Abstract
This study aimed to examine the associations of body mass index (BMI) across adult life with cognitive function in 2,637 participants aged 60 years or over from NHANES 2011-2014. The primary outcome was a composite score based on test scores on word list learning, animal naming, and digit symbol substitution. Exposures of interest included BMI at age 25, BMI 10 years before the survey, BMI at the survey (current BMI), and BMI burden calculated from age 25 to age at survey. BMI at age 25 was inversely associated with the composite score (β=-0.0271±0.0130 per kg/m2, P=0.038) and positively with low cognitive performance (odd ratio=1.04, 95% confidence interval: 1.01-1.07, P=0.010), defined as below 20 percentile of the composite score. Similar results were observed for BMI 10 years before the survey and BMI burden. Current BMI was positively associated with the composite score (β=0.0369±0.0113, P=0.001) and inversely associated with low cognitive performance (odd ratio=0.96, 95% confidence interval: 0.94-0.99, P=0.004). In conclusion, high BMI in early adult life is associated with low cognitive function in late life, which underscores the importance of a healthy body weight across the life course. The association between BMI and cognitive function at late life requires further investigation.
Highlights
As world populations are rapidly aging, healthy aging has become a public health priority [1, 2]
We aimed to examine the associations between body mass index (BMI) at different periods in adult life with cognitive function in late life among adults aged 60 or older from the National Health and Nutrition Examination Surveys (NHANES) 2011-2014
BMI at age 25, BMI 10 years before the survey, and BMI burden were inversely associated with cognitive function, whereas current BMI was positively associated with cognitive function (Supplementary Table 2)
Summary
As world populations are rapidly aging, healthy aging has become a public health priority [1, 2]. While older adults typically experience declines in cognitive functioning, adults over the age of 65 may experience cognitive impairments that compromise daily functions and undermine quality of life. Many factors, including but not limited to, age, race, education, adverse environments, unhealthy lifestyle (smoking and excessive drinking), early life exposure to cardiometabolic risk factors, including obesity, and chronic conditions, contribute to an accelerated decline in cognitive function in later life [2, 4, 5]. Some studies support an inverse association between different www.aging-us.com obesity measures and cognitive function in young and middle-aged adults [6, 7], including individuals with normal weight obesity [8], while others support a positive association between BMI and cognitive function among older adults [9,10,11,12]. The Baltimore Longitudinal Study of Aging reported that obesity is associated with poorer performance in a variety of cognitive domains but enhanced performance on tests of attention and visuospatial ability [13]
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