Association between late-life body mass index and dementia
The Kame Project
T. F. Hughes, PhD, MPH, A. R. Borenstein, PhD, MPH, E. Schofield, MPH, Y. Wu, PhD and E. B. Larson, MD, MPH
From the Department of Psychiatry (T.F.H.), University of Pitturgh, PA; the Department of Epidemiology and Biostatistics (A.R.B., E.S., Y.W.), University of South Florida, Tampa; and the Group Health Center for Health Studies (E.B.L.), University of Washington, Seattle.
Address correspondence and reprint requests to Dr. Tiffany F. Hughes, Department of Psychiatry, University of Pitturgh School of Medicine, 3811 O’Hara St., Pitturgh, PA 15213
hughest2@upmc.eduObjective: To examine the association between body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) and risk of dementia and its subtypes in late life.
Methods: Participants were members of the Kame Project, a population-based prospective cohort study of 1,836 Japanese Americans living in King County, WA, who had a mean age of 71.8 years and were dementia-free at baseline (1992–1994), and were followed for incident dementia through 2001. Cox proportional hazards models were used to estimate the risk of dementia, Alzheimer disease (AD), and vascular dementia (VaD) controlling for demographic and lifestyle characteristics and vascular comorbidities as a function of baseline BMI, WC, and WHR and change in BMI over time.
Results: Higher baseline BMI was significantly associated with a reduced risk of AD (hazard ratio [HR] = 0.56, 95% confidence interval [CI] = 0.33–0.97) in the fully adjusted model. Slower rate of decline in BMI was associated with a reduced risk of dementia (HR = 0.37, 95% CI = 0.14–0.98), with the association stronger for those who were overweight or obese (HR = 0.18, 95% CI = 0.05–0.58) compared to normal or underweight (HR = 1.00, 95% CI = 0.18–5.66) at baseline.
Conclusion:
Higher baseline body mass index (BMI) and slower declining BMI in late life are associated with a reduced risk of dementia, suggesting that low BMI or a faster decline in BMI in late life may be preclinical indicators of an underlying dementing illness, especially for those who were initially overweight or obese. 老年人基线水平高体重指数和体重指数缓慢下降与痴呆风险下降有关，提示老年人低体重指数和快速降低体重指数可能是痴呆临床前期，尤其是那些最初超重或肥胖的老年人。是这个意思吧？看来不能老年人瘦了的确不好，也不应该迅速减肥。
