Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-26T21:49:03.630Z Has data issue: false hasContentIssue false
  • English
  • Français

Changes in body mass in later life and incident dementia

Published online by Cambridge University Press:  14 November 2012

Brian D. Power ,
Helman Alfonso ,
Leon Flicker ,
Graeme J. Hankey ,
Bu B. Yeap  and
Osvaldo P. Almeida
Brian D. Power*
Affiliation:
Peel and Rockingham Kwinana Older Adult Mental Health Service, South Metropolitan Area Health Service, Rockingham, Western Australia Western Australian Centre for Health & Ageing, Centre for Medical Research, WAIMR, University of Western Australia, Perth, Australia School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
Helman Alfonso
Affiliation:
Western Australian Centre for Health & Ageing, Centre for Medical Research, WAIMR, University of Western Australia, Perth, Australia School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
Leon Flicker
Affiliation:
Western Australian Centre for Health & Ageing, Centre for Medical Research, WAIMR, University of Western Australia, Perth, Australia School of Medicine and Pharmacology, University of Western Australia, Perth, Australia Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia
Graeme J. Hankey
Affiliation:
School of Medicine and Pharmacology, University of Western Australia, Perth, Australia Department of Neurology, Royal Perth Hospital, Perth, Australia
Bu B. Yeap
Affiliation:
School of Medicine and Pharmacology, University of Western Australia, Perth, Australia Department of Endocrinology and Diabetes, Fremantle Hospital, Fremantle, Australia
Osvaldo P. Almeida
Affiliation:
Western Australian Centre for Health & Ageing, Centre for Medical Research, WAIMR, University of Western Australia, Perth, Australia School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia Department of Psychiatry, Royal Perth Hospital, Perth, Australia
*
Correspondence should be addressed to: Dr. Brian D. Power, Peel and Rockingham Kwinana Older Adult Mental Health Service, 7/5 Goddard Street South, Rockingham, 6168, Australia. Phone: +61-8-9527 9000; Fax: +61-8-9527 7222. Email: brian.power@health.wa.gov.au.
Get access

Abstract

Background: There is ongoing debate about whether a decline in body mass represents a true risk factor for dementia, whether it is a phenotypic marker of incipient dementia, or perhaps a marker of another process that increases dementia risk. This study was designed to determine if changes in body mass index (BMI) in later life are associated with hazard of incident dementia over a follow-up period of up to eight years.

Methods: Method followed was a prospective cohort study of 4,181 men aged 65–84 years, resident in Perth, Australia. The exposure of interest was change in BMI measured between 1996–1998 and 2001–2004. The outcome was incident dementia, established using the Western Australia Data Linkage System until 2009. We used Cox regression models to establish crude and adjusted hazard of dementia for change in BMI.

Results: Compared with men with a stable BMI, those with a decrease in BMI >1 kg/m2 had a higher adjusted hazard of dementia (hazard ratio (HR) = 1.89, 95% CI = 1.32–2.70). The cumulative hazard of dementia over follow-up for changes in BMI was greatest for men with a decrease in BMI >1 kg/m2; this trend was apparent for men in all BMI categories (underweight, normal, overweight, obese). A reverse “J-shaped” association between BMI change and incident dementia was observed, with the lowest dementia rate being for men whose BMI remained stable.

Conclusions: Men who maintained a stable body mass had the lowest incidence of dementia. Further studies are needed to clarify causality and assess feasibility of interventional studies to preserve body mass in aging men.

