title: Body Mass Index Predicts Progression of Mild Cognitive Impairment to Dementia.
abstract: To examine the relationship between body mass index (BMI) and progression to dementia and Alzheimer's disease (AD) in mild cognitive impairment (MCI).
  
  
  
  Two hundred and twenty-eight MCI subjects (mean age 74.04 ± 6.94 years; 57% female) from a memory clinic were followed for 2.40 ± 1.58 years. Baseline height and weight were used to calculate the BMI. The main outcome was progression to dementia (DSM-IV criteria) and AD (NINCDS-ADRDA criteria). Cox proportional hazard models were used to assess the longitudinal association of BMI with dementia and AD, adjusting for a comprehensive set of covariates, including vascular risk factors/diseases and neuroimaging profiles.
  
  
  
  Out of 228 subjects with MCI, 117 (51.3%) progressed to dementia. Eighty-nine (76%) of the incident dementia cases had AD. In both unadjusted and multi-adjusted models, a higher BMI was associated with a reduced risk of dementia (multi-adjusted HR 0.9; 95% CI 0.8-0.9) and AD (multi-adjusted HR 0.9; 95% CI 0.8-0.9). Being underweight increased the risk of all types of dementia (multi-adjusted HR 2.5; 95% CI 1.2-5.1) but was not specifically associated with AD (multi-adjusted HR 2.2; 95% CI 0.9-5.3).
  
  
  
  BMI predicted progression of MCI to dementia and AD. In particular, a higher BMI was associated with a lower risk of dementia and AD, and underweight was associated with a higher risk of dementia. BMI assessment may improve the prognostic accuracy of MCI in clinical practice.
authors.affiliation: Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, x2018;Luigi Sacco' Hospital, University of Milan, Milan, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Cova
authors.forename: Francesca
authors.initials: F
authors.lastname: Clerici
authors.forename: Laura
authors.initials: L
authors.lastname: Maggiore
authors.forename: Simone
authors.initials: S
authors.lastname: Pomati
authors.forename: Valentina
authors.initials: V
authors.lastname: Cucumo
authors.forename: Roberta
authors.initials: R
authors.lastname: Ghiretti
authors.forename: Daniela
authors.initials: D
authors.lastname: Galimberti
authors.forename: Elio
authors.initials: E
authors.lastname: Scarpini
authors.forename: Claudio
authors.initials: C
authors.lastname: Mariani
authors.forename: Barbara
authors.initials: B
authors.lastname: Caracciolo
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology*; D015992:Body Mass Index; D060825:Cognitive Dysfunction / Q000150:complications* / Q000523:psychology; D003704:Dementia / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models