Article

Lower cognitive function in the presence of obesity and hypertension: the Framingham heart study

Department of Mathematics and Statistics, Statistics and Consulting Unit, Boston University, MA 02215, USA.
International Journal of Obesity (Impact Factor: 5.39). 03/2003; 27(2):260-8. DOI: 10.1038/sj.ijo.802225
Source: PubMed

ABSTRACT To determine the independent effects of obesity and hypertension on cognitive functioning.
Using a prospective design, male (n=551) and female (n=872) participants of the Framingham Heart Study were classified by presence or absence of obesity and hypertension based on data collected over an 18-y surveillance period. All subjects were free from dementia, stroke, and clinically diagnosed cardiovascular disease up to the time of cognitive testing. Statistical models were adjusted for age, education, occupation, cigarette smoking, alcohol consumption, total cholesterol, and a diagnosis of type II diabetes. Body mass index status (nonobese or obese) and blood pressure status (normotensive or hypertensive) were then related to cognitive performance (learning, memory, executive functioning, and abstract reasoning) on tests administered 4-6 y later.
Adverse effects of obesity and hypertension on cognitive performance were observed for men only. Obese and hypertensive men performed more poorly than men classified as either obese or hypertensive, and the best performance was observed in nonobese, normotensive men.
The adverse effects of obesity and hypertension in men are independent and cumulative with respect to cognitive deficit.

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Available from: Merrill F Elias, May 12, 2014
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    • "A growing body of evidence indicates that cognitive impairment is associated with obesity, metabolic syndrome, and type 2 diabetes (T2D) (Elias et al. 2003; Hassing et al. 2004; Calvo-Ochoa and Arias 2014), suggesting common yet undefined pathogenic mechanisms among the conditions. However, the cellular and molecular mechanisms driving these peripherally induced CNS deficits remain elusive in this emerging area of interest. "
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    • "Recently, our group examined GM changes in structural MRI data from elderly subjects with different degrees of cardiovascular risk (de Toledo Ferraz Alves et al., 2011) using the Framingham Coronary Heart Disease Risk [FCHDR (Grundy et al., 1998; Wilson et al., 1998)] score, a composite index comprising five clinical factors (age, blood pressure, diabetes mellitus, smoking status, and cholesterol levels ). Given recent findings regarding cardiovascular risk effects on cognitive performance (Mosconi, 2005; Obisesan et al., 2008; Fitzpatrick et al., 2009; Purandare, 2009; Scarmeas et al., 2009; Buchman et al., 2012), the FCHDR score has presented excellent potential for investigations involving brain imaging (Elias et al., 2003; Jeerakathil et al., 2004; Massaro et al., 2004; Seshadri et al., 2004; DeCarli et al., 2005; Romero et al., 2009). For the study by de Toledo Ferraz Alves et al. (2011), dementiafree individuals aged from 66 to 75 years were recruited from the database " São Paulo Aging and Health Study " (SPAH) (Scazufca and Seabra, 2008; Scazufca et al., 2008) and divided into three subgroups (high-risk, medium-risk, and low-risk) according to their FCHDR scores and gender (Table 1). "
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    • "In one study (Kuo et al., 2006) of men and women between the ages of 65 and 94, BMI had no effect on measures of explicit memory (the Hopkins Verbal Learning Test word lists, the Rey Auditory- Verbal Learning, and the Rivermead Behavioral Memory Test paragraph recall task). In contrast, obese men between the ages of 32–62 displayed deficits in both immediate and delayed recall on a logical memory task (Elias et al., 2003). In another study in which age was entered as a covariate, a negative correlation was observed between BMI and both immediate and delayed recall of a list of words at a 5-year follow-up (Cournot et al., 2006). "
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