A 32-year prospective study of change in body weight and incident dementia: the Honolulu-Asia Aging Study.
BACKGROUND
The course of weight loss associated with dementia is unclear, particularly prior to and around the onset of the clinical syndrome.


OBJECTIVE
To compare the natural history of weight change from mid to late life in men with and without dementia in late life.


METHODS
The Honolulu-Asia Aging Study, a 32-year, prospective, population-based study of Japanese American men who had been weighed on 6 occasions between 1965 and 1999 and who had been screened for dementia 3 times between 1991 and 1999.


METHODS
Of 1890 men (aged 77-98 years), 112 with incident dementia were compared with 1778 without dementia at the sixth examination (1997-1999).


METHODS
Weight change up to and including the sixth examination was treated as the dependent variable and estimated using a repeated measures analysis.


RESULTS
Groups with and without dementia did not differ with respect to baseline weight or change in weight from mid to late life (first 26 years' follow-up). In the late-life examinations (final 6 years), mean age- and education-adjusted weight loss was -0.22 kg/y (95% confidence intervals, -0.26 to -0.18) in participants without dementia. Men with incident dementia at the same examination had an additional yearly weight loss of -0.36 kg (95% confidence interval, -0.53 to -0.19). This was not changed substantially with adjustment for risk factors for vascular disease or functional impairment and was significant for both Alzheimer disease and vascular dementia subtypes.


CONCLUSIONS
Dementia-associated weight loss begins before the onset of the clinical syndrome and accelerates by the time of diagnosis. The potential impact on prognosis should be considered in the case of elderly persons at risk for dementia.
Stewart
Robert
R
Institute of Psychiatry, London, United Kingdom.
Masaki
Kamal
K
Xue
Qian-Li
QL
Peila
Rita
R
Petrovitch
Helen
H
White
Lon R
LR
Launer
Lenore J
LJ
D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D015992:Body Mass Index; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D004522:Educational Status; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010808:Physical Examination; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D015431:Weight Loss / Q000502:physiology*