title: Weight Trajectory over 20 Years and Likelihood of Mild Cognitive Impairment or Dementia Among Older Women.
abstract: OBJECTIVE
  The association between weight change and cognition is controversial. We examined the association between 20-year weight change and cognitive function in late life.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Study of Osteoporotic Fractures (SOF).
  
  
  METHODS
  One thousand two hundred eighty-nine older, community-dwelling women (mean baseline age 68 (65-81) and 88 (82-102) at cognitive testing).
  
  
  METHODS
  Study of Osteoporotic Fractures participants had body weight measured repeatedly over 20 years (mean 8 weights). Adjudicated cognitive status was classified as normal (n = 775) or mild cognitive impairment (MCI)/dementia (n = 514) at Year 20. Logistic models were used to evaluate whether absolute weight change, rate of weight loss per year, presence of abrupt, unrecovered weight loss, and weight variability were associated with MCI or dementia.
  
  
  RESULTS
  Women with greater rate of weight loss over 20 years had increased chance of developing MCI or dementia. In age/education/clinic-adjusted "base" models, each 0.5 kg/yr decrease resulted in 30% increased odds of MCI/dementia (OR = 1.30 [95% CI: 1.14, 1.49]). After adjustment for age, education, clinic, depression, and walking speed, there was 17% (OR = 1.17 [95% CI: 1.02, 1.35]) increased odds of MCI/dementia for each 0.5 kg/yr decrease in weight. In base models, variability in weight was significant. Each 1% average deviation from each woman's predicted weight curve was associated with 11% increased odds of MCI/dementia (OR = 1.11 [95% CI: 1.04, 1.18]). The estimate was attenuated after full adjustment (OR = 1.06 [95% CI: 0.99, 1.14]). The presence of an abrupt weight decline was not associated with MCI/dementia.
  
  
  CONCLUSIONS
  Rate of weight loss over 20 years was associated with development of MCI or dementia in women surviving past 80 years, suggesting that nutritional status, social-environmental factors, and/or adipose tissue function and structure may affect cognitive function with aging.
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
authors.forename: Erin S
authors.initials: ES
authors.lastname: LeBlanc
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
authors.forename: Joanne H
authors.initials: JH
authors.lastname: Rizzo
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Pedula
authors.affiliation: Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California San Francisco School of Medicine and San Francisco VA Medical Center, San Francisco, California.
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.affiliation: Department of Medicine, University of Minnesota, University of Epidemiology & Community Health, Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Jane
authors.initials: J
authors.lastname: Cauley
authors.affiliation: Research Institute, California Pacific Medical Center, San Francisco, California.
authors.forename: Peggy M
authors.initials: PM
authors.lastname: Cawthon
authors.affiliation: Research Institute, California Pacific Medical Center, San Francisco, California.
authors.forename: Steven
authors.initials: S
authors.lastname: Cummings
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.|Center for Health Research, Kaiser Permanente Hawaii, Honolulu, Hawaii.
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Hillier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D015331:Cohort Studies; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D009483:Neuropsychological Tests; D014481:United States / Q000453:epidemiology; D015431:Weight Loss
keywords: cognitive dysfunction; dementia; weight trajectory