Association of BMI and Cognitive Performance in the Diabetes Prevention Program Outcomes Study
José A Luchsinger1, Qing Pan2, William C Knowler2
1Department of Medicine and Epidemiology, Columbia University Irving Medical Center, New York, New York, USA.
Obesity (Silver Spring, Md.)
|September 29, 2025
Summary
Individuals with overweight or obesity and diabetes or prediabetes showed a slower decline in verbal learning and memory compared to those with normal BMI. This suggests a potential protective effect of higher BMI on cognitive function in this population.
Area of Science:
- Endocrinology
- Neuroscience
- Public Health
Background:
- Diabetes and prediabetes are associated with cognitive decline.
- Body Mass Index (BMI) is a key factor in metabolic health.
- Understanding the interplay between BMI and cognition in these populations is crucial for public health interventions.
Purpose of the Study:
- To investigate the association between Body Mass Index (BMI) categories and cognitive performance.
- To analyze cognitive trajectories over time in individuals with diabetes or prediabetes based on BMI.
- To determine if overweight or obesity influences the rate of cognitive decline.
Main Methods:
- Utilized data from the Diabetes Prevention Program Outcomes Study (DPPOS).
- Categorized participants' BMI into normal, overweight, and obesity.
- Assessed cognitive function using the Brief Spanish English Verbal Learning Test (B-SEVLT) and Digit Symbol Substitution Test (DSST), with linear mixed models analyzing changes over 15 years.
Main Results:
- Overweight or obesity at Year 8 was linked to a slower decline in verbal learning and memory (B-SEVLT recall).
- Participants with overweight or obesity demonstrated higher Modified Mini-Mental State exam (3MS) scores at Year 15.
- A total of 2285 participants were analyzed, with 31% overweight and 60% obese at Year 8.
Conclusions:
- Overweight and obesity are associated with preserved verbal learning and memory decline in individuals with diabetes or prediabetes.
- Higher BMI may confer a protective effect against cognitive decline in specific populations.
- Findings suggest a complex relationship between BMI and cognitive health in metabolic disease contexts.
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