Physical Activity, Weight Status, Diabetes and Dementia: A 34-Year Follow-Up of the Population Study of Women in Gothenburg

Mehlig, Kirsten; Skoog, Ingmar; Wærn, Margda; Jonasson, Junmei Miao; Lapidus, Leif; Björkelund, Cecilia; Östling, Svante; Lissner, Lauren

doi:10.1159/000362201

Cited by 39 publications

(32 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We examined the 86 potentially eligible publications and two more retrieved from other sources as full texts, 30 reports met the inclusion criteria. Of these, 11 were excluded because midlife BMI was predicted rather than measured in midlife [14], was modeled as a continuous variable [36], as a covariate in multivariate models [37], [38], or data were previously published [21], [39], [40], [41], [42], [43]. We retained 19 studies for further analysis (Launer LJ, personal communication, 2015) [10], [18], [19], [20], [22], [29], [30], [31], [44], [45], [46], [47], [48], [49], [50], [51], [52], [53].…”

Section: Resultsmentioning

confidence: 99%

Body mass index in midlife and dementia: Systematic review and meta‐regression analysis of 589,649 men and women followed in longitudinal studies

Albanese

Launer

Egger

et al. 2017

Alz & Dem Diag Ass & Dis Mo

198

160

View full text Add to dashboard Cite

IntroductionWe conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia.MethodsWe searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity.ResultsWe included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95% confidence interval [CI], 1.08–1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95% CI, 0.96–1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95% CI, 1.13–1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007).DiscussionObesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.

show abstract

Section: Resultsmentioning

confidence: 99%

Body mass index in midlife and dementia: Systematic review and meta‐regression analysis of 589,649 men and women followed in longitudinal studies

Albanese

Launer

Egger

et al. 2017

Alz & Dem Diag Ass & Dis Mo

198

160

View full text Add to dashboard Cite

show abstract

“…Based on previous publications, potential confounding variables such as age, sex, level of education, history of stroke, transient ischemic attack (TIA), depression, cardiovascular disease (CVD), diabetes mellitus, and living status were assessed at baseline and included in the analyses. Education was defined as a categorical variable (≤high school, vocational school or some college, ≥college degree).…”

Section: Methodsmentioning

confidence: 99%

Sound Body Sound Mind? Physical Performance and the Risk of Dementia in the Oldest‐Old: The 90+ Study

Bullain

Corrada

Perry

et al. 2016

J American Geriatrics Society

View full text Add to dashboard Cite

OBJECTIVES:To examine the longitudinal association between physical performance and risk of dementia in individuals aged 90 and older without dementia. DESIGN: Population-based longitudinal study. SETTINGS: The 90+ Study, Laguna Woods, California. PARTICIPANTS: Men n = 176 and women n = 402 without dementia from The 90+ Study (n = 578, mean age 93.3). At baseline, 54% of participants were cognitively normal, and 46% had cognitive impairment, no dementia. MEASUREMENTS: Physical performance measures (4-m walk, 5 chair stands, handgrip, standing balance) were scored from 0 (unable to perform) to 4 (best performance). The outcome was dementia, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Hazard ratios (HRs) for dementia in relation to baseline physical performance were estimated using Cox regression after adjustment for potential confounders. HRs and P-values for the overall Wald chi-square are reported to show the magnitude of each physical performance measure and the strength of the association between each measure and incident dementia. RESULTS: Poor physical performance in most measures was associated with greater risk of incident dementia over a mean follow-up of 2.6 years (range 0.6-9.0 years). After controlling for potential confounders, standing balance had the strongest association with incident dementia (HRs = 1.9-2.5, overall P = .02), followed by 4-m walk (HRs = 1.1-1.8, overall P = .04) and handgrip (HRs = 1.0-2.0, overall P = .03). The association with five chair stands was not significant. In a subanalysis limited to cognitively normal participants, HRs were attenuated, but most remained in the same direction. CONCLUSION:Poor physical performance is associated with risk of developing dementia over an average 2.6-year follow-up in the oldest-old, indicating that poor physical performance may be an early sign of late-age dementia. J Am Geriatr Soc 64:1408-1415, 2016.Key words: dementia; gait; longitudinal survey; oldestold; postural balance I n the United States, the number of people living to age 90 and older the oldest-old, is projected to quadruple by 2050, resulting in 8.7 million of the oldest-old individuals by midcentury. 1,2 Living longer does not necessarily mean living well, as the oldest-old has the highest incidence of dementia. 3 The combination of rapid growth of the oldest population and high rates of dementia is one of the greatest public health challenges facing the United States unless effective treatment or preventive options are identified.In The 90+ Study, a strong, dose-dependent, crosssectional association between poor physical performance on 4-m walk, balance, five chair stands, and grip strength and dementia was previously shown, with poorer physical performance associated with greater odds of prevalent dementia in the oldest-old. 4 Although studies in younger adults (mean age <85) have shown that poor physical performance is associated with greater odds of poor cognition cross-sectionally 5,6 and longitudinally, 7,8...

