Table 16Obesity and risk of developing AD

StudySample (n)Followup/EventsExposureCase definitionConfounding adjustmentResults
Atti et al., 2008124Community cohort (1255 total; 646 analyzed)9 yearsBMIDSM III
Clinical evaluation by two doctors
MMSE
Depression
Impaired ADLs
Chronic disease before baseline
Overweight subjects had a lower risk of developing dementia over 9 years: HR 0.66 (95% CI 0.50 to 0.88)
Hughes et al., 2009125Community cohort (1836 total; 1478 analyzed)7 to 9 yearsBMININCDS-ADRDA
DSM IV
Age
Race
Sex
Educational level
Alcohol
Smoking
Hypertension
Hypercholesterolemia
Diabetes
Angina pectoris
Stroke
TIA
Physical activity
APOE genotype
Lower decrease in BMI was associated with decreased risk of AD: HR 0.21 (95% CI 0.06 to 0.80)

Higher baseline BMI was significantly associated with a reduced risk of AD: HR 0.56 (0.33 to 0.97). This was not statistically significant after correcting for APOE: HR 0.68 (0.31 to 1.51).
Fitzpatrick et al., 2009126Community cohort (2798)5.4 yearsBMININCDS-ADRDAAge
Race
Sex
Educational level
Baseline cognitive status
Cardiovascular and dementia risk
For late life BMI, underweight persons (BMI < 20) had an increased risk of dementia (HR 1.62; 95% CI 1.02 to 2.64), whereas being overweight (BMI 25–30) was not associated (0.92; 0.72 to 1.18) and being obese reduced the risk of dementia (HR 0.63; 0.44 to 0.91) compared with those with normal BMI. However, midlife obesity was associated with increased risk of dementia (HR 1.39; 1.03 to 1.87).

Abbreviations: ADLs = activities of daily living; APOE = apolipoprotein E gene; BMI = body mass index; CI = confidence interval; DSM = Diagnostic and Statistical Manual of Mental Disorders; HR = hazard ratio; MMSE = Mini-Mental State Examination; SDMT = Symbol Digit Modalities Test; TIA = transient ischemic attack

From: 3, Results

Cover of Preventing Alzheimer's Disease and Cognitive Decline
Preventing Alzheimer's Disease and Cognitive Decline.
Evidence Reports/Technology Assessments, No. 193.
Williams JW, Plassman BL, Burke J, et al.

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