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. 2010 Apr-Jun;24(2):126-30.
doi: 10.1097/WAD.0b013e3181a6bf3f.

Body mass index and cognitive decline in mild cognitive impairment

Benjamin B Cronk  1 , David K Johnson, Jeffrey M Burns; Alzheimer's Disease Neuroimaging Initiative
Affiliations

Body mass index and cognitive decline in mild cognitive impairment

Benjamin B Cronk et al. Alzheimer Dis Assoc Disord. 2010 Apr-Jun.

Abstract

Objective: To examine the relationship between body mass index (BMI) and cognitive decline in subjects diagnosed with mild cognitive impairment (MCI).

Methods: Neuropsychologic and clinical evaluations were conducted at baseline, 6-months, and 1-year on 286 MCI subjects enrolled in the Alzheimer's Disease Neuroimaging Initiative. A global cognitive composite score was derived (mean Z-score) from performance on 9 neuropsychologic subtests. Height and weight were assessed at baseline and used to calculate BMI. Generalized estimating equations (linear and logistic) assessed the relationships of baseline BMI with cognitive outcomes, clinician judgment of "clinically significant decline" over 1-year, and diagnostic progression from MCI to Alzheimer disease.

Results: Lower baseline BMI was associated with significant declines in cognitive performance in individuals with MCI over 1 year (Mini-Mental State Examination, Alzheimer Disease Assessment Scale-Cognitive subscale, and a global cognitive composite; all P<0.05). We observed a significant protective effect of baseline BMI in reducing the risk of a clinically significant decline in Alzheimer Disease Assessment Scale-Cognitive subscale and mini-mental state examination (P<0.05). No association was found between BMI and changes in the clinical dementia rating sum of boxes or conversion to Alzheimer disease.

Conclusions: Lower baseline BMI is associated with more rapid cognitive decline in MCI. This relationship suggests either body composition may influence the rate of cognitive decline in MCI or factors related to MCI influence body composition.

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Figures

FIGURE 1
FIGURE 1
Predicted means of cognitive outcomes and BMI in tertiles at baseline and 1-year follow up for mild cognitive impairment participants. The predicted means of cognitive outcomes are presented for tertiles of BMI adjusted for age, education, and sex. Lower scores represent worse performance for the global composite score and Mini-Mental Status Examination (MMSE), whereas higher scores represent decline in clinical dementia rating (CDR) sum of boxes and Alzheimer Disease Assessment Scale-Cognitive subscale. Less cognitive decline over 1-year is apparent in the highest BMI tertile across the measures. BMI indicates body mass index.
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