Article

Association between late-life body mass index and dementia: The Kame Project.

Department of Psychiatry, University of Pittsburgh, PA 15213, USA.
Neurology (Impact Factor: 8.3). 06/2009; 72(20):1741-6. DOI: 10.1212/WNL.0b013e3181a60a58
Source: PubMed

ABSTRACT To examine the association between body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) and risk of dementia and its subtypes in late life.
Participants were members of the Kame Project, a population-based prospective cohort study of 1,836 Japanese Americans living in King County, WA, who had a mean age of 71.8 years and were dementia-free at baseline (1992-1994), and were followed for incident dementia through 2001. Cox proportional hazards models were used to estimate the risk of dementia, Alzheimer disease (AD), and vascular dementia (VaD) controlling for demographic and lifestyle characteristics and vascular comorbidities as a function of baseline BMI, WC, and WHR and change in BMI over time.
Higher baseline BMI was significantly associated with a reduced risk of AD (hazard ratio [HR] = 0.56, 95% confidence interval [CI] = 0.33-0.97) in the fully adjusted model. Slower rate of decline in BMI was associated with a reduced risk of dementia (HR = 0.37, 95% CI = 0.14-0.98), with the association stronger for those who were overweight or obese (HR = 0.18, 95% CI = 0.05-0.58) compared to normal or underweight (HR = 1.00, 95% CI = 0.18-5.66) at baseline.
Higher baseline body mass index (BMI) and slower declining BMI in late life are associated with a reduced risk of dementia, suggesting that low BMI or a faster decline in BMI in late life may be preclinical indicators of an underlying dementing illness, especially for those who were initially overweight or obese.

0 Bookmarks
 · 
128 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The occurrence of obesity, commonly estimated using body mass index (BMI), and the most common late-onset dementia, Alzheimer's disease (AD), are increasing globally. The year 2013 marked a decade of epidemiologic observational reports on the association between BMI and late-onset dementias. In this review, we highlight epidemiological studies that measured both mid- and late-life BMI in association with dementia. Studies investigating the association between midlife BMI and risk for dementia demonstrated generally an increased risk among overweight and obese adults. When measured in late-life, elevated BMI has been associated with lower risk. In addition, being underweight and/or having a decrease in BMI in late-life are associated with higher dementia risk compared to BMI in the normal range or stable BMI. In this review, a decade (2003-2013) of epidemiologic observational studies on associations between BMI and AD is highlighted. These observations provide a strong base for addressing biological mechanisms underlying this complex association.
    Journal of Alzheimer's disease: JAD 08/2014; · 3.61 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Obesity impairs cognition and health-related quality of life (HRQOL) in older adults; however, the appropriate treatment of obese older adults remains controversial. The objective was to determine the independent and combined effects of weight loss and exercise on cognition, mood, and HRQOL in obese older adults. One hundred seven frail, obese older adults were randomly assigned to a control, weight-management (diet), exercise group or to a weight-management-plus-exercise (diet-exercise) group for 1 y. In this secondary analysis, main outcomes were Modified Mini-Mental State Examination (3MS) and total Impact of Weight on Quality of Life-Lite (IWQOL) scores. Other outcomes included Word Fluency Test, Trail Making Test Parts A and B, and Geriatric Depression Scale (GDS) scores. Scores on the 3MS improved more in the diet (mean ± SE: 1.7 ± 0.4), exercise (2.8 ± 0.4), and diet-exercise (2.9 ± 0.4) groups than in the control group (0.1 ± 0.4) (between-group P = 0.0001-0.04); scores in the diet-exercise group improved more than in the diet group but not more than in the exercise group. Scores on the Word Fluency Test improved more in the exercise (4.1 ± 0.8) and diet-exercise (4.2 ± 0.7) groups than in the control group (-0.8 ± 0.8; both P = 0.001). For the Trail Making Test Part A, scores in the diet-exercise group (-11.8 ± 1.9) improved more than in the control group (-0.8 ± 1.9) (P = 0.001); a similar finding was observed for the Trail Making Test Part B. Scores on the IWQOL improved more in the diet (7.6 ± 1.6), exercise (10.1 ± 1.6), and diet-exercise (14.0 ± 1.4) groups than in the control group (0.3 ± 1.6) (P = 0.0001-0.03); scores in the diet-exercise group improved more than in the diet group but not more than in the exercise group. In the diet-exercise group, peak oxygen consumption and strength changes were independent predictors of 3MS changes; weight and strength changes were independent predictors of IWQOL changes. GDS scores did not change. Weight loss and exercise each improve cognition and HRQOL, but their combination may provide benefits similar to exercise alone. These findings could inform practice guidelines with regard to optimal treatment strategies for obese older adults. This trial was registered at clinicaltrials.gov as NCT00146107.
    American Journal of Clinical Nutrition 04/2014; · 6.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Rationale Although dementia and nutritional status have been shown to be strongly associated, differences in body composition (BC) among elderly with dementia have not yet to be firmly established. Objective To assess the BC through conventional and vector bioimpedance analysis (BIA and BIVA, respectively) in a sample of institutionalized elderly men with and without dementia, in order to detect dementia-related BC changes. Methods Forty-one institutionalized men aged 65 years or older (23 without dementia- CG- and 18 with dementia-DG-) were measured with BIA and interpreted with BIVA and predictive equations. Results Age (74.4 and 75.7 y) and BMI (22.5 and 23.6 kg/m2) were similar for DG and CG, respectively. Resistance and resistance/height ratio did not differ significantly between groups Reactance and reactance/height ratio were 21.2 and 20.4% lower in DG than in CG. Phase angle was significantly lower in DG (mean: 4.0; 95% CI: 3.6-4.3 degrees) than in CG (mean: 4.7; 95% CI: 4.3-5.1 degrees). Mean fat mass index (6.0 and 7.0 kg/m2), and mean fat-free mass index (16.4 and 16.6 kg/m2) were similar in DG and CG. BIVA showed a significant downward migration of the ellipse in DG with respect to CG (T2=15.1, p<0.01). Conclusion Conventional BIA showed no significant differences in BC between DG and CG, even though reactance and reactance/height were about 21% lower in DG. Nevertheless, a body cell mass depletion and an increase in the extracellular/intracellular water-ratio were identified in DG using BIVA. BIVA reflects dementia-related changes in BC better than BIA.
    Nutrition 07/2014; · 3.05 Impact Factor

Full-text (2 Sources)

Download
28 Downloads
Available from
Jun 1, 2014