Association of obesity, diabetes and hypertension with cognitive impairment in older age

Abstract

BackgroundAge-related cognitive impairment is rising in prevalence but is not yet fully characterized in terms of its epidemiology. Here, we aimed to elucidate the role of obesity, diabetes and hypertension as candidate risk factors.MethodsOriginal baseline data from 3 studies (OCTOPUS, DECS, SuDoCo) were obtained for secondary analysis of cross-sectional associations of diabetes, hypertension, blood pressure, obesity (body mass index [BMI] ≥30 kg/m2) and BMI with presence of cognitive impairment in log-binomial regression analyses. Cognitive impairment was defined as scoring more than 2 standard deviations below controls on at least one of 5–11 cognitive tests. Underweight participants (BMI<18.5 kg/m2) were excluded. Results were pooled across studies in fixed-effects inverse variance models.ResultsAnalyses totaled 1545 participants with a mean age of 61 years (OCTOPUS) to 70 years (SuDoCo). Cognitive impairment was found in 29.0% of participants in DECS, 8.2% in SuDoCo and 45.6% in OCTOPUS. In pooled analyses, after adjustment for age, sex, diabetes and hypertension, obesity was associated with a 1.29-fold increased prevalence of cognitive impairment (risk ratio [RR] 1.29; 95% CI 0.98, 1.72). Each 1 kg/m2 increment in BMI was associated with 3% increased prevalence (RR 1.03; 95% CI 1.00, 1.06). None of the remaining risk factors were associated with impairment.ConclusionOur results show that older people who are obese have higher prevalence of cognitive impairment compared with normal weight and overweight individuals, and independently of co-morbid hypertension or diabetes. Prospective studies are needed to investigate the temporal relationship of the association.

Trajectories of cognitive function and their determinants in older people: 12 years of follow-up in the Chinese Longitudinal Healthy Longevity Survey

“…Except for the age, gender and education variables mentioned above, other factors were also associated with trajectory membership, such as BMI. There are ongoing discussions about the relationship between body weight and cognitive function (Dahl et al, 2013;Feinkohl et al, 2018;Kim et al, 2019). In accordance with the previous studies conducted among other populations (Kim et al, 2019;Sabia et al, 2009), which reported that being underweight was a risk factor for cognitive decline, our results also suggested that being underweight plays a role in differentiating group membership, with an OR of 1.70 for rapid decline compared with the stable group.…”

Prevalence and factors associated with overweight and central obesity among adults in the Eastern Sudan

“…Consistent with the current results, obesity was reported in many countries, including Northern Sudan, as one of the leading risk factors for hypertension [9,14,25]. Obese older adults are at higher risk of comorbidities such as hypertension [26]. Unlike the previous study in Ghana [27], the current study showed that participants with low education were less likely to be underweight (0.40 (0.18, 0.92)).…”

Association between Sympathetic Nervous System Activation, Obesity and Insulin Resistance

“…[14] в разделе, посвященном оценке поражения органовмишеней, для выявления поражения головного мозга указана необходимость оценки состояния когнитивных функций у пациентов с АГ. В этой связи интересны результаты ряда работ [51,52], указывающие на роль ожирения в развитии когнитивной дисфункции.…”

“…Так, в работе I. Feinkohl и соавт. [51] был проведен анализ трех исследований (OCTOPUS, DECS, SuDoC) для оценки потенциальных взаимосвязей между когнитивной дисфункцией и ожирением, ИМТ, АГ, уровнем АД и сахарным диабетом. В анализ вошло 1545 пациентов со средним возрастом 61-70 лет, когнитивные нарушения в каждом из включенных в анализ исследований были обнаружены у 8,2-45,6% больных.…”

“…Патофизиологические основы взаимосвязи когнитивных нарушений и ожирения требуют дальнейшего изучения, однако предполагается, что здесь играет роль провоспалительный баланс цитокинов, сопутствующий избыточной массе тела, и сам по себе являющийся фактором риска когнитивных нарушений [51], и гипертриглицеридемия, которая, как продемонстрировано на моделях животных, тоже оказывает негативное влияние на когнитивные процессы [51]. Вместе с тем еще одним важным механизмом когнитивных нарушений может служить ассоциированное с ожирением системное повреждение сосудистого русла, в котором, как описано выше, существенное значение имеет активация СНС [29,40,47,48].…”