Unstable Body Mass Index and Progression to Probable Alzheimer's Disease Dementia in Patients with Amnestic Mild Cognitive Impairment.
OBJECTIVE
We investigated the influence of body mass index (BMI) status at baseline and changes in BMI over a follow-up period on the development of dementia in amnestic mild cognitive impairment (aMCI) patients.


METHODS
The longitudinal data of 747 aMCI patients were used to investigate the relationships among baseline BMI status, subsequent changes in BMI (median follow-up duration: 1.6 years, interquartile range: 1.0-2.3 years), and risk of progression to probable Alzheimer's disease dementia (pADD). The aMCI patients were classified into underweight, normal weight, overweight, and obese subgroups, and further categorized into increased BMI, stable BMI, and decreased BMI subgroups during follow-up using a 4% mean annual change in BMI cut-off value.


RESULTS
Compared to the normal weight group, the underweight group had a higher risk of pADD (hazard ratio [HR]: 1.89, 95% confidence interval [CI]: 1.07-3.37) while the obese group had a lower risk (HR: 0.70, 95% CI: 0.49-0.999). After controllingfor baseline BMI status, the decreased BMI (HR: 2.29, 95% CI: 1.41-3.72) and increased BMI (HR: 3.96, 95% CI: 2.62-6.00) groups were at increased risk of progression to pADD.


CONCLUSIONS
Our findings suggested that underweight at baseline was associated with a higher risk of progression to pADD, while obesity at baseline predicted a lower risk. Furthermore, significant changes in BMI during the follow-up period reflected an increased risk of progression to pADD, regardless of BMI status at baseline.
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Byoung Seok
BS
Ye
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Eun Young
EY
Jang
Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Seong Yoon
SY
Kim
Department of Neurology, Pusan National University School of Medicine, Pusan, Korea.
Eun-Joo
EJ
Kim
Department of Neurology, Soonchunhyang University College of Medicine, Bucheon, Korea.
Sun Ah
SA
Park
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
Yunhwan
Y
Lee
Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea.
Chang Hyung
CH
Hong
Department of Neurology, Inha University School of Medicine, Incheon, Korea.
Seong Hye
SH
Choi
Department of Neurology, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, Korea.
Bora
B
Yoon
Department of Neurology, Eulji University College of Medicine, Daejeon, Korea.
Soo Jin
SJ
Yoon
Department of Neurology, Bobath Memorial Hospital, Seongnam, Korea.
Hae Ri
HR
Na
Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Jae-Hong
JH
Lee
Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea.
Jee H
JH
Jeong
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hee Jin
HJ
Kim
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Duk L
DL
Na
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.|Neuroscience Center, Samsung Medical Center.|Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University.
Sang Won
SW
Seo
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology*; D000704:Analysis of Variance; D015992:Body Mass Index; D001835:Body Weight; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D003704:Dementia / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D012042:Registries
Alzheimer’s disease; amnestic mild cognitive impairment; body mass index; dementia; progression