Weight change and cognitive function: findings from the Women's Health Initiative Study of Cognitive Aging

Abstract

Although studies exploring relationships between obesity and cognitive impairment in the elderly are conflicting, literature suggests that overweight and obesity may be protective against cognitive impairment and dementia in older women. We examine the associations between changes in weight and waist circumference (WC) with global and domain-specific cognitive function in a large, well-defined cohort of 2,283 older, postmenopausal women (aged 65-79) prospectively followed through the Women's Health Initiative (WHI) Study of Cognitive Aging (WHISCA). We assessed the associations between changes in weight and WC collected up to 5 years before WHISCA enrollment and mean levels of global and domain-specific cognitive performance across an average of 5.4 years of subsequent follow-up. There was a lack of associations between weight and cognition in women who remained stable or gained weight. The only significant relationships observed were in association with weight loss (P ≤ 0.05), most likely signaling incipient disease. Moreover, cognition was not related to changes in WC. Relationships were largely independent of initial BMI, self-reported caloric intake or dieting. The lack of associations between weight gain and cognition in women is consistent with the existing literature.

Figure 1. Association between weight changes and global cognitive function

Presented are fitted mean standardized global cognitive function scores from the full covariate model for women grouped according to prior changes in weight (p=0.002, overall). The pairwise differences between weight change groups that reach statistical significance (Bonferroni-adjusted p<0.05) are between 10-20% weight loss and each other weight change group and between 0-10% weight loss and 0-10% weight gain.