Association Between Waist Circumference and Dementia in Older Persons: A Nationwide Population‐Based Study

Abstract

Objective This study examined whether a positive association exists between waist circumference (WC) and dementia among older persons. Methods The study population comprised 872,082 participants aged 65 years and older who participated in a Korean national health screening examination between January 1, 2009, and December 31, 2009. Adjusted hazard ratios and 95% CIs for dementia during follow‐up from 2009 to 2015 were calculated according to baseline BMI and WC categories. Results After a multivariate adjustment that included BMI, the hazard ratios for dementia showed a stepwise increase according to the increase in WC categories by 5 cm from 85 to 90 cm in men and from 80 to 85 cm in women until ≥ 110 cm (from 1.06 [95% CI: 1.03‐1.09] to 1.64 [95% CI: 1.37‐1.94] in men and from 1.04 [95% CI: 1.02‐1.07] to 1.58 [95% CI: 1.36‐1.84] in women). The influence of the current WC category for abdominal obesity on the risk of dementia was different according to BMI; especially, the normal weight men and women with abdominal obesity had a prominent increased risk of dementia compared with those without abdominal obesity. Conclusions Abdominal obesity, as measured by WC, was associated with significantly increased risk of dementia after adjustment for general obesity.

Dynapenic abdominal obesity is associated with mild cognitive impairment in patients with cardiometabolic disease: a cross-sectional study

“…These findings are consistent with previous reports that separately analysed the relationship of cognitive function with muscle strength or waist circumference [ 6 , 8 , 12 , 36 ]. One study in Taiwan found that low muscle strength and low physical performance were more associated with global cognitive function impairment, compared to sarcopenia [ 8 ].…”

“…A longitudinal study demonstrated that poor muscle function is a better predictor of incidence MCI and cognitive decline, compared to reduced lean muscle mass [ 6 ]. On the other hand, it has been reported that despite normal BMI, high waist circumference increases the risk of developing dementia in older people [ 12 ]. Additionally, central fat mass was associated with MCI, but skeletal muscle mass was not [ 36 ].…”

“…Compared to middle-aged people, obesity reduces the risk of dementia in older people [ 9 – 11 ]; however, abdominal obesity (AO) increases the risk of developing cognitive impairment and dementia, regardless of body mass index (BMI) level, even in older people [ 12 , 13 ].…”

Association among cognitive function, physical fitness, and health status in older women

“…Moreover, participants with an abnormally large waist circumference were at 1.8 times greater risk for poor cognitive function. In addition, a large-scale cohort study involving 872,082 adults aged 65 years or older reported that abdominal obesity, as measured by waist circumference, significantly increased the risk of dementia ( Cho et al, 2019 ). However, contradictory findings have also been reported, showing an association between lower abdominal fat mass and worse cognitive function in elderly women ( Bagger et al, 2004 ).…”

Proposed cut-off points for anthropometric and bioelectrical measures based on overweight and obesity criteria in Spanish institutionalised elderly people

“…In this respect, individuals of shorter height may have higher health risks than taller individuals in the moderately-to-large WC group for both sexes and across different ages among Japanese adults [26]. Furthermore, WC has also been associated with a significantly increased risk of dementia among older adults [27]. Additionally, abdominal obesity (WC > 88 cm) has also been positively associated with fragility fractures in a sample of community-dwelling elderly Israeli women [28].…”