title: Obesity and lowered cognitive performance in a Canadian First Nations population.
abstract: The association between obesity, other cardiovascular risk factors, and cognitive function in a Canadian First Nations population was investigated using a cross-sectional design. Eligible individuals were aged >/=18 years, without a history of stroke, nonpregnant, with First Nations status, and who had undergone cognitive function assessment by the Clock Drawing Test (CDT) and Trail Making Test Parts A and B. Parts A and B were combined into an Executive Function Score (TMT-exec). Hypertension, a previous history of cardiovascular disease, dyslipidemia, metabolic syndrome, insulin resistance, and the presence and duration of diabetes were examined in addition to obesity. In the case of TMT-exec only, obese individuals were at an approximately fourfold increased risk for lowered cognitive performance compared to those who were not obese in multivariable models (odds ratio (OR): 3.77, 95% confidence interval (CI): 1.46-9.72) whereas there was no effect for overweight individuals compared to those with a normal weight in unadjusted analysis. Those having an increased waist circumference also had 5 times the risk compared to those without an increased waist circumference (OR: 5.41, 95% CI: 1.83-15.99). Adjusted for age, sex, and insulin resistance, individuals having the metabolic syndrome were at an approximately fourfold increased risk compared to those without the metabolic syndrome (OR: 3.67, 95% CI: 1.34-10.07). No other cardiovascular risk factors were associated. Obesity and metabolic syndrome were associated with lowered cognitive performance. These results highlight the importance of studying the health effects of obesity beyond traditional disease endpoints, even in a relatively youthful population.
authors.affiliation: Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. jennifer.fergenbaum@utoronto.ca
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Fergenbaum
authors.forename: Sharon
authors.initials: S
authors.lastname: Bruce
authors.forename: Wendy
authors.initials: W
authors.lastname: Lou
authors.forename: Anthony J G
authors.initials: AJ
authors.lastname: Hanley
authors.forename: Carol
authors.initials: C
authors.lastname: Greenwood
authors.forename: T Kue
authors.initials: TK
authors.lastname: Young
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology; D007198:Indians, North American; D007333:Insulin Resistance / Q000502:physiology; D016015:Logistic Models; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology; D012424:Rural Population; D055105:Waist Circumference / Q000502:physiology