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Abstract
Objective: To examine the association of body mass index (BMI) and metabolic status with cognitive function and decline.
Methods: A total of 6,401 adults (71.2% men), aged 39–63 years in 1991–1993, provided data on BMI (normal weight 18.5–24.9 kg/m2, overweight 25–29.9 kg/m2; and obese ≥30 kg/m2) and metabolic status (abnormality defined as 2 or more of 1) triglycerides ≥1.69 mmol/L or lipid-lowering drugs, 2) systolic blood pressure ≥130 mm Hg, diastolic blood pressure ≥85 mm Hg, or antihypertensive drugs, 3) glucose ≥5.6 mmol/L or medications for diabetes, and 4) high-density lipoprotein cholesterol <1.04 mmol/L for men and <1.29 mmol/L for women). Four cognitive tests (memory, reasoning, semantic, and phonemic fluency) were administered in 1997–1999, 2002–2004, and 2007–2009, standardized to z scores, and averaged to yield a global score.
Results: Of the participants, 31.0% had metabolic abnormalities, 52.7% were normal weight, 38.2% were overweight, and 9.1% were obese. Among the obese, the global cognitive score at baseline (p = 0.82) and decline (p = 0.19) over 10 years was similar in the metabolically normal and abnormal groups. In the metabolically normal group, the 10-year decline in the global cognitive score was similar (p for trend = 0.36) in the normal weight (−0.40; 95% confidence interval [CI] −0.42 to −0.38), overweight (−0.42; 95% CI −0.45 to −0.39), and obese (−0.42; 95% CI −0.50 to −0.34) groups. However, in the metabolically abnormal group, the decline on the global score was faster among obese (−0.49; 95% CI −0.55 to −0.42) than among normal weight individuals (−0.42; 95% CI −0.50 to −0.34), (p = 0.03).
Conclusions: In these analyses the fastest cognitive decline was observed in those with both obesity and metabolic abnormality.
GLOSSARY
- BMI=
- body mass index;
- HDL=
- high-density lipoprotein;
- MHO=
- metabolically healthy obesity
Footnotes
Study funding: Supported by the NIH (R01-AG013196, R01-AG034454, and R01-HL036310), Academy of Finland, the BUPA Foundation, UK, and the Medical Research Council, UK (G0902037).
Supplemental data at www.neurology.org
- Received December 20, 2011.
- Accepted April 10, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
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