Association of Long-Term Body Weight Variability With Dementia: A Prospective Study

Abstract

Background Body weight variability (BWV) refers to intraindividual weight loss and gain over a period. The association of long-term BWV with dementia remains unclear and whether this association is beyond body weight change is undetermined. Methods In the Health and Retirement Study (HRS), a total of 5,547 dementia-free participants (56.7% women; mean [SD] age, 71.1 [3.2] years) at baseline (2008) were followed up to 8 years (mean=6.8 years) to detect incident dementia. Body weight was self-reported biennially from 1992-2008. BWV was measured as the coefficient of variation utilizing the body weight reported 9 times across 16 years before baseline. Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI). Results Among the 5,547 participants, a total of 427 incident dementia cases were identified during follow-up. Greater long-term BWV was significantly associated with a higher risk of dementia (HR comparing extreme quartiles: 2.01, 95% CI: 1.48-2.72; HR of each SD increment: 1.21, 95% CI: 1.10-1.32; P-trend<0.001) independent of mean body weight and body weight change. This significant association was even observed for BWV estimated approximately 15 years preceding dementia diagnosis (HR of each SD increment: 1.13, 95% CI: 1.03-1.23) and was more pronounced for that closer to diagnosis. Conclusions Our prospective study suggested that greater BWV may be a novel risk factor for dementia.

Weight Loss Is a Strong Predictor of Memory Disorder Independent of Genetic Influences

“…This also suggests that our finding aligns with previously conducted research that suggests that a higher degree of weight loss can be observed in patients several years before a diagnosis of dementia [ 7 , 8 , 9 , 11 , 30 ]. Our results are also in agreement with two recent publications using different analytical approaches that identified pre-diagnosis weight changes as a predictor of dementia [ 31 , 32 ].…”

Longitudinal body weight dynamics in relation to cognitive decline over two decades: A prospective cohort study

“…Global cognitive decline (z-score) - Research on the association of BWV with CF and dementia remains scarce [31,32]. Our previous efforts have revealed the long-term association between greater BWV and a higher risk of dementia beyond weight change (hazard ratio per SD increment in BWV = 1.21; 95% CI: 1.10-1.32), which was even observed 15 years before diagnosis [23]. Additionally, one of our recent studies reported that larger BWV was associated with progression from normal to mild cognitive impairment and from mild cognitive impairment to dementia [22].…”

“…We included multiple covariates in different models for confounding adjustments, according to previous studies [22, 23]. Sociodemographic and lifestyle factors were measured at baseline, including age, sex, race (White/Black/others), education level (lower than high school/high school/college/above college), smoking status (never/former/current), alcohol consumption (never/former/current), household income (in quartiles), and vigorous exercise engagement (yes/no).…”

“…We included multiple covariates in different models for confounding adjustments, according to previous studies [22,23]. Sociodemographic…”

Effect modifications of BMI transition and trajectory in the associations of adverse childhood experiences with new-onset dementia and its subtypes in older US adults

“…BMI in 2004 was obtained from self-report only. 25 Participants were then classified as normal weight, overweight and obesity according to a BMI of <25 kg/m 2 , 25≤BMI<30 kg/ m 2 and ≥30 kg/m 2 , respectively. 26 BMI transition was identified using the BMI status in 2004 and 2010.…”