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. 2018 Feb;14(2):178-186.
doi: 10.1016/j.jalz.2017.06.2637. Epub 2017 Sep 21.

Obesity trajectories and risk of dementia: 28 years of follow-up in the Whitehall II Study

Archana Singh-Manoux  1 , Aline Dugravot  2 , Martin Shipley  3 , Eric J Brunner  3 , Alexis Elbaz  2 , Séverine Sabia  4 , Mika Kivimaki  3
Affiliations

Obesity trajectories and risk of dementia: 28 years of follow-up in the Whitehall II Study

Archana Singh-Manoux et al. Alzheimers Dement. 2018 Feb.

Abstract

Introduction: We examined whether obesity at ages 50, 60, and 70 years is associated with subsequent dementia. Changes in body mass index (BMI) for more than 28 years before dementia diagnosis were compared with changes in BMI in those free of dementia.

Methods: A total of 10,308 adults (33% women) aged 35 to 55 years in 1985 were followed up until 2015. BMI was assessed six times and 329 cases of dementia were recorded.

Results: Obesity (BMI ≥30 kg/m2) at age 50 years (hazard ratio = 1.93; 1.35-2.75) but not at 60 or 70 years was associated with risk of dementia. Trajectories of BMI differed in those with dementia compared with all others (P < .0001) or to matched control subjects (P < .0001) such that BMI in dementia cases was higher from 28 years (P = .001) to 16 years (P = .05) and lower starting 8 years before diagnosis.

Discussion: Obesity in midlife and weight loss in the preclinical phase characterizes dementia; the current obesity epidemic may affect future dementia rates.

Keywords: BMI; Dementia; Obesity; Waist circumference; Waist-to-hip ratio.

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Figures

Fig. 1
Fig. 1
Trajectories of BMI in the 28 years before dementia. (1) The figure represents marginal effects of dementia on trajectories of BMI, adjusted for age, sex, and education and 5-year birth cohort in panel (A). Mean number of observations per participant is 3.3 for dementia cases and 4.1 for those dementia free for approach (A) and 4.4 for control subjects for approach (B). (2) The 95% confidence intervals are presented for alternate time points for ease of presentation.
Fig. 2
Fig. 2
Trajectories of waist circumference (A) and waist-to-hip ratio (B) in the 22 years before dementia. Note: (1) The figure represents marginal effects of dementia on trajectories of waist circumference and waist-to-hip ratio, adjusted for age, sex, and education. Mean number of observations per participant is 2.8 for cases and 3.4 for control subjects. (2) Confidence intervals are presented for alternate time points for ease of presentation. (3) Estimated differences in BMI at each time point are presented in Supplementary Table 4.
See this image and copyright information in PMC

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