Weight Loss Precedes Dementia in Community‐Dwelling Older Adults

Barrett‐Connor, Elizabeth; Edelstein, Sharon L.; Corey–Bloom, Jody; Wiederholt, W. C.

doi:10.1111/j.1532-5415.1996.tb01362.x

Cited by 273 publications

(198 citation statements)

References 32 publications

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“…Previous studies have shown that higher midlife BMI increases risk for the clinical diagnosis of AD (28)(29)(30), but this effect is diminished or even reversed in latelife (29)(30)(31)(32)(33). A similar pattern is evident in the ex vivo literature.…”

Section: Discussionsupporting

confidence: 65%

Late-Life Vascular Risk Factors and Alzheimer Disease Neuropathology in Individuals with Normal Cognition

Besser

Alosco

Gómez

et al. 2016

J Neuropathol Exp Neurol

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Vascular risk factors (VRFs) have been associated with clinically diagnosed Alzheimer disease (AD), but few studies have examined the association between VRF and AD neuropathology (ADNP) in cognitively normal individuals. We used longitudinal data from the National Alzheimer's Disease Center's Uniform Data Set and Neuropathology Data Set to examine the association between VRF and ADNP (moderate to frequent neuritic plaques; Braak stage III-VI) in those with normal cognition. Our sample included 53 participants with ADNP and 140 without ADNP. Body mass index (BMI), resting heart rate (HR), and pulse pressure (PP) were measured at each visit; values were averaged across participant visits and examined annual change in BMI, PP, and HR. Hypertension, diabetes, and hypercholesterolemia were self-reported. In the multivariable logistic regression analyses, average BMI and HR were associated with lower odds of ADNP, and annual increases in HR and BMI were associated with higher odds of ADNP. A previously experienced decline in BMI or HR in late-life (therefore, currently low BMI and low HR) as well as a late-life increase in BMI and HR may indicate underlying AD pathology. Additional clinicopathological research is needed to elucidate the role of changes in late-life VRF and AD pathogenesis.

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Section: Discussionsupporting

confidence: 65%

Late-Life Vascular Risk Factors and Alzheimer Disease Neuropathology in Individuals with Normal Cognition

Besser

Alosco

Gómez

et al. 2016

J Neuropathol Exp Neurol

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“…As noted previously, patients with AD have been found to have lower serum leptin levels compared to controls, independent of BMI (Power et al, 2001). Interestingly, in a 20-year prospective study of 299 community-dwelling older adults, Barrett-Connor et al (1998) found that weight loss precedes mild and moderate dementia, suggesting that early weight loss is unlikely to be a consequence of AD itself, and that AD may be linked to underlying metabolic abnormalities.…”

Section: Discussionmentioning

confidence: 68%

“…In case-controlled studies, patients with AD have lower leptin levels than controls, also independent of body mass index (Power et al, 2001). Weight loss is a common feature of AD, and is found to occur before the onset of dementia (Barrett-Connor et al, 1998), suggesting an underlying metabolic abnormality in the pathogenesis of AD.…”

Section: Introductionmentioning

confidence: 96%

Serum leptin level and cognition in the elderly: Findings from the Health ABC Study

Holden

Lindquist

Tylavsky

et al. 2009

Neurobiology of Aging

204

142

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Leptin is a peptide hormone secreted by adipocytes. It has been shown to modulate production and clearance of amyloid beta (Aβ) in rodent models. We sought to determine if serum leptin was associated with cognitive decline in the elderly.We studied 2871 well-functioning elders, aged 70-79, who were enrolled in a prospective study. Serum leptin concentrations were measured at baseline and analyzed by mean ± 1 SD. Clinically significantly cognitive decline over 4 years was defined as ≥ 5 point drop on the Modified Mini Mental State Exam (3MS).Compared to those in the lower leptin groups, elders in the high leptin group had less cognitive decline, 20.5% vs. 24.7% (OR=0.79 95% CI 0.61-1.02, p=0.07). After adjustment for demographic and clinical variables, including body mass index and total percent body fat, those in the high leptin group had significantly less likelihood of cognitive decline, OR=0.66 (95% CI 0.48-0.91). We conclude that in elderly individuals, higher serum leptin appears to protect against cognitive decline, independent of comorbidites and body fat. HHS Public Access

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“…Weight loss among older people, often due to conditions such as cancer and heart disease, has been associated with increased risks of disability and mortality (Galanos et al, 1994). Weight loss precedes mild and moderate dementia (Barrett-Connor et al, 1996). However, in our longitudinal study height and weight were measured at baseline, before the decline.…”

Section: Discussionmentioning

confidence: 86%

Nutritional status of healthy elderly persons living in Dordogne, France, and relation with mortality and cognitive or functional decline

et al. 2002

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OBJECTIVE: Description of the nutritional status of healthy elderly people and investigation of its longitudinal relationship with mortality and cognitive or functional decline. DESIGN: Longitudinal study. SETTING: In Dordogne, France. SUBJECTS: A total of 169 French elderly community dwellers aged 68 y and older from in the PAQUID (Personnes Agées QUID) study were included. Dietary intake was assessed by a 3 day food record and a dietary history. Self-reported weight and height were used to calculate the body mass index (BMI, kg=m 2 ). Mortality, activities of daily living (ADL), instrumental activities of daily living (IADL) and the Mini Mental State Examination (MMSE) were measured at 5 y follow-up. RESULTS: Nutritional intake and BMI vary according to age and sex. Men generally have a higher nutritional intake than women. Intake decreases with age especially in men. Among the 169 subjects, 22 died. When analyzed by logistic regression, there was no relation between markers of risk of poor nutrition and mortality but a BMI greater or equal 27 at baseline was associated with a increased risk of 5 y mortality (OR ¼ 6.27, 95% CI 1.29 -30.37) adjusted for sex and age. With regard to cognitive decline, subjects with a BMI greater or equal than 23 kg=m 2 had 3.6 times lower chance of presenting a decline in the subsequent 5 y adjusted by age and sex (OR ¼ 0.28, 95%, CI 0.09 -0.90). BMI ranging between 23 and 27 was associated with a significantly decreased risk of IADL disability (OR ¼ 0.31, 95% CI 0.10 -0.93) in multivariate analyses. CONCLUSION: In apparently healthy elderly people a BMI ranging between 23 and 27 is associated with lower risks of functional and cognitive declines in the subsequent 5 y.

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Weight Loss Precedes Dementia in Community‐Dwelling Older Adults

Abstract: Weight loss precedes mild to moderate dementia; early weight loss is, therefore, unlikely to be a consequence of AD patients being unable or unwilling to eat.

Cited by 273 publications

References 32 publications

Late-Life Vascular Risk Factors and Alzheimer Disease Neuropathology in Individuals with Normal Cognition

Late-Life Vascular Risk Factors and Alzheimer Disease Neuropathology in Individuals with Normal Cognition

Serum leptin level and cognition in the elderly: Findings from the Health ABC Study

Nutritional status of healthy elderly persons living in Dordogne, France, and relation with mortality and cognitive or functional decline

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