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. 2022 Aug 30;14(1):e12352.
doi: 10.1002/dad2.12352. eCollection 2022.

Weight loss in a cardiovascular trial population identifies people at future risk of dementia

Pieter van der Veere  1 , Imen Hammami  1 , Georgina Buck  1 , Melanie Greenland  1 , Alison Offer  1 , Michelle Nunn  1 , William Whiteley  1   2 , Richard Bulbulia  1 , Rory Collins  1 , Jane Armitage  1   3 , Marion Mafham  1 , Sarah Parish  1   3 ; Heart Protection Study Collaborative Group
Affiliations

Weight loss in a cardiovascular trial population identifies people at future risk of dementia

Pieter van der Veere et al. Alzheimers Dement (Amst). .

Abstract

Introduction: Populations at increased risk of dementia need to be identified for well-powered trials of preventive interventions. Weight loss, which often occurs in pre-clinical dementia, could identify a population at sufficiently high dementia risk.

Methods: In 12,975 survivors in the Heart Protection Study statin trial of people with, or at high risk of, cardiovascular disease, the association of weight change over 5 years during the trial with post-trial dementia recorded in electronic hospital admission and death records (n = 784) was assessed, after adjustment for age, sex, treatment allocation, and deprivation measures.

Results: Among the 60% without substantial weight gain (≤2 kg weight gain), each 1 kg weight loss was associated with a risk ratio for dementia of 1.04 (95% confidence interval, 1.02-1.07). Weight loss ≥4 kg and cognitive function below the mean identified participants aged ≥67 years with a 13% 10-year dementia risk.

Discussion: The combination of weight loss and high vascular risk identified individuals at high risk of dementia who could be recruited to dementia prevention trials.

Keywords: cognitive function; dementia; risk prediction; weight loss.

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Conflict of interest statement

All authors worked in the Clinical Trial Service Unit & Epidemiological Studies Unit of the Nuffield Department of Population Health at the University of Oxford. The Clinical Trial Service Unit & Epidemiological Studies Unit has a staff policy of not taking any personal payments directly or indirectly from industry (with reimbursement sought only for the costs of travel and accommodation to attend scientific meetings). Support for the present manuscript to all authors came from grants to the University of Oxford from Merck, Roche, the UK Medical Research Council, the British Heart Foundation and Cancer Research UK (see acknowledgements section for full details of funding). P.V., I.H., G.B., M.G., A.O., and M.N. have nothing further to disclose. W.W. reports support from the Chief Scientist's Office and the Alzheimer's Society, membership of a Data Safety Monitoring Board outside the area of this publication and a leadership or fiduciary role on the Stroke editorial board. R.B. reports he is chair of a NIHR funded trial (CHAPS) looking at compression hosiery to prevent post‐thrombotic syndrome (unpaid). R.C. is deputy chair of a not‐for‐profit Clinical Trial Company, Chief Executive of UK Biobank and chair of the Data Monitoring Committee of PROMINENT Data Safety Monitoring Board of Pemafibrate. J.A. reports a grant from Novartis and membership of Data Safety Monitoring Board (unpaid). M.M. reports grants from Novartis and Novo Nordisk. S.P. is statistician to the Data Monitoring Committee of the ORION‐4 trial of inclisiran. S.P. and R.C. are co‐inventors of a genetic test for statin‐related myopathy risk but receive no income from it. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
Number of participants included in analyses. APOE, apolipoprotein E
FIGURE 2
FIGURE 2
Associations of different weight measures with the incidence of first recorded dementia post‐trial, after standard adjustment. Number of dementia cases shown below each square. The lines displayed in the panels reflect data‐driven summaries of the observed patterns. In the first two panels, the solid line shows the trend over the three fifths with weight loss or little change and the dotted line shows the continuation of this line. *Using the mean weight measure in each group as exposure dose
FIGURE 3
FIGURE 3
Association of cognitive function with the incidence of first recorded dementia post‐trial and different weight measures, after standard adjustment. In the first panel, the residual of cognitive function z‐score from a model allowing for age (20 groups) and sex is ranked into fifths and the number of dementia cases is shown below each square. Missing = Cognitive function z‐score not available
See this image and copyright information in PMC

References

    1. GBD 2016 Dementia Collaborators . Global, regional, and national burden of Alzheimer's disease and other dementias, 1990‐2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019;18:88‐106. - PMC - PubMed
    1. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396:413‐446. - PMC - PubMed
    1. World Health Organization. Dementia. 2021. Accessed May 5, 2022. Available from: https://www.who.int/news‐room/fact‐sheets/detail/dementia
    1. Winblad B, Amouyel P, Andrieu S, et al. Defeating Alzheimer's disease and other dementias: a priority for European science and society. Lancet Neurol. 2016;15:455‐532. - PubMed
    1. Cummings J, Lee G, Ritter A, Sabbagh M, Zhong K. Alzheimer's disease drug development pipeline: 2019. Alzheimers Dement (N Y). 2019;5:272‐293. - PMC - PubMed