Association between late-life body mass index and dementia: The Kame Project.
OBJECTIVE
To examine the association between body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) and risk of dementia and its subtypes in late life.


METHODS
Participants were members of the Kame Project, a population-based prospective cohort study of 1,836 Japanese Americans living in King County, WA, who had a mean age of 71.8 years and were dementia-free at baseline (1992-1994), and were followed for incident dementia through 2001. Cox proportional hazards models were used to estimate the risk of dementia, Alzheimer disease (AD), and vascular dementia (VaD) controlling for demographic and lifestyle characteristics and vascular comorbidities as a function of baseline BMI, WC, and WHR and change in BMI over time.


RESULTS
Higher baseline BMI was significantly associated with a reduced risk of AD (hazard ratio [HR] = 0.56, 95% confidence interval [CI] = 0.33-0.97) in the fully adjusted model. Slower rate of decline in BMI was associated with a reduced risk of dementia (HR = 0.37, 95% CI = 0.14-0.98), with the association stronger for those who were overweight or obese (HR = 0.18, 95% CI = 0.05-0.58) compared to normal or underweight (HR = 1.00, 95% CI = 0.18-5.66) at baseline.


CONCLUSIONS
Higher baseline body mass index (BMI) and slower declining BMI in late life are associated with a reduced risk of dementia, suggesting that low BMI or a faster decline in BMI in late life may be preclinical indicators of an underlying dementing illness, especially for those who were initially overweight or obese.
Hughes
T F
TF
Department of Psychiatry, University of Pittsburgh, PA 15213, USA. hughest2@upmc.edu
Borenstein
A R
AR
Schofield
E
E
Wu
Y
Y
Larson
E B
EB
D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D003704:Dementia / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio