Accelerated Weight Loss and Incident Dementia in an Elderly African-American Cohort

Abstract

OBJECTIVES-To examine the association between changes in body mass index (BMI), dementia, and mild cognitive impairment (MCI). DESIGN-Prospective observational study.SETTING-Urban community in Indianapolis, Indiana. PARTICIPANTS-Participantswere African Americans aged 65 and older enrolled in the Indianapolis Dementia Project and followed through 2007. This analysis included 1,331 participants who did not have dementia at their first BMI measurement. MEASUREMENTS-Cognitive assessment and clinical evaluations were conducted every other year to identify participants with dementia or MCI during 12 years of follow-up (mean follow-up 6.4 years). BMI measures; alcohol and smoking history; and medical conditions including history of cancer, hypertension, diabetes mellitus, heart attack, stroke; and depression were collected at each follow-up evaluation. Mixed-effect models were used to examine the differences in BMI between participants who developed dementia or MCI and those who did not, adjusting for covariates.RESULTS-Mean BMI at baseline was 29.8 ± 5.7 for women and 28.3 ± 4.8 for men. Participants with incident dementia or MCI had greater decline in BMI than those without (P=.02 for dementia, P=.04 for MCI). BMI in participants with incident dementia, MCI, and normal © 2010, The American Geriatrics Society Address correspondence to Sujuan Gao, Department of Medicine, Indiana University School of Medicine, 410 West 10th Street, Suite 3000, Indianapolis, IN 46202. sgao@iupui.edu. Author Contributions: Study design: Gao, Hendrie, Unverzagt, Hall. Data acquisition: Hendrie, Unverzagt, Hake, Smith-Gambel, Hall. Data analysis and interpretation: Gao, Nguyen, Hendrie. Preparation of manuscript: Gao, Nguyen, Hendrie, Unverzagt, Hake, Smith-Gambel, Hall. Conflict of Interest:The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Sponsor's Role:The data used in this manuscript are from a NIH-funded study "Indianapolis-Ibadan Dementia Project." The sponsor played no role in the design, method, analysis, or preparation of the manuscript. NIH Public AccessAuthor Manuscript J Am Geriatr Soc. Author manuscript; available in PMC 2012 January 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript cognition did not differ 12 or 9 years before diagnosis, but 6 years before diagnosis, participants with incident dementia had significantly lower BMI than participants with normal cognition (P=. 03), as did participants with MCI (P=.006).CONCLUSION-Decline in BMI appears to be an early marker for dementia. There is a need for the close monitoring of weight loss in older adults. Keywordsbody mass index; dementia; mild cognitive impairment; African AmericansObesity is associated with risk of diabetes mellitus, hypertension, and cardiovascular disease, conditions related to risk of dementia. There are studies confirming that midlife obesity is a risk factor for dem...

Weight Change in Midlife and Risk of Mortality From Dementia up to 35 Years Later

“…Our result regarding weight loss being associated with increased dementia related mortality risk fits with studies using clinical dementia as end point (10)(11)(12)(13)(14)(15)(16)(17)(18). Most previous studies investigate weight change in old age, typically above 65 years or older, where reverse causality might be a plausible explanation for the association between weight loss and dementia.…”

“…A better understanding of the association between body weight and dementia may be achieved by studying weight trajectories and patterns from midlife into old age (1). Studies with weight at multiple time points have generally reported weight loss (10)(11)(12)(13)(14)(15)(16)(17)(18) or weight instability (19) to be associated with increased dementia risk. However, many of these studies are limited to weight trajectories in old age, and might be prone to reverse causality because dementia and preclinical dementia might cause weight loss (1,20).…”

Alzheimer disease biomarkers are associated with body mass index

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