Body Mass Index and Mild Cognitive Impairment Among Middle-Aged and Older Adults from Low- and Middle-Income Countries

Smıth, Lee; Shin, Jae Il; Oh, Hans; Carmichael, Christina; Jacob, Louis; Štefanac, Siniša; Lindsay, Rosie K.; Soysal, Pınar; Veronese, Nicola; Tully, Mark A.; Butler, Laurie; Barnett, Yvonne; Koyanagi, Ai

doi:10.3233/jad-215345

Cited by 5 publications

(3 citation statements)

References 40 publications

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“…High body mass index (BMI) in midlife has been established as a modifiable risk factor for both MCI 4,5 and dementia. 6 However, the associations between late-life BMI and cognitive health remain unclear.…”

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confidence: 99%

“…6 However, the associations between late-life BMI and cognitive health remain unclear. A few studies have reported that high BMI in late life is associated with dementia risk, 7,8 but others have shown that late-life obesity is either not significantly related to dementia [9][10][11] or associated with a decreased risk of MCI, 4,5 dementia, [12][13][14] and the progression from MCI to dementia. [15][16][17] These conflicting findings may be attributable to reverse causation because of weight loss preceding dementia.…”

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Body Mass Index Trajectories Preceding Incident Mild Cognitive Impairment and Dementia

et al. 2022

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ImportanceBody mass index (BMI) trajectories before the onset of mild cognitive impairment (MCI) and during the progression from MCI to dementia remain unclear.ObjectiveTo assess the long-term BMI trajectories preceding incident MCI and dementia and explore whether they are associated with brain pathologies.Design, Setting, and ParticipantsThe Rush Memory and Aging Project (MAP) was an ongoing community-based cohort study. This study included cognitively intact participants aged 60 to 90 years at baseline with annual follow-up from October 1997 to December 2020 (maximum follow-up of 22 years). During the follow-up, participants underwent brain autopsies. Data were analyzed from August 2021 to February 2022 using mixed-effect models.ExposuresBMI was calculated using height and weight measured at baseline and follow-ups.Main Outcomes and MeasuresIncident MCI and dementia were diagnosed following standard criteria. Neuropathological assessments (including global Alzheimer disease and vascular pathology) were performed for autopsies.ResultsA total of 1390 participants (mean [SD] age, 78.4 [6.5] years; 1063 female [76.5%]) were included in the study. In the analysis of BMI trajectories before MCI (n = 939), during the follow-up (median [IQR] duration, 6 [3-9] years), 371 participants (39.5%) developed MCI, of whom 88 (23.7%) progressed to dementia. Those who developed MCI were older (mean [SD] age, 79.6 [5.9] years vs 76.9 [6.6] years), consumed less alcohol (median [IQR] consumption, 0 [0-5.8] g/day vs 1.1 [0-6.9] g/day), had a lower BMI (mean [SD], 27.2 [4.9] vs 28.2 [5.9]), and were more likely to be apolipoprotein E (APOE) ε4 carriers (89 of 371 [24.0%] vs 98 of 568 [17.3%]) compared with those who remained cognitively intact over follow-up. Those who developed dementia were older (mean [SD] age, 81.0 [5.2] years vs 79.1 [6.0] years), had a lower level of physical activity (median [IQR] activity, 1.0 [0-2.5] h/week vs 1.8 [0.2-3.8] h/week), and were more likely to be APOE ε4 carriers than those who were dementia-free (33 of 88 [37.5%] vs 56 of 283 [19.8%]). Compared with participants who remained cognitively intact, in those with incident MCI, BMI tended to decline earlier and faster. From 7 years before diagnosis, people with incident MCI had an associated significantly lower BMI (mean difference, −0.96; 95% CI, −1.85 to −0.07) than those who were cognitively intact. Among people with incident MCI, the slopes of BMI decline did not differ significantly between those who did and did not develop dementia (β, −0.03; 95% CI, −0.21 to 0.15). In the analysis of BMI trajectories before autopsy (n = 358), BMI was associated with a faster declination among participants with a high burden of global Alzheimer disease pathology (β for pathology × time highest vs lowest tertile, −0.14; 95% CI, −0.26 to −0.02) or vascular pathology (β for pathology × time2 highest vs lowest tertile, 0.02; 95% CI, 0-0.05).Conclusions and RelevanceResults of this cohort study suggest that among cognitively intact people, significantly lower BMI occurs beginning approximately 7 years before MCI diagnosis. After MCI diagnosis, BMI declines at the same pace in people who develop dementia and those who do not. High brain pathologies may underly the BMI decline preceding dementing disorders.

