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BMJ Open. 2019 May 20;9(5):e021739. doi: 10.1136/bmjopen-2018-021739.

Effect of late-life weight change on dementia incidence: a 10-year cohort study using claim data in Korea.

Author information

1
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of Korea.
2
College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea.
3
Division of Mathematics and Big Data Science, Daegu University, Gyeongsan, Republic of Korea.
#
Contributed equally

Abstract

BACKGROUND:

The association between body mass index (BMI) in late-life and dementia risk remains unclear. We investigated the association between BMI changes over a 2-year period and dementia in an elderly Korean population.

METHODS:

We examined 67 219 participants aged 60-79 years who underwent BMI measurement in 2002/2003 and 2004/2005 as part of the National Health Insurance Service-Health Screening Cohort. Baseline characteristics including BMI, socioeconomic status and cardiometabolic risk factors were measured at baseline (2002/2003). The difference between BMI at baseline and at the next health screening (2004/2005) was used to calculate the BMI change. After 2 years, the incidence of dementia was monitored for a mean 5.3 years from 2008 to 2013. Multivariate HRs for dementia incidence were estimated on the basis of baseline BMI and its changes after adjusting for various other risk factors. A subgroup analysis was conducted to determine the effects of baseline BMI and BMI changes.

RESULTS:

We demonstrated a significant association between late-life BMI changes and dementia in both sexes (men: >-10% HR=1.26, 95% CI 1.08 to 1.46, >+10% HR=1.25, 95% CI 1.08 to 1.45; women: >-10% HR=1.15, 95% CI 1.03 to 1.29, >+10% HR=1.17, 95% CI 1.05 to 1.31). However, the baseline BMI was not associated with dementia, except in underweight men. After stratification based on the baseline BMI, the BMI increase over 2 years was associated with dementia in men with a BMI of <25 kg/m2 and women with a BMI of 18.5-25 kg/m2, but not in the obese subgroup in either sex. However, BMI decrease was associated with dementia in those with a BMI of ≥18.5 kg/m2, but not in the underweight subgroup in either sex.

CONCLUSION:

Both weight gain and weight loss may be significant risk factors associated with dementia. Continuous weight control and careful monitoring of weight changes are necessary to prevent dementia development.

KEYWORDS:

body mass index; dementia; health behaviours; weight change

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