title: Body mass index and cognitive decline in mild cognitive impairment.
abstract: OBJECTIVE
  To examine the relationship between body mass index (BMI) and cognitive decline in subjects diagnosed with mild cognitive impairment (MCI).
  
  
  METHODS
  Neuropsychologic and clinical evaluations were conducted at baseline, 6-months, and 1-year on 286 MCI subjects enrolled in the Alzheimer's Disease Neuroimaging Initiative. A global cognitive composite score was derived (mean Z-score) from performance on 9 neuropsychologic subtests. Height and weight were assessed at baseline and used to calculate BMI. Generalized estimating equations (linear and logistic) assessed the relationships of baseline BMI with cognitive outcomes, clinician judgment of "clinically significant decline" over 1-year, and diagnostic progression from MCI to Alzheimer disease.
  
  
  RESULTS
  Lower baseline BMI was associated with significant declines in cognitive performance in individuals with MCI over 1 year (Mini-Mental State Examination, Alzheimer Disease Assessment Scale-Cognitive subscale, and a global cognitive composite; all P<0.05). We observed a significant protective effect of baseline BMI in reducing the risk of a clinically significant decline in Alzheimer Disease Assessment Scale-Cognitive subscale and mini-mental state examination (P<0.05). No association was found between BMI and changes in the clinical dementia rating sum of boxes or conversion to Alzheimer disease.
  
  
  CONCLUSIONS
  Lower baseline BMI is associated with more rapid cognitive decline in MCI. This relationship suggests either body composition may influence the rate of cognitive decline in MCI or factors related to MCI influence body composition.
authors: Department of Neurology, University of Kansas School of Medicine, Kansas City, KS 66160, USA.
authors: Benjamin B
authors: BB
authors: Cronk
authors: David K
authors: DK
authors: Johnson
authors: Jeffrey M
authors: JM
authors: Burns
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003072:Cognition Disorders / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests