Abstract

BackgroundBoth weight loss and cognitive impairment are common in late-life, but it remains unknown whether weight change is associated with risk of incident dementia among elderly Japanese. Our study aimed to investigate the association between long-term weight change since midlife and risk of incident disabling dementia using a community-based cohort study of elderly Japanese.MethodsIn 2006, we conducted a cohort study of 6,672 disability-free Japanese adults aged ≥65 years. In both 1994 and 2006, the participants reported their weight using a self-reported questionnaire. Based on weight obtained at these two time points, participants were classified into: stable weight (−1.4 to +1.4 kg), weight gain (≥+1.5 kg), and weight loss of −2.4 to −1.5 kg, −3.4 to −2.5 kg, −4.4 to −3.5 kg, −5.4 to −4.5 kg, and ≥−5.5 kg. Incident disabling dementia was retrieved from the public Long-term Care Insurance database. Participants were followed-up for 5.7 years (between April 2007 and November 2012). Cox proportional hazards model was used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident disabling dementia.ResultsDuring 32,865 person-years of follow-up, 564 participants were ascertained as having incident disabling dementia. Compared with stable weight, the multivariable-adjusted HRs were 0.97 (95% CI, 0.70–1.34) for weight loss of −2.4 to −1.5 kg, 0.98 (95% CI, 0.70–1.38) for −3.4 to −2.5 kg, 1.28 (95% CI, 0.91–1.81) for −4.4 to −3.5 kg, 1.27 (95% CI, 0.92–1.77) for −5.4 to −4.5 kg, and 1.64 (95% CI, 1.29–2.09) for ≥−5.5 kg.ConclusionOur study suggested that a ≥−3.5 kg weight loss over 12 years might be associated with higher risk of incident disabling dementia among elderly Japanese.

Highlights

  • The number of people living with dementia is rising rapidly worldwide, estimated at 47 million in 2015 and projected to triple by 2050.1 the incidence rate of dementia has been reported to have declined in Europe and North America,[2] it is still increasing in most countries worldwide.[1]

  • One study suggested that a weight loss of ≤−7.5 kg over 30 years was significantly associated with risk of death from dementia,[7] whereas others reported a >5%

  • During 32,865 person-years of follow-up, among 6,672 participants, 564 (8.5%) participants were ascertained as having incident disabling dementia

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Summary

Introduction

The number of people living with dementia is rising rapidly worldwide, estimated at 47 million in 2015 and projected to triple by 2050.1 the incidence rate of dementia has been reported to have declined in Europe and North America,[2] it is still increasing in most countries worldwide.[1]. One study suggested that a weight loss of ≤−7.5 kg over 30 years was significantly associated with risk of death from dementia,[7] whereas others reported a >5%. Both weight loss and cognitive impairment are common in late-life, but it remains unknown whether weight change is associated with risk of incident dementia among elderly Japanese.

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