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Multicenter Study
. 2014 May;11(4):349-56.
doi: 10.2174/1567205010666131120110930.

Change in body mass index before and after Alzheimer's disease onset

Yian Gu, Nikolaos Scarmeas, Stephanie Cosentino, Jason Brandt, Marilyn Albert, Deborah Blacker, Bruno Dubois, Yaakov Stern  1
Affiliations
Multicenter Study

Change in body mass index before and after Alzheimer's disease onset

Yian Gu et al. Curr Alzheimer Res. 2014 May.

Abstract

Objectives: A high body mass index (BMI) in middle-age or a decrease in BMI at late-age has been considered a predictor for the development of Alzheimer's disease (AD). However, little is known about the BMI change close to or after AD onset.

Methods: BMI of participants from three cohorts, the Washington Heights and Inwood Columbia Aging Project (WHICAP; population-based) and the Predictors Study (clinic-based), and National Alzheimer's Coordinating Center (NACC; clinic-based) were analyzed longitudinally. We used generalized estimating equations to test whether there were significant changes of BMI over time, adjusting for age, sex, education, race, and research center. Stratification analyses were run to determine whether BMI changes depended on baseline BMI status.

Results: BMI declined over time up to AD clinical onset, with an annual decrease of 0.21 (p=0.02) in WHICAP and 0.18 (p=0.04) kg/m2 in NACC. After clinical onset of AD, there was no significant decrease of BMI. BMI even increased (b=0.11, p=0.004) among prevalent AD participants in NACC. During the prodromal period, BMI decreased over time in overweight (BMI≥25 and <30) WHICAP participants or obese (BMI≥30) NACC participants. After AD onset, BMI tended to increase in underweight/normal weight (BMI<25) patients and decrease in obese patients in all three cohorts, although the results were significant in NACC study only.

Conclusions: Our study suggests that while BMI declines before the clinical AD onset, it levels off after clinical AD onset, and might even increase in prevalent AD. The pattern of BMI change may also depend on the initial BMI.

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Figures

Figure 1
Figure 1. GEE-predicted BMI during the course of follow-up among three cohorts of Alzheimer's disease (AD) patients
Figure 1 shows GEE-predicted BMI (y-axis) during the course of follow-up in years (x-Axis) among three cohorts of Alzheimer's disease (AD) patients. The figure is derived from models that are adjusted for age, sex, ethnicity, and education. Duration of follow-up is based on the average number of follow-up years in each phase (before onset, after and on AD onset, prevalent AD), separately for the three cohorts. Dotted lines indicate non-significant trends while solid lines indicate significant increase or decrease of BMI
See this image and copyright information in PMC

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