Aims/hypothesisTo determine the relationship of dementia with preceding body mass index (BMI), changes in body weight and waist circumference in older people with type 2 diabetes
MethodsIn the Edinburgh Type 2 Diabetes Study (1064 men and women with type 2 diabetes, aged 60-75), body weight, waist circumference and BMI were measured at baseline and after 4 years in a sub-group (n=821). Percentage body weight and waist circumference change over four years were calculated. Data on incident dementia was recorded during a median follow up time of 10.84 years. Survival models considering a range of co-variables and/or death as a competing risk, were used to estimate the risks of dementia associated with each weight-related variable.
ResultsA total of 105 incident dementia events were recorded. When compared with people in the lowest BMI group (<25 kg/m 2 ), risk of dementia was lower in intermediate BMI groups (25-29.9 kg/m 2 , HR 0.44, p=0.002; 30-34.9 kg/m 2 , HR 0.41, p=0.001) and the highest BMI group (≧35 kg/m 2 , HR 0.35, p=0.001). In the weight change subgroup, 78 incident dementia events were recorded between years four and ten.Body weight loss over 5% (compared with ≦5%) was associated with higher incidence of dementia (HR 2.06, p=0.010). The association between waist circumference change and dementia was not significant.
Conclusions/InterpretationsBoth a lower BMI and weight loss over a period of years are indicative of increased dementia risk for older people with type 2 diabetes, while waist circumference changes may be less informative.
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