Weight Loss Predicts Progression of Mild Cognitive Impairment to Alzheimer's Disease

Abstract

Background: Weight loss is common in people with Alzheimer's disease (AD) and it could be a marker of impending AD in Mild Cognitive Impairment (MCI) and improve prognostic accuracy, if accelerated progression to AD would be shown.

Aims: To assess weight loss as a predictor of dementia and AD in MCI.

Methods: One hundred twenty-five subjects with MCI (age 73.8 ± 7.1 years) were followed for an average of 4 years. Two weight measurements were carried out at a minimum time interval of one year. Dementia was defined according to DSM-IV criteria and AD according to NINCDS-ADRDA criteria. Weight loss was defined as a ≥4% decrease in baseline weight.

Results: Fifty-three (42.4%) MCI progressed to dementia, which was of the AD-type in half of the cases. Weight loss was associated with a 3.4-fold increased risk of dementia (95% CI = 1.5-6.9) and a 3.2-fold increased risk of AD (95% CI = 1.4-8.3). In terms of years lived without disease, weight loss was associated to a 2.3 and 2.5 years earlier onset of dementia and AD.

Conclusions: Accelerated progression towards dementia and AD is expected when weight loss is observed in MCI patients. Weight should be closely monitored in elderly with mild cognitive impairment.

Fig 1. Progression to dementia of MCI subjects divided into three categories of weight change.

Fig 2

Cumulative risk curves of the effects of body weight change on progression from mild cognitive impairment (MCI) to dementia (A) and Alzheimer’s disease (B). The figure derived from a model adjusted for sex, age, education, Mini-Mental State Examination score, MCI subtypes, APOE genotype, smoking habit, depression, diabetes, cerebrovascular disease, ARWMC score, comorbidity total score.