title: Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging.
abstract: Unintentional weight loss has been associated with risk of dementia. Because mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI.
  
  
  
  To investigate the association of change in weight and BMI with risk of MCI.
  
  
  
  A population-based, prospective study of participants 70 years of age or older from the Mayo Clinic Study of Aging, which was initiated on October 1, 2004. Maximum weight and height in midlife (40-65 years of age) were retrospectively ascertained from the medical records of participants using a medical records-linkage system. The statistical analyses were performed between January and November 2015.
  
  
  
  Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and BMI with risk of MCI was investigated using proportional hazards models.
  
  
  
  Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI (50.3% were men; mean age, 78.5 years). The mean (SD) rate of weight change per decade from midlife to study entry was greater for participants who developed incident MCI vs those who remained cognitively normal (-2.0 [5.1] vs -1.2 [4.9] kg; P = .006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR], 1.04 [95% CI, 1.02-1.06]; P < .001) after adjusting for sex, education, and apolipoprotein E (APOE) ε4 allele. A weight loss of 5 kg per decade corresponds to a 24% increase in risk of MCI (HR, 1.24). A higher decrease in BMI per decade was also associated with incident MCI (HR, 1.08 [95% CI, 1.03-1.13]; P = .003).
  
  
  
  These findings suggest that increasing weight loss per decade from midlife to late life is a marker for MCI and may help identify persons at increased risk for MCI.
authors.affiliation: Mayo Clinic Graduate School of Medicine, Rochester, Minnesota2Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Rabe E
authors.initials: RE
authors.lastname: Alhurani
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Maria
authors.initials: M
authors.lastname: Vassilaki
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jeremiah A
authors.initials: JA
authors.lastname: Aakre
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota3Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Mielke
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Walter K
authors.initials: WK
authors.lastname: Kremers
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Machulda
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota6Departments of Psychiatry and Psychology and of Neurology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Yonas E
authors.initials: YE
authors.lastname: Geda
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: David S
authors.initials: DS
authors.lastname: Knopman
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota3Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Petersen
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota3Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Rosebud O
authors.initials: RO
authors.lastname: Roberts
mesh_terms: D000046:Academic Medical Centers / Q000639:trends*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology / Q000502:physiology / Q000523:psychology*; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D015431:Weight Loss / Q000502:physiology
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