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Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging
Rabe E Alhurani1, Maria Vassilaki2, Jeremiah A Aakre3
1Mayo Clinic Graduate School of Medicine, Rochester, Minnesota2Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Importance:
Unintentional weight loss has been associated with risk of dementia. Because mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI.
Objective:
To investigate the association of change in weight and BMI with risk of MCI.
Design, Setting, And Participants:
A population-based, prospective study of participants 70 years of age or older from the Mayo Clinic Study of Aging, which was initiated on October 1, 2004. Maximum weight and height in midlife (40-65 years of age) were retrospectively ascertained from the medical records of participants using a medical records-linkage system. The statistical analyses were performed between January and November 2015.
Main Outcomes And Measures:
Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and BMI with risk of MCI was investigated using proportional hazards models.
Results:
Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI (50.3% were men; mean age, 78.5 years). The mean (SD) rate of weight change per decade from midlife to study entry was greater for participants who developed incident MCI vs those who remained cognitively normal (-2.0 [5.1] vs -1.2 [4.9] kg; P = .006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR], 1.04 [95% CI, 1.02-1.06]; P < .001) after adjusting for sex, education, and apolipoprotein E (APOE) ε4 allele. A weight loss of 5 kg per decade corresponds to a 24% increase in risk of MCI (HR, 1.24). A higher decrease in BMI per decade was also associated with incident MCI (HR, 1.08 [95% CI, 1.03-1.13]; P = .003).
Conclusions And Relevance:
These findings suggest that increasing weight loss per decade from midlife to late life is a marker for MCI and may help identify persons at increased risk for MCI.
Insights
Significant weight loss from midlife to late life increases the risk of developing mild cognitive impairment (MCI). This finding may help identify individuals at higher risk for MCI.
Area of Science:
- Neurology
- Gerontology
- Epidemiology
Background:
- Unintentional weight loss is a known risk factor for dementia.
- Mild cognitive impairment (MCI) is a precursor to dementia, making it a critical stage for early detection and intervention.
Purpose of the Study:
- To investigate the association between changes in weight and body mass index (BMI) and the risk of developing incident MCI.
- To determine if weight and BMI changes from midlife can predict MCI in older adults.
Main Methods:
- A population-based, prospective study (Mayo Clinic Study of Aging) involving participants aged 70 years and older.
- Retrospective ascertainment of midlife weight and height, with prospective cognitive assessments over a mean follow-up of 4.4 years.
- Proportional hazards models were used to analyze the association between the rate of change in weight/BMI and MCI risk, adjusting for covariates.
Main Results:
- Participants who developed MCI showed a greater rate of weight loss per decade from midlife compared to those who remained cognitively normal.
- Increased weight loss per decade was significantly associated with a higher risk of incident MCI (HR, 1.04).
- A decrease of 5 kg per decade corresponded to a 24% increased risk of MCI, and a greater decrease in BMI also predicted higher MCI risk.
Conclusions:
- Progressive weight loss from midlife into late life serves as a potential biomarker for MCI.
- These findings can aid in identifying individuals at elevated risk for developing MCI, facilitating timely interventions.
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