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Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging.
JAMA Neurol. 2016 04; 73(4):439-46.JN

Abstract

IMPORTANCE

Unintentional weight loss has been associated with risk of dementia. Because mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI.

OBJECTIVE

To investigate the association of change in weight and BMI with risk of MCI.

DESIGN, SETTING, AND PARTICIPANTS

A population-based, prospective study of participants 70 years of age or older from the Mayo Clinic Study of Aging, which was initiated on October 1, 2004. Maximum weight and height in midlife (40-65 years of age) were retrospectively ascertained from the medical records of participants using a medical records-linkage system. The statistical analyses were performed between January and November 2015.

MAIN OUTCOMES AND MEASURES

Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and BMI with risk of MCI was investigated using proportional hazards models.

RESULTS

Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI (50.3% were men; mean age, 78.5 years). The mean (SD) rate of weight change per decade from midlife to study entry was greater for participants who developed incident MCI vs those who remained cognitively normal (-2.0 [5.1] vs -1.2 [4.9] kg; P = .006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR], 1.04 [95% CI, 1.02-1.06]; P < .001) after adjusting for sex, education, and apolipoprotein E (APOE) ε4 allele. A weight loss of 5 kg per decade corresponds to a 24% increase in risk of MCI (HR, 1.24). A higher decrease in BMI per decade was also associated with incident MCI (HR, 1.08 [95% CI, 1.03-1.13]; P = .003).

CONCLUSIONS AND RELEVANCE

These findings suggest that increasing weight loss per decade from midlife to late life is a marker for MCI and may help identify persons at increased risk for MCI.

Authors+Show Affiliations

Mayo Clinic Graduate School of Medicine, Rochester, Minnesota2Department of Neurology, Mayo Clinic, Rochester, Minnesota.Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.Department of Neurology, Mayo Clinic, Rochester, Minnesota3Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota6Departments of Psychiatry and Psychology and of Neurology, Mayo Clinic, Scottsdale, Arizona.Department of Neurology, Mayo Clinic, Rochester, Minnesota.Department of Neurology, Mayo Clinic, Rochester, Minnesota3Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.Department of Neurology, Mayo Clinic, Rochester, Minnesota3Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.

Pub Type(s)

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

Language

eng

PubMed ID

26831542

Citation

Alhurani, Rabe E., et al. "Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging." JAMA Neurology, vol. 73, no. 4, 2016, pp. 439-46.
Alhurani RE, Vassilaki M, Aakre JA, et al. Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging. JAMA Neurol. 2016;73(4):439-46.
Alhurani, R. E., Vassilaki, M., Aakre, J. A., Mielke, M. M., Kremers, W. K., Machulda, M. M., Geda, Y. E., Knopman, D. S., Petersen, R. C., & Roberts, R. O. (2016). Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging. JAMA Neurology, 73(4), 439-46. https://doi.org/10.1001/jamaneurol.2015.4756
Alhurani RE, et al. Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging. JAMA Neurol. 2016;73(4):439-46. PubMed PMID: 26831542.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging. AU - Alhurani,Rabe E, AU - Vassilaki,Maria, AU - Aakre,Jeremiah A, AU - Mielke,Michelle M, AU - Kremers,Walter K, AU - Machulda,Mary M, AU - Geda,Yonas E, AU - Knopman,David S, AU - Petersen,Ronald C, AU - Roberts,Rosebud O, PY - 2016/2/3/entrez PY - 2016/2/3/pubmed PY - 2016/9/13/medline SP - 439 EP - 46 JF - JAMA neurology JO - JAMA Neurol VL - 73 IS - 4 N2 - IMPORTANCE: Unintentional weight loss has been associated with risk of dementia. Because mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI. OBJECTIVE: To investigate the association of change in weight and BMI with risk of MCI. DESIGN, SETTING, AND PARTICIPANTS: A population-based, prospective study of participants 70 years of age or older from the Mayo Clinic Study of Aging, which was initiated on October 1, 2004. Maximum weight and height in midlife (40-65 years of age) were retrospectively ascertained from the medical records of participants using a medical records-linkage system. The statistical analyses were performed between January and November 2015. MAIN OUTCOMES AND MEASURES: Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and BMI with risk of MCI was investigated using proportional hazards models. RESULTS: Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI (50.3% were men; mean age, 78.5 years). The mean (SD) rate of weight change per decade from midlife to study entry was greater for participants who developed incident MCI vs those who remained cognitively normal (-2.0 [5.1] vs -1.2 [4.9] kg; P = .006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR], 1.04 [95% CI, 1.02-1.06]; P < .001) after adjusting for sex, education, and apolipoprotein E (APOE) ε4 allele. A weight loss of 5 kg per decade corresponds to a 24% increase in risk of MCI (HR, 1.24). A higher decrease in BMI per decade was also associated with incident MCI (HR, 1.08 [95% CI, 1.03-1.13]; P = .003). CONCLUSIONS AND RELEVANCE: These findings suggest that increasing weight loss per decade from midlife to late life is a marker for MCI and may help identify persons at increased risk for MCI. SN - 2168-6157 UR - https://www.unboundmedicine.com/medline/citation/26831542/Decline_in_Weight_and_Incident_Mild_Cognitive_Impairment:_Mayo_Clinic_Study_of_Aging_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/jamaneurol.2015.4756 DB - PRIME DP - Unbound Medicine ER -