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Obes Rev. 2020 Jan 3. doi: 10.1111/obr.12989. [Epub ahead of print]

Association of anthropometry and weight change with risk of dementia and its major subtypes: A meta-analysis consisting 2.8 million adults with 57 294 cases of dementia.

Author information

1
School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.
2
Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, New South Wales, Australia.
3
The George Institute for Global Health, University of Oxford, Oxford, UK.
4
The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
5
Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
6
Department of Epidemiology and Public Health, University College London, London, UK.
7
School of Biological & Population Health Sciences, Oregon State University, Corvallis, Oregon, USA.
8
Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA.
9
Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.
10
Framingham Heart Study, Framingham, Massachusetts, USA.
11
The National Institute for Health Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, University of Cambridge, Cambridge, UK.
12
UK Medical Research Council/British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge, UK.
13
British Heart Foundation Centre of Excellence, Division of Cardiovascular Medicine, Addenbrooke's Hospital, Cambridge, UK.
14
INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, Montpellier, France.
15
Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France.
16
Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway.
17
Clinical Trial Service Unit, Nuffield Department of Population health, University of Oxford, Oxford, UK.
18
Unité INSERM 1219, Université de Bordeaux, Bordeaux, France.
19
INSERM, Bordeaux Population Health Research Center and Department of Neurology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
20
INSERM, Bordeaux Population Health Research Center, UMR U1219, University of Bordeaux, Bordeaux, France.
21
Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.
22
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
23
Department of Medical Statistics, LSHTM, London, UK.
24
Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA.
25
Department of Psychology, and Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden.
26
Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
27
Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
28
Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland.
29
Department of Public Health, University of Helsinki, Helsinki, Finland.
30
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
31
Kaiser Permanente Washington Health Research Institute Seattle, Seattle, Washington, USA.
32
Kaiser Permanente Center for Health Research NW, Portland, Oregon, USA.
33
Research Institute, California Pacific Medical Center, San Francisco, Carlifornia, USA.
34
Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
35
Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
36
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
37
Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia.
38
Neuroscience Research Australia, Sydney, New South Wales, Australia.
39
Faculty of Medicine, Imperial College London, London, UK.
40
OXON Epidemiology, London, UK.
41
Department of Neurology, Donderds Centre for Brain, Behaviour and Cognition, Radboud University Medical Center, Nijmegen, the Netherlands.
42
Sahlgrenska University Hospital, Östra Sjukhuset, Gothenburg, Sweden.
43
Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas, USA.
44
INSERM U1153, Hôpital Hôtel-Dieu, Paris, France.
45
Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.
46
Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Tønsberg, Norway.
47
Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
48
Faculty of Medicine, University of Oslo, Oslo, Norway.
49
Department of Psychiatry, University of California San Francisco, San Francisco, California, USA.
50
College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia.
51
Faculty of Health, Deakin University, Melbourne, Victoria, Australia.

Abstract

Uncertainty exists regarding the relation of body size and weight change with dementia risk. As populations continue to age and the global obesity epidemic shows no sign of waning, reliable quantification of such associations is important. We examined the relationship of body mass index, waist circumference, and annual percent weight change with risk of dementia and its subtypes by pooling data from 19 prospective cohort studies and four clinical trials using meta-analysis. Compared with body mass index-defined lower-normal weight (18.5-22.4 kg/m2 ), the risk of all-cause dementia was higher among underweight individuals but lower among those with upper-normal (22.5-24.9 kg/m2 ) levels. Obesity was associated with higher risk in vascular dementia. Similarly, relative to the lowest fifth of waist circumference, those in the highest fifth had nonsignificant higher vascular dementia risk. Weight loss was associated with higher all-cause dementia risk relative to weight maintenance. Weight gain was weakly associated with higher vascular dementia risk. The relationship between body size, weight change, and dementia is complex and exhibits non-linear associations depending on dementia subtype under scrutiny. Weight loss was associated with an elevated risk most likely due to reverse causality and/or pathophysiological changes in the brain, although the latter remains speculative.

PMID:
31898862
DOI:
10.1111/obr.12989

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