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Body Mass Index Trajectories Preceding Incident Mild Cognitive Impairment and Dementia

et al. 2022

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“…This study showed that a BMI of ≥ 25 kg/m 2 (obesity) was associated with a higher risk of MCI than was a normal BMI. A recent study of people aged 50 to 65 years also revealed that BMIs of < 18.5 and ≥ 25 kg/m 2 were associated with a higher risk of MCI [ 39 ]. However, the present study showed no association between BMI and a higher risk of dementia.…”

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Association of body mass index and dietary intake with mild cognitive impairment and dementia: a retrospective cohort study

et al. 2023

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Background The prevalence of cognitive impairment in older adults is gradually increasing, and this is leading to many adverse outcomes. Common causes of cognitive impairment in advancing age are mild cognitive impairment (MCI) and dementia. However, how the nutritional status and nutrient intake are related to MCI and dementia is controversial. Therefore, we aimed to evaluate the association of body mass index (BMI) and dietary intake with the risk of MCI and dementia. Methods This retrospective cohort study involved 821 participants aged ≥ 50 years from a previous population-based cohort study: the Electricity Generating Authority of Thailand (EGAT) study in 2013–2014 (baseline) and 2018–2019 (follow-up). Dietary intake was recorded using a 12-month self-reported food frequency questionnaire. MCI and dementia were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria using the Montreal Cognitive Assessment with ADL and the Kessler Psychological Distress Scale (K10) at study entry and at the 5-year follow-up. Results Among the 821 participants, the mean age was 60.0 ± 4.3 years, and the incidence rate of MCI and dementia was 42.5 and 11.2 per 1,000 person-years, respectively. The rate of MCI and dementia was higher in participants aged ≥ 60 years and with an education level of < 7 years. The rate of MCI was also higher in those with a BMI of ≥ 25 kg/m2 and type 2 diabetes. Compared to BMI 18.5–22.9 kg/m2, BMI of ≥ 25 kg/m2 (odds ratio 1.91 [95% confidence interval, 1.12–3.26], p < 0.001) was associated with an increased risk of MCI after adjusted for age, education level, and type 2 diabetes. Regarding dietary intake, fresh red meat consumption was inversely associated with the risk of MCI (p = 0.037) and dementia (p = 0.011) after adjusting for age, education level, type 2 diabetes, and BMI. Conclusion Obesity was associated with a greater risk of MCI. Moreover, low consumption of fresh red meat could be a risk factor for MCI and dementia. Further studies are required to confirm and explain these findings.

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Associations among body mass index, handgrip strength, and cognitive impairment in older men and women in India

Pai,

Muhammad,

Bannerjee

et al. 2023

Aging and Health Research

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Body Mass Index and Mild Cognitive Impairment Among Middle-Aged and Older Adults from Low- and Middle-Income Countries

Cited by 5 publications

References 40 publications

Body Mass Index Trajectories Preceding Incident Mild Cognitive Impairment and Dementia

Body Mass Index Trajectories Preceding Incident Mild Cognitive Impairment and Dementia

Association of body mass index and dietary intake with mild cognitive impairment and dementia: a retrospective cohort study

Associations among body mass index, handgrip strength, and cognitive impairment in older men and women in India

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