By comparison with BMI, waist circumference and waist-hip ratio, waist-to-height ratio ≥ 0.5 may be the best indicator for undiagnosed Type 2 diabetes and impaired fasting glucose.
Objective: This study examines whether overweight in midlife increases dementia risk later in life. Methods: In 1963 body mass index was assessed in 1152 participants of The Swedish Twin Registry, at the age of 45-65 years. These participants were later screened for dementia in a prospective study with up to 40 years follow-up. A total of 312 participants were diagnosed with dementia. Results: Logistic regression analyses adjusted for demographic factors, smoking and alcohol habits, indicated that men and women categorized as overweight in their midlife had an elevated risk of dementia (OR ¼ 1.59; 95% CI: 1.21-2.07, P ¼ 0.002), Alzheimer's disease (OR ¼ 1.71; 95% CI: 1.24-2.35, P ¼ 0.003), and vascular dementia (OR ¼ 1.55; 95% CI: 0.98-2.47, P ¼ 0.059). Further adjustments for diabetes and vascular diseases did not substantially affect the associations, except for vascular dementia (OR ¼ 1.36; 95% CI: 0.82-2.56, P ¼ 0.116), reflecting the significance of diabetes and vascular diseases in the etiology of vascular dementia. There was no significant interaction between overweight and APOE e4 status, indicating that having both risk factors does not have a multiplicative effect with regard to dementia risk. Conclusions: This study gives further support to the notion that overweight in midlife increases later risk of dementia. The risk is increased for both Alzheimer's disease and vascular dementia, and follows the same pattern for men and women.
Obesity is a health problem that has reached epidemic proportions. Given the high prevalence of obesity, even a small adverse impact of obesity on cognitive aging might have a serious effect on public health. The purpose of this systematic review was to examine the relation between obesity and cognitive function in late life among persons not diagnosed with dementia and to evaluate the evidence for a causal association. Medline was used to search for the following terms: obesity, overweight, cognition, cognitive, age, and aged. To be included, studies must have had a population-based, dementia-free sample and a 5-year minimum interval between measurement of the predictor and the outcome. Only 11 studies met the criteria. Of these, 7 studies assessed obesity in midlife and cognitive function in later life, and 4 studies assessed obesity and cognitive function in late life. The reviewed studies showed clear evidence that midlife obesity was associated with cognitive aging, whereas this association was weaker in late life; thus, no firm conclusions could be drawn. The findings of this review suggest that, although there is evidence for an association between midlife obesity and low cognitive abilities in late life, the direction of the association and the causality remain to be clarified.
Background Current recommendations from the World Health Organization (WHO) are that individuals should seek to maintain a body mass index (BMI) between 18.5–25 kg/m2, independent of age. However, there is an ongoing discussion whether the WHO recommendations apply to old (70 ≥ 80 years) and very old persons (80+ years). In the present study we examine how BMI status and change in BMI are associated with mortality among old and very old individuals. Design Pooled data from three multidisciplinary prospective population-based studies OCTO-twin, GENDER, and NONA. Setting Sweden. Participants 882 individuals aged 70 to 95 years. Measurements Body Mass Index was calculated from measured height and weight as kg/m2. Information about survival status and time of death was obtained from Swedish Civil Registration System Results Mortality hazard was 20% lower for the overweight group relative to the normal/underweight group (RR = 0.80, p< .05), and the mortality hazard for the obese group did not differ significantly from the normal/underweight group (RR = 0.93, > .10), independent of age, education, and multimorbidity. Furthermore, mortality hazard was 65% higher for the BMI loss group than for the BMI stable group (RR = 1.65, p< .001) and 53% higher for the BMI gain group than for the BMI stable group (RR = 1.53, p≤ .001). However, the BMI change differences were moderated by age, i.e., the higher mortality risks associated with both loss in BMI and BMI gain were less severe in very old age. Conclusion Old persons who were overweight had a decreased mortality risk compared to old persons having a BMI below 25, even after controlling for weight change and multimorbidity. Compared to persons who had a stable BMI those who increased or decreased in BMI had a higher mortality risk, particularly among people aged 70 to 80. This study lends further support for the opinion that the WHO guidelines are overly restrictive in old age.
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