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Adiposity indicators and dementia over 32 years in Sweden
D R Gustafson1, K Bäckman, M Waern
1Section for Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Sahlgrenska Academy, University of Gothenburg, Sweden. deborah.gustafson@neuro.gu.se
Neurology
|November 11, 2009
Summary
High midlife waist-to-hip ratio (WHR) may double dementia risk in older women. Weight changes before diagnosis suggest reverse causality, highlighting dynamic risk factors for dementia prevention.
Area of Science:
- Gerontology
- Neurology
- Epidemiology
Background:
- High adiposity in midlife and late life is a potential dementia risk factor.
- Late-life decreases in body mass index (BMI) or weight precede dementia diagnosis.
- Study designs and analysis methods influence observed relationships between adiposity and dementia.
Purpose of the Study:
- To investigate the longitudinal relationship between anthropometric measures and dementia risk.
- To explore the impact of midlife and late-life adiposity on dementia incidence.
- To examine potential reverse causality in anthropometric changes preceding dementia.
Main Methods:
- Longitudinal analysis of body weight, BMI, waist circumference, and waist-to-hip ratio (WHR) over 32 years in 1,462 women.
- Use of Cox proportional hazards regression for baseline risk assessment.
- Logistic regression models to analyze anthropometric measures in relation to dementia among survivors.
Main Results:
- A midlife WHR > 0.80 was associated with a twofold increased dementia risk (OR 2.22) in survivors using logistic models.
- Baseline anthropometric factors showed no association with dementia risk via Cox models.
- Evidence of reverse causality was observed for body weight, BMI, and waist circumference preceding dementia diagnosis.
Conclusions:
- High midlife WHR may increase dementia odds among women surviving to age 70.
- Traditional Cox models may not detect this association.
- Dynamic changes in anthropometry preceding dementia onset have implications for prevention and risk factor identification.
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