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The association between regional adiposity, cognitive function, and dementia-related brain changes: a systematic
Ethel Boccara1,2, Sapir Golan2,3, Michal Schnaider Beeri2,4
1Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.
Frontiers in Medicine
|July 17, 2023
Summary
Regional fat distribution, not just overall adiposity, impacts cognitive decline and Alzheimer's disease risk. Understanding specific fat depots like visceral adipose tissue offers insights into brain health and potential targeted therapies.
Area of Science:
- Neuroscience
- Metabolic Health
- Gerontology
Background:
- Adiposity is linked to cognitive impairment and Alzheimer's disease and related disorders (ADRD).
- Body Mass Index (BMI) offers a global measure of adiposity but fails to capture regional fat distribution differences.
- Regional fat distribution varies by sex, race, and age, potentially influencing cognitive decline and ADRD differently.
Purpose of the Study:
- To systematically review the literature on regional adiposity and its association with cognitive function, dementia, and brain changes.
- To explore whether regional fat depots, rather than general adiposity or central obesity, are more critical in understanding the link between adiposity and brain health.
- To identify specific regional fat depots that may be associated with increased risk of cognitive impairment and Alzheimer's disease.
Main Methods:
- Systematic review of 33 English-language studies involving human adults (18+ years).
- Inclusion criteria focused on studies assessing regional adiposity via imaging techniques, cognitive function, dementia, and brain measures.
- Exclusion of review articles, abstracts, letters, pediatric studies, animal studies, and studies on gastrointestinal diseases. Literature search conducted in PubMed, PsychInfo, and Web of Science until November 2022.
Main Results:
- Findings suggest distinct regional fat depots are associated with increased risk of cognitive impairment, brain changes, and dementia, particularly Alzheimer's disease.
- Different regional fat depots demonstrate varied cognitive outcomes and distinct effects on the brain.
- Visceral adipose tissue (VAT) and liver fat (via non-alcoholic fatty liver disease, NAFLD) were the most frequently studied regional fat depots; pancreatic fat was least studied.
Conclusions:
- Regional adiposity, being a modifiable factor, may clarify inconsistencies in the association between global adiposity, brain structure/function, and cognition.
- Specific regional fat depots can trigger abnormal adipose factor secretion, potentially crossing the blood-brain barrier and causing neurodegeneration and cognitive decline.
- Targeting specific fat depots could pave the way for personalized interventions to improve cognitive health.
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