Adiposity in middle and old age and risk of death from dementia: 40-year follow-up of 19,000 men in the Whitehall study

Abstract

Aims and objectives To examine the hypothesis that obesity is protective for dementia, we compared the associations of death from dementia with body weight and body mass index (BMI) in both middle and old age. Design: Height and weight were measured in a prospective study of 19,019 middle aged men in the Whitehall study in 1967-1970 and in 6158 surviving participants at resurvey in 1997. Cox regression was used to examine the associations of death from dementia over a 40-year period with weight or BMI measured by health professionals in middle and old age adjusting for age, smoking habits, employment grade and marital status. Setting: Central government employees in London, England Main outcomes measure: Death due to dementia in 320 participants Results: Body weight measured in middle age was weakly inversely associated with death from dementia (hazard ratio 0.98 [95%CI: 0.97-0.99] per kg), but neither height nor BMI were related to risk of dementia. In contrast, body weight in old age was more strongly inversely related to deaths from dementia (0.96; [0.95-0.98] per kg) as was BMI (0.92 [0.86-0.97] per kg/m 2). Weight loss over the 30 years between baseline and resurvey was associated with a higher risk of death from dementia, with an adjusted HR per kg/30 years of 1.04 [95%CI: 1.02-1.08] and the association with loss of BMI was even stronger (adjusted HR of 1.10 [1.03-1.19]) per kg/m 2 decrease). Conclusions The stronger associations of deaths from dementia with BMI in old age, compared with middle age, together with strong positive associations of loss of BMI or body weight between middle and old age casts doubt on previous suggestions that obesity protects against death from dementia.

Association Between Long-term Weight Change Since Midlife and Risk of Incident Disabling Dementia Among Elderly Japanese: The Ohsaki Cohort 2006 Study

“…Our findings of the association between weight loss and dementia are generally consistent with the results from previous studies, [6][7][8][9][10][11][12][13]28 but most of them were conducted among Caucasians who usually had larger body weight and weight change than Asians. The Whitehall study suggested that a ≤-7.5 kg weight loss over 30 years from midlife to late-life was associated with risk of death from dementia compared to stable weight (-2.5 -+2.5 kg).…”

“…4 There has been accumulating evidence that weight loss during adulthood is associated with dementia. [5][6][7][8][9][10][11][12][13] However, most studies were conducted among Caucasians 7-13 that usually have higher body weight and weight change than Asians. One study suggested that a weight loss of ≤-7.5kg over 30 years was significantly associated with risk of death from dementia, 7 whereas others reported a > 5% loss in body mass index (BMI) over 3 to 9 years was associated with dementia risk.…”

“…[5][6][7][8][9][10][11][12][13] However, most studies were conducted among Caucasians 7-13 that usually have higher body weight and weight change than Asians. One study suggested that a weight loss of ≤-7.5kg over 30 years was significantly associated with risk of death from dementia, 7 whereas others reported a > 5% loss in body mass index (BMI) over 3 to 9 years was associated with dementia risk. 8,12 Only one study was conducted in Asia, which was a report from South Korea that also found a >10% loss in BMI over a 2-year period was associated with dementia.…”

Nativity, Neighborhoods, and Body Composition in the Sacramento Area Latino Study on Aging

“…We examined the role of individual nativity and neighborhood-level nativity (immigrant concentration) on weight, BMI, and WC over time in a cohort of older Latinos. We found that, among older Latinos, weight and BMI decreased over time; this has been documented in other aging populations (Allen et al, 2019;Karahalios, English, & Simpson, 2016). Foreign born Latinos had lower baseline weight and BMI than US-born Latinos, even with adjustment for age, gender, and height.…”

“…In aging populations, change in obesity and weight are complex factors; although obesity can be a risk factor for other diseases/outcomes, weight and body composition (i.e., fat distribution, muscle mass, and height) are often found to decrease with increasing age (Allen, Clarke, Shipley, & Leon, 2019;Cetin & Nasr, 2014;Miller & Wolfe, 2008;Rothman, 2008). A large number of studies in older populations have reported that weight loss is associated with increased risk of death (Park et al, 2018).…”