., ... Skoog, I. (2009). Adiposity indicators and dementia over 32 years in Sweden. Neurology, 73(19), pp. 1559-66. doi:10.1212/WNL.0b013e3181c0d4b6.
Gustafson DR, et al. Adiposity Indicators and Dementia Over 32 Years in Sweden. Neurology. 2009 Nov 10;73(19):1559-66. PubMed PMID: 19901247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adiposity indicators and dementia over 32 years in Sweden. AU - Gustafson,D R, AU - Bäckman,K, AU - Waern,M, AU - Ostling,S, AU - Guo,X, AU - Zandi,P, AU - Mielke,M M, AU - Bengtsson,C, AU - Skoog,I, PY - 2009/11/11/entrez PY - 2009/11/11/pubmed PY - 2009/12/16/medline SP - 1559 EP - 66 JF - Neurology JO - Neurology VL - 73 IS - 19 N2 - BACKGROUND: High midlife and late-life adiposity may increase risk for dementia. Late-life decrease in body mass index (BMI) or body weight within several years of a dementia diagnosis has also been reported. Differences in study designs and analyses may provide different pictures of this relationship. METHODS: Thirty-two years of longitudinal body weight, BMI, waist circumference, and waist-to-hip ratio (WHR) data, from the Prospective Population Study of Women in Sweden, were related to dementia. A representative sample of 1,462 nondemented women was followed from 1968 at ages 38-60 years, and subsequently in 1974, 1980, 1992, and 2000, using neuropsychiatric, anthropometric, clinical, and other measurements. Cox proportional hazards regression models estimated incident dementia risk by baseline factors. Logistic regression models including measures at each examination were related to dementia among surviving participants 32 years later. RESULTS: While Cox models showed no association between baseline anthropometric factors and dementia risk, logistic models showed that a midlife WHR greater than 0.80 increased risk for dementia approximately twofold (odds ratio 2.22, 95% confidence interval 1.00-4.94, p = 0.049) among surviving participants. Evidence for reverse causality was observed for body weight, BMI, and waist circumference in years preceding dementia diagnosis. CONCLUSIONS: Among survivors to age 70, high midlife waist-to-hip ratio may increase odds of dementia. Traditional Cox models do not evidence this relationship. Changing anthropometric parameters in years preceding dementia onset indicate the dynamic nature of this seemingly simple relationship. There are midlife and late-life implications for dementia prevention, and analytical considerations related to identifying risk factors for dementia. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/19901247/Adiposity_indicators_and_dementia_over_32_years_in_Sweden_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=19901247 DB - PRIME DP - Unbound Medicine ER -