show abstract

“…Not only younger but also elder people should exercise as much as they can because it may directly benefit the brain by increasing blood and oxygen flow into the brain. Accordingly, a report demonstrated an inverse association between physical activities and cognitive decline [47] and also mentioned that an increase level of physical activity is associated with a subsequently decreased incidence of dementia [48] . To reduce the chance of dementia, people should quit smoking because when compared with non-smokers, smokers were found to have decreased grey matter density in the posterior cingulate and presumes, right thalamus, and frontal cortex [49] .…”

Section: Recommendationmentioning

confidence: 99%

Benzodiazepine Use and Risk of Dementia in the Elderly Population: A Systematic Review and Meta-Analysis

et al. 2016

View full text Add to dashboard Cite

Background: Benzodiazepines are a widely used medication in developed countries, particularly among elderly patients. However, benzodiazepines are known to affect memory and cognition and might thus enhance the risk of dementia. The objective of this review is to synthesize evidence from observational studies that evaluated the association between benzodiazepines use and dementia risk. Summary: We performed a systematic review and meta-analysis of controlled observational studies to evaluate the risk of benzodiazepines use on dementia outcome. All control observational studies that compared dementia outcome in patients with benzodiazepine use with a control group were included. We calculated pooled ORs using a random-effects model. Ten studies (of 3,696 studies identified) were included in the systematic review, of which 8 studies were included in random-effects meta-analysis and sensitivity analyses. Odds of dementia were 78% higher in those who used benzodiazepines compared with those who did not use benzodiazepines (OR 1.78; 95% CI 1.33-2.38). In subgroup analysis, the higher association was still found in the studies from Asia (OR 2.40; 95% CI 1.66-3.47) whereas a moderate association was observed in the studies from North America and Europe (OR 1.49; 95% CI 1.34-1.65 and OR 1.43; 95% CI 1.16-1.75). Also, diabetics, hypertension, cardiac disease, and statin drugs were associated with increased risk of dementia but negative association was observed in the case of body mass index. There was significant statistical and clinical heterogeneity among studies for the main analysis and most of the sensitivity analyses. There was significant statistical and clinical heterogeneity among the studies for the main analysis and most of the sensitivity analyses. Key Messages: Our results suggest that benzodiazepine use is significantly associated with dementia risk. However, observational studies cannot clarify whether the observed epidemiologic association is a causal effect or the result of some unmeasured confounding variable. Therefore, more research is needed.

show abstract

Physical Activity, Weight Status, Diabetes and Dementia: A 34-Year Follow-Up of the Population Study of Women in Gothenburg

Cited by 39 publications

References 32 publications

Body mass index in midlife and dementia: Systematic review and meta‐regression analysis of 589,649 men and women followed in longitudinal studies

Body mass index in midlife and dementia: Systematic review and meta‐regression analysis of 589,649 men and women followed in longitudinal studies

Sound Body Sound Mind? Physical Performance and the Risk of Dementia in the Oldest‐Old: The 90+ Study

Benzodiazepine Use and Risk of Dementia in the Elderly Population: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About