Abstract
To examine the association of baseline body mass index (BMI) and BMI change with cognitive impairment among older adults in China. The study included data from the Chinese Longitudinal Healthy Longevity Study, a national community-based prospective cohort study from 2002 to 2018. Baseline BMI and BMI change were available for 12,027 adults aged older than 65years. Cognitive impairment was defined as Chinese version of the Mini Mental State Examination score lower than 18. Multivariable Cox proportional hazard model was used.Among 12,027 participants (mean age was 81.23years old and 47.48% were male), the proportion of underweight, normal, overweight and obese at baseline was 33.87%, 51.39%, 11.39% and 3.34%, respectively. During an average of 5.9years' follow-up, 3086 participants (4.35 per 100 person-years) with incident cognitive impairment were identified. Compared with normal weight group, adjusted hazard ratio (AHR) for cognitive impairment was 0.86 (95% CI 0.75-0.99) among overweight group, whereas corresponding AHR was 1.02 (95% CI 0.94-1.10) in underweight and 1.01 (95% CI 0.80-1.28) in obese participants. Large weight loss (< -10%) was significantly associated with an increased risk of cognitive impairment (AHR, 1.42, 95% CI 1.29-1.56), compared to stable weight status group (-5% ~ 5%). In the restricted cubic spline models, BMI change showed a reverse J-shaped association with cognitive impairment.BMI-defined overweight, but not obesity, was associated with a lower risk of cognitive impairment among elderly Chinese adults, while large weight loss was associated with an increased risk. These findings are consistent with weight loss in the prodromal phase of dementia.
Highlights
With the rapid growing of elderly population, cognitive impairment and dementia have become a major public health concern worldwide, in China[1]
Compared with normal weight group, adjusted hazard ratio (AHR) for cognitive impairment was 0.86 among overweight group, whereas corresponding AHR was 1.02 in underweight and 1.01 in obese
Large weight loss (
Summary
With the rapid growing of elderly population, cognitive impairment and dementia have become a major public health concern worldwide, in China[1]. Epidemiological studies estimated the prevalence of mild cognitive impairment as 15.5% among Chinese elderly over 60 years old, representing approximately 38 million cases[2]. There is limited effective therapy on dementia, the critical prognosis of cognitive impairment. It is critically important to identify the potential risk factors associated with cognitive impairment, modifiable risk factors, to prevent or delay cognitive impairment effectively. Limited studies have adopted prospective methods on this topic among Chinese elderly population, despite some cross-sectional studies[6, 8]. The association between BMI status and cognitive impairment has not been thoroughly evaluated among a national cohort of Chinese older adults
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