Keywords

Alzheimer diseasedementiaepidemiologyhealth agingmetabolic diseases
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 3 , March 2013 , pp. 467 - 478
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andres, R., Muller, D. C. and Sorkin, J. D. (1993). Long-term effects of change in body weight on all cause mortality: a review. Annals of Internal Medicine, 119, 737–743.CrossRefGoogle ScholarPubMed
Atti, A. R., Palmer, K., Volpato, S., Winblad, B., De Ronchi, D. and Fratiglioni, L. (2008). Late-life body mass index and dementia incidence: nine-year follow-up data from the Kungsholmen project. Journal of the American Geriatrics Society, 56, 111–116.CrossRefGoogle ScholarPubMed
Barrett-Connor, E., Edelstein, S. L., Corey-Bloom, J. and Wiederholt, W. C. (1996). Weight loss precedes dementia in community-dwelling older adults. Journal of the American Geriatrics Society, 44, 1147–1152.CrossRefGoogle ScholarPubMed
Buchman, A. S., Wilson, R. S., Bieias, J. L., Shah, R. C., Evans, D. A. and Bennett, D. A. (2005). Change in body mass index and risk of incident Alzheimer disease. Neurology, 65, 892–897.CrossRefGoogle ScholarPubMed
Buchman, A. S., Boyle, P. A., Wilson, R. S., Tang, Y. and Bennett, D. A. (2007). Frailty is associated with incident Alzheimer's disease and cognitive decline in the elderly. Psychosomatic Medicine, 69, 483–489.CrossRefGoogle ScholarPubMed
Buchman, A. S., Wilson, R. S., Bienias, J. L. and Bennett, D. A. (2009). Change in frailty and risk of death in older persons. Experimental Aging Research, 35, 61–82.CrossRefGoogle ScholarPubMed
Charlson, M. E., Pompei, P., Ales, K. L. and MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Disease, 40, 373–383.CrossRefGoogle ScholarPubMed
Deeg, D. J., Miles, T. P., van Zonneveld, R. J. and Curb, J. D. (1990). Weight change, survival time and cause of death in Dutch elderly. Archives of Gerontology and Geriatrics, 10, 97–111.CrossRefGoogle ScholarPubMed
Flicker, L.et al. (2010). Body mass index and survival in men and women aged 70 to 75. Journal of the American Geriatrics Society, 58, 234–241.CrossRefGoogle ScholarPubMed
Gustafson, D., Rothenberg, E., Blennow, K., Steen, B. and Skoog, I. (2003). An 18 year follow-up of overweight and risk of Alzheimer disease. Archives of Internal Medicine, 163, 1524–1528.CrossRefGoogle ScholarPubMed
Harris, T., Cook, E. F., Garrison, R., Higgins, M., Kannel, W. and Goldman, L. (1988). Body mass index and mortality among nonsmoking older persons: the Framingham Heart Study. JAMA, 259, 1520–1524.CrossRefGoogle ScholarPubMed
Harvey, J., Shanley, L. J., O'Malley, D. and Irving, A. J. (2005). Leptin: a potential cognitive enhancer? Biochemical Society Transactions, 33, 1029–1032.CrossRefGoogle ScholarPubMed
Hayden, K. M.et al. (2006). Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study. Alzheimer Disease and Associated Disorders, 20, 93–100.CrossRefGoogle ScholarPubMed
Heiat, A., Vaccarino, V. and Krumholz, H. M. (2001). An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Archives of Internal Medicine, 161, 1194–1203.CrossRefGoogle ScholarPubMed
Heinzl, H. and Kaider, A. (1997). Gaining more flexibility in Cox proportional hazards regression models with cubic spline functions. Computer Methods and Programs in Biomedicine, 54, 201–208.CrossRefGoogle ScholarPubMed
Holman, C. D., Bass, A. J., Rouse, I. L. and Hobbs, M. S. (1999). Population-based linkage of health records in Western Australia: development of a health services research linked database. Australian and New Zealand Journal of Public Health, 23, 453–459.CrossRefGoogle ScholarPubMed
Johnson, D. K., Wilkins, C. H. and Morris, J. C. (2006). Accelerated weight loss may precede diagnosis in Alzheimer disease. Archives of Neurology, 63, 1312–1317.CrossRefGoogle ScholarPubMed
Koenig, H. G.et al. (1993). Abbreviating the Duke Social Support Index for use in chronically ill elderly patients. Psychosomatics, 34, 61–69.CrossRefGoogle Scholar
Krabbe, K. S., Kanaya, A. and Bruunsgaard, H. (2004). Inflammatory mediators in the elderly. Experimental Gerontology, 39, 687–699.CrossRefGoogle ScholarPubMed
Kukull, W. A., Larson, E. B., Teri, L., Bowen, J., McCormick, W. and Pfanschmidt, M. L. (1994). The Mini-Mental State Examination score and the clinical diagnosis of dementia. Journal of Clinical Epidemiology, 47, 1061–1067.CrossRefGoogle ScholarPubMed
Lee, I. M. and Paffenbarger, R. S. (1992). Change in body weight and longevity. JAMA, 270, 2823–2828.CrossRefGoogle Scholar
Lee, I. M. and Paffenbarger, R. S. (1996). Is weight loss hazardous? Nutrition Reviews, 54, S116–S124.CrossRefGoogle ScholarPubMed
Luchsinger, J. A., Patel, B., Tang, M. X., Schupf, N. and Mayeux, R. (2007). Measures of adiposity and dementia risk in elderly persons. Archives of Neurology, 64, 392–398.CrossRefGoogle ScholarPubMed
Norman, P. E.et al. (2009). Cohort profile: the Health in Men Study (HIMS). International Journal of Epidemiology, 38, 48–52.CrossRefGoogle ScholarPubMed
Nourhashemi, F.et al. (2003). Body mass index and incidence of dementia: the PAQUID study. Neurology, 60, 117–119.CrossRefGoogle ScholarPubMed
Power, B. D., Alfonso, H., Flicker, L., Hankey, G. J., Yeap, B. B. and Almedia, O. P. (2011). Body adiposity in later life and the incidence of dementia: the Health in Men Study. PLoS ONE, 6, e17902; doi:10.1371/journal.pone.0017902.CrossRefGoogle ScholarPubMed
Quan, H.et al. (2005). Coding algorithms for defining comorbidities in ICD-9 CM and ICD-10 administrative data. Medical Care, 43, 1130–1139.CrossRefGoogle ScholarPubMed
Stewart, R.et al. (2005). A 32-year prospective study of change in body weight and incident dementia: the Honolulu-Asia Aging Study. Archives of Neurology, 62, 55–60.CrossRefGoogle ScholarPubMed
Wannamethee, S. G., Shaper, G. A. and Lennon, L. (2005). Reasons for intentional weight loss, unintentional weight loss, and mortality in older men. Archives of Internal Medicine, 165, 1035–1040.CrossRefGoogle ScholarPubMed
Weaver, J. D.et al. (2002). Interleukin-6 and risk of cognitive decline: MacArthur studies of successful aging. Neurology, 59, 371–378.CrossRefGoogle ScholarPubMed
West, N. A. and Haan, M. N. (2009). Body adiposity in late life and risk of dementia or cognitive impairment in a longitudinal community-based study. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 64, 103–109.CrossRefGoogle ScholarPubMed
World Health Organization (1999). Definition, Diagnosis and Classification of Diabetes and Its Complications. Part 1: Diagnosis and Classification of Diabetes Mellitus Provisional Report of a WHO Consultation. Geneva: World Health Organization.Google Scholar
World Health Organization (2000). Obesity: preventing and managing global epidemic. Report of a World Health Organization Consultation. WHO Technical Report Series, 894, i-xii; 1–253.Google Scholar
Yaffe, K.et al. (2004). The metabolic syndrome, inflammation, and risk of cognitive decline. JAMA, 292, 2237–2242.CrossRefGoogle ScholarPubMed
Supplementary material: File

Power Supplementary Material

Appendix

Download Power Supplementary Material(File)
File 21 KB