Longitudinal Body Weight Change, Visit-To-Visit Body Weight Fluctuation, and Cognitive Decline Among Older Adults

Abstract

Background: The evidence regarding dementia and late-life weight change is inconsistent, and data on body weight fluctuation and dementia are limited. Objective: To test the hypothesis that weight loss and substantial weight fluctuation predict cognitive decline independent of body weight and traditional risk factors of dementia. Methods: This study utilized longitudinal data from the National Alzheimer’s Coordinating Center for 10,639 stroke- and dementia-free older adults (60.9%female, mean age 71.6 years, median follow-up 5.5 years). Trends in weight change and weight fluctuation were estimated for each individual by regressing repeated body weight measurements on time. Cognitive decline was examined as diagnostic progression from normal to mild cognitive impairment (MCI) or dementia and from MCI to dementia. Results: Compared to participants with stable weight, those with weight loss had increased odds of diagnostic progression (adjusted OR = 1.35, 95%CI [1.21, 1.51]). Also, large weight fluctuation was associated with increased odds of diagnostic progression (OR comparing the extreme quartiles = 1.20, 95%CI [1.04, 1.39]) after adjusting for traditional risk factors for dementia and body weight change. The magnitude of the association appeared larger among those older than 80 and those with 3 or more cardiometabolic risk factors at baseline (both p for interaction < 0.05). Conclusion: Weight loss and substantial weight fluctuation during late-life were associated with increased odds of cognitive decline independent of body weight and traditional risk factors of dementia. Our results suggested the linkage between late-life body weight instability and cognitive decline especially among those with greater age or higher cardiometabolic risk.

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

“…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]. In addition, two previous cohort studies (14–15 years of follow‐up) have found that higher BWV was related to faster decline in memory, as represented by a z score change per year from −0.009 to −0.027 [14, 33].…”

“…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…”

Association Between Late-Life Weight Change and Dementia: A Population-based Cohort Study

“…Previous studies that have explored the association between weight change in late life and dementia mostly observed an increased dementia risk linked to weight loss ( 14–16 , 19 , 27 , 33 , 34 ). Conversely, in some studies, weight gain has been either not significantly related to dementia or seemed to be with reduced dementia risk ( 15 , 19 , 35 ).…”

Association of cognition with leptin and vascular endothelial growth factor in individuals with type 2 diabetes mellitus

“…We have speculated that other weight‐related mechanisms may account for these troubling findings. There is evidence that obesity may provide some protection against age‐related neurodegeneration [44], which may be accelerated among those with cardiovascular disease and obesity; however, this remains controversial [45].…”