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Interaction between body mass index and central adiposity and risk of incident cognitive impairment and dementia: results from the Women's Health Initiative Memory Study.

Abstract

OBJECTIVES

To assess the relationship between body mass index (BMI) and waist-hip ratio (WHR) and the clinical end points of cognitive impairment and probable dementia in a cohort of older women enrolled in the Women's Health Initiative Memory Study (WHIMS).

DESIGN

Prospective, randomized clinical trial of hormone therapies with annual cognitive assessments and anthropometrics.

SETTING

Fourteen U.S. clinical sites of the WHIMS.

PARTICIPANTS

Seven thousand one hundred sixty-three postmenopausal women aged 65 to 80 without dementia.

MEASUREMENTS

Annual cognitive assessments, average follow-up of 4.4 years, including classification of incident cognitive impairment and probable dementia. Height, weight, waist, and hip measurements were assessed at baseline, and a waist-hip ratio (WHR) of 0.8 or greater was used as a marker of central adiposity.

RESULTS

There were statistically significant interactions between BMI and WHR and incident cognitive impairment and probable dementia with and without adjustment for a panel of cognitive risk factors. Women with a WHR of 0.80 or greater with a BMI of 20.0 to 24.9 kg/m² had a greater risk of cognitive impairment and probable dementia than more-obese women or women with a WHR less than 0.80, although women with a WHR less than 0.80 and a BMI of 20.0 to 24.9 kg/m² had poorer scores on cognitive assessments.

CONCLUSION

WHR affects the relationship between BMI and risk of cognitive impairment and probable dementia in older women. Underweight women (BMI < 20.0 kg/m²) with a WHR less than 0.80 had a greater risk than those with higher BMIs. In normal-weight to obese women (20.0-29.9 kg/m², central adiposity (WHR ≥ 0.80) is associated with greater risk of cognitive impairment and probable dementia than in women with higher BMI. These data suggest that central adiposity as a risk factor for cognitive impairment and probable dementia in normal-weight women.

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  • Authors+Show Affiliations

    ,

    Division of Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. d-kerwin@northwestern.edu

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    Source

    MeSH

    Aged
    Aged, 80 and over
    Body Mass Index
    Cognition Disorders
    Dementia
    Female
    Follow-Up Studies
    Humans
    Obesity, Abdominal
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Thinness
    United States
    Waist-Hip Ratio

    Pub Type(s)

    Journal Article
    Multicenter Study
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    21226681

    Citation

    Kerwin, Diana R., et al. "Interaction Between Body Mass Index and Central Adiposity and Risk of Incident Cognitive Impairment and Dementia: Results From the Women's Health Initiative Memory Study." Journal of the American Geriatrics Society, vol. 59, no. 1, 2011, pp. 107-12.
    Kerwin DR, Gaussoin SA, Chlebowski RT, et al. Interaction between body mass index and central adiposity and risk of incident cognitive impairment and dementia: results from the Women's Health Initiative Memory Study. J Am Geriatr Soc. 2011;59(1):107-12.
    Kerwin, D. R., Gaussoin, S. A., Chlebowski, R. T., Kuller, L. H., Vitolins, M., Coker, L. H., ... Espeland, M. A. (2011). Interaction between body mass index and central adiposity and risk of incident cognitive impairment and dementia: results from the Women's Health Initiative Memory Study. Journal of the American Geriatrics Society, 59(1), pp. 107-12. doi:10.1111/j.1532-5415.2010.03219.x.
    Kerwin DR, et al. Interaction Between Body Mass Index and Central Adiposity and Risk of Incident Cognitive Impairment and Dementia: Results From the Women's Health Initiative Memory Study. J Am Geriatr Soc. 2011;59(1):107-12. PubMed PMID: 21226681.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Interaction between body mass index and central adiposity and risk of incident cognitive impairment and dementia: results from the Women's Health Initiative Memory Study. AU - Kerwin,Diana R, AU - Gaussoin,Sarah A, AU - Chlebowski,Rowan T, AU - Kuller,Lewis H, AU - Vitolins,Mara, AU - Coker,Laura H, AU - Kotchen,Jane M, AU - Nicklas,Barbara J, AU - Wassertheil-Smoller,Sylvia, AU - Hoffmann,Raymond G, AU - Espeland,Mark A, AU - ,, PY - 2011/1/14/entrez PY - 2011/1/14/pubmed PY - 2011/2/22/medline SP - 107 EP - 12 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 59 IS - 1 N2 - OBJECTIVES: To assess the relationship between body mass index (BMI) and waist-hip ratio (WHR) and the clinical end points of cognitive impairment and probable dementia in a cohort of older women enrolled in the Women's Health Initiative Memory Study (WHIMS). DESIGN: Prospective, randomized clinical trial of hormone therapies with annual cognitive assessments and anthropometrics. SETTING: Fourteen U.S. clinical sites of the WHIMS. PARTICIPANTS: Seven thousand one hundred sixty-three postmenopausal women aged 65 to 80 without dementia. MEASUREMENTS: Annual cognitive assessments, average follow-up of 4.4 years, including classification of incident cognitive impairment and probable dementia. Height, weight, waist, and hip measurements were assessed at baseline, and a waist-hip ratio (WHR) of 0.8 or greater was used as a marker of central adiposity. RESULTS: There were statistically significant interactions between BMI and WHR and incident cognitive impairment and probable dementia with and without adjustment for a panel of cognitive risk factors. Women with a WHR of 0.80 or greater with a BMI of 20.0 to 24.9 kg/m² had a greater risk of cognitive impairment and probable dementia than more-obese women or women with a WHR less than 0.80, although women with a WHR less than 0.80 and a BMI of 20.0 to 24.9 kg/m² had poorer scores on cognitive assessments. CONCLUSION: WHR affects the relationship between BMI and risk of cognitive impairment and probable dementia in older women. Underweight women (BMI < 20.0 kg/m²) with a WHR less than 0.80 had a greater risk than those with higher BMIs. In normal-weight to obese women (20.0-29.9 kg/m², central adiposity (WHR ≥ 0.80) is associated with greater risk of cognitive impairment and probable dementia than in women with higher BMI. These data suggest that central adiposity as a risk factor for cognitive impairment and probable dementia in normal-weight women. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/21226681/Interaction_between_body_mass_index_and_central_adiposity_and_risk_of_incident_cognitive_impairment_and_dementia:_results_from_the_Women's_Health_Initiative_Memory_Study_ L2 - https://doi.org/10.1111/j.1532-5415.2010.03219.x DB - PRIME DP - Unbound Medicine ER -