Central obesity and increased risk of dementia more than three decades later
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Abstract
Background: Numerous reports show that a centralized distribution of adiposity is a more dangerous risk factor for cardiovascular disease and diabetes than total body obesity. No studies have evaluated whether the same pattern exists with dementia. The objective was to evaluate the association between midlife central obesity and risk of dementia three decades later.
Methods: A longitudinal analysis was conducted of 6,583 members of Kaiser Permanente of Northern California who had their sagittal abdominal diameter (SAD) measured in 1964 to 1973. Diagnoses of dementia were from medical records an average of 36 years later, January 1, 1994, to June 16, 2006. Cox proportional hazard models adjusted for age, sex, race, education, marital status, diabetes, hypertension, hyperlipidemia, stroke, heart disease, and medical utilization were conducted.
Results: A total of 1,049 participants (15.9%) were diagnosed with dementia. Compared with those in the lowest quintile of SAD, those in the highest had nearly a threefold increased risk of dementia (hazard ratio, 2.72; 95% CI, 2.33–3.33), and this was only mildly attenuated after adding body mass index (BMI) to the model (hazard ratio, 1.92; 95% CI, 1.58–2.35). Those with high SAD (>25 cm) and normal BMI had an increased risk (hazard ratio, 1.89; 95% CI, 0.98–3.81) vs those with low SAD (<25 cm) and normal BMI (18.5–24.9 kg/m2), whereas those both obese (BMI >30 kg/m2) and with high SAD had the highest risk of dementia (HR, 3.60; 95% CI, 2.85–4.55).
Conclusions: Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. Fifty percent of adults have central obesity; therefore, mechanisms linking central obesity to dementia need to be unveiled.
Glossary
- AD=
- Alzheimer disease;
- BMI=
- body mass index;
- KP=
- Kaiser Permanente;
- MHC=
- Multiphasic Health Checkups;
- SAD=
- sagittal abdominal diameter.
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Letters: Rapid online correspondence
- Central obesity and increased risk of dementia more than three decades later
- Emanuele Cereda, International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Italy., via Botticelli 21, 20133 Milan, Italyemanuele.cereda@virgilio.it
- Manuela Chiara Sacchi (Division of Clinical Nutrition, Niguarda Ca Granda Hospital, Milan, Italy) Alexis Elias Malavazos (Endocrinology Unit, Department of Medical and Surgical Sciences, University of Milan, IRCCS Policlinico San Donato, Milan, Italy)
Submitted June 26, 2008 - Central obesity and increased risk of dementia more than three decades later
- Azeez Farooki, Memorial Sloan Kettering Cancer Center, 1275 York Ave Box 296, New York, NY 10065farookia@mskcc.org
Submitted June 26, 2008 - Central obesity and increased risk of dementia more than three decades later
- Nikolaos Tezapsidis, Neurotez, Inc., 991 Highway 22, Suite 200A, Bridgewater, NJ 08807ntezapsidis@neurotez.com
- Mark A. Smith (Case Western Reserve University), J. Wes Ashford (Stanford University)
Submitted June 26, 2008 - Reply from the authors
- Rachael A. Whitmer, Kaiser Permanente Division of Research, Oakland, CARachel.Whitmer@nsmtp.kp.org
- D. R. Gustafson, E. Barrett-Connor, M. N. Haan, E. P. Gunderson, and K. Yaffe
Submitted June 26, 2008
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