Associations between obesity and cognitive impairment in the Chinese elderly: an observational study

Qingtao Hou, Yang Guan, Weihua Yu, Xintong Liu, Lihua Wu, Mingzhao Xiao, Yang Lü, Qingtao Hou, Yang Guan, Weihua Yu, Xintong Liu, Lihua Wu, Mingzhao Xiao, Yang Lü

Abstract

Purpose: The aim of this study was to investigate the relationship between obesity and cognitive impairment in the Chinese elderly.

Patients and methods: Patients aged 60 years or above were enrolled from the Department of Geriatrics of The First Affiliated Hospital of Chongqing Medical University from March 2013 to May 2017. Mini-Mental State Examination scale was used to assess the cognitive function. Body mass index (BMI) and waist-hip ratio were used to classify obesity. Student's t-test, Mann-Whitney U-test, or chi-squared test was used to compare the data between participants with normal cognition and participants with cognitive impairment as appropriate. Univariate logistic regression models and multivariate logistic regression models were performed to explore the relationship between BMI or abdominal obesity and cognitive impairment.

Results: A total of 1,100 patients including 568 men and 532 women aged 60-98 years (median age 79 years) were enrolled. After adjusting for age, gender, smoking, drinking, education level, hypercholesterolemia, hypertension, and diabetes, overweight was significantly associated with a decreased risk of cognitive impairment (OR=0.458, 95% CI=0.298-0.703, P<0.001). After adjustment for age, education level, hypercholesterolemia, hypertension, and diabetes, abdominal obesity remained significantly associated with an increased risk of cognitive impairment (OR=1.532, 95% CI=1.037-2.263, P=0.032).

Conclusion: Overweight is associated with a decreased risk of cognitive impairment in the Chinese elderly, while abdominal obesity is associated with an increased risk of cognitive impairment independent of conventional sociodemographic, lifestyle, and health-related comorbid factors.

Keywords: body mass index; cognitive function; elderly; waist-hip ratio.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

References

    1. Hugo J, Ganguli M. Dementia and cognitive impairment: epidemiology, diagnosis, and treatment. Clin Geriatr Med. 2014;30(3):421–442.
    1. Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention, and care. Lancet. 2017;390(10113):2673–2734.
    1. General Administration of sport of China National physique monitoring Bulletin. 2014. [Accessed November 25, 2015]. Available from:
    1. Rosengren A, Skoog I, Gustafson D, Wilhelmsen L. Body mass index, other cardiovascular risk factors, and hospitalization for dementia. Arch Intern Med. 2005;165(3):321–326.
    1. Whitmer RA, Gunderson EP, Barrett-Connor E, Quesenberry CP, Jr, Yaffe K. Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study. BMJ. 2005;330(7504):1360–1362.
    1. Businaro R, Ippoliti F, Ricci S, Canitano N, Fuso A. Alzheimer’s disease promotion by obesity: induced mechanisms-molecular links and perspectives. Curr Gerontol Geriatr Res. 2012;2012:986823, 1–13.
    1. Luchsinger JA, Patel B, Tang MX, Schupf N, Mayeux R. Measures of adiposity and dementia risk in elderly persons. Arch Neurol. 2007;64(3):392–398.
    1. Kivipelto M, Ngandu T, Fratiglioni L, et al. Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Arch Neurol. 2005;62(10):1556–1560.
    1. Fitzpatrick AL, Kuller LH, Lopez OL, et al. Midlife and late-life obesity and the risk of dementia: cardiovascular health study. Arch Neurol. 2009;66(3):336–342.
    1. Katzman R, Zhang MY, Ouang-Ya-Qu, et al. A Chinese version of the Mini-Mental State Examination; impact of illiteracy in a Shanghai dementia survey. J Clin Epidemiol. 1988;41(10):971–978.
    1. Zhou B. Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population. Chin J Epidemiol. 2002;23:5–10.
    1. Atti AR, Palmer K, Volpato S, Winblad B, De Ronchi D, Fratiglioni L. Late-life body mass index and dementia incidence: nine-year follow-up data from the Kungsholmen Project. J Am Geriatr Soc. 2010;56(1):111–116.
    1. Ghaderpanahi M, Fakhrzadeh H, Sharifi F, et al. Association between late-life body mass index, waist circumference, and dementia: Kahrizak elderly study. J Am Geriatr Soc. 2012;60(1):173–174.
    1. Emmerzaal TL, Kiliaan AJ, Gustafson DR. 2003–2013: a decade of body mass index, Alzheimer’s disease, and dementia. J Alzheimers Dis. 2015;43(3):739–755.
    1. Harvey J, Solovyova N, Irving A. Leptin and its role in hippocampal synaptic plasticity. Prog Lipid Res. 2006;45(5):369–378.
    1. Oomura Y, Hori N, Shiraishi T, et al. Leptin facilitates learning and memory performance and enhances hippocampal CA1 long-term potentiation and CaMK II phosphorylation in rats. Peptides. 2006;27(11):2738–2749.
    1. Dahl AK, Fauth EB, Ernsth-Bravell M, Hassing LB, Ram N, Gerstof D. Body mass index, change in body mass index, and survival in old and very old persons. J Am Geriatr Soc. 2013;61(4):512–518.
    1. Cheng G, Huang C, Deng H, Wang H. Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of Longitudinal studies. Intern Med J. 2012;42(5):484–491.
    1. Whitmer RA, Sidney S, Selby J, Johnston SC, Yaffe K. Midlife cardiovascular risk factors and risk of dementia in late life. Neurology. 2005;64(2):277–281.
    1. Liu Z, Yang H, Chen S, Cai J, Huang Z. The association between body mass index, waist circumference, waist-hip ratio and cognitive disorder in older adults. J Public Health. 2018;278(9)
    1. Luchsinger JA, Cheng D, Tang MX, Schupf N, Mayeux R. Central obesity in the elderly is related to late-onset Alzheimer disease. Alzheimer Dis Assoc Disord. 2012;26(2):101–105.
    1. Li X, Wu J, Zuo SY, et al. Epidemiological characteristics of central obesity. Chin J Gerontol. 2012;32:4015–4018.
    1. Wang W, Wang K, Li T, et al. A discussion on utility and purposed value of obesity and abdomen obesity when body mass index, waist circumference, waist to hip ratio used as indexes predicting hypertension and hyper-blood glucose. Zhonghua Liu Xing Bing Xue Za Zhi. 2002;23(1):16–19. Chinese.
    1. Capuron L, Su S, Miller AH, et al. Depressive symptoms and metabolic syndrome: is inflammation the underlying link? Biol Psychiatry. 2008;64(10):896–900.
    1. Cholerton B, Baker LD, Craft S. Insulin, cognition, and dementia. Eur J Pharmacol. 2013;719(1–3):170–179.
    1. Grillo CA, Piroli GG, Lawrence RC, et al. Hippocampal insulin resistance impairs spatial learning and synaptic plasticity. Diabetes. 2015;64(11):3927–3936.
    1. Arshad N’, Lin TS, Yahaya MF. Metabolic syndrome and its effect on the brain: possible mechanism. CNS Neurol Disord Drug Targets. 2018;17(8):595–603.
    1. Nourhashémi F, Deschamps V, Larrieu S, et al. PAQUID study Personnes Agées Quid. Body mass index and incidence of dementia: the PAQUID study. Neurology. 2003;60(1):117–119.

Source: PubMed

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