Predictive value of BMI in Cognitive Outcome in Mild Cognitive Impairment

Abstract

AbstractBackgroundThis study aimed to determine the association between neuropsychological performance and body mass index (BMI) in patients with mild cognitive impairment (MCI). In addition, this study investigated the effects of the APOE genotype and sex in the relationship between the BMI and cognition in MCI.MethodsA total of 3,038 subjects with MCI aged 65‐90 were enrolled from the Clinical Research Center for Dementia of South Korea (CREDOS) cohort and a dementia cohort of the Ewha Womans University Mokdong Hospital (EUMC). MCI patients were classified into three subgroups (normal‐weight, overweight and obesity) according to the Asian standard of BMI. Cognitive performances between groups were compared by one way analysis of variance. To investigate the effects of the age, education, APOE genotype and sex, multivariate linear regression models after adjusting for possible confounders were used.ResultsEven‐though normal BMI groups were younger, had more males and less comorbidities, higher BMI groups (Overweigh and Obese) were associated with better performance in cognitive functions, scores of all neurocognitive tests were significantly increased (RCFT copy, p = 0.047; animal fluency, p = 0.039; phonemic fluency, p = 0.013; SVLT delay recall, p = 0.005; RCFT delay recall, K‐MMSE, p = 0.001; K‐BNT and Stroop test, p<0.001), and CDR‐SB (p = 0.001) was decreased. The APOE ε4 carriers showed positive relationship between the BMI and the memory tasks: SVLT delay recall (p = 0.017) and RCFT delay recall (p = 0.002). And comparing between APOE ε4 carrier gender groups, significant positive relationship was shown only with visual memory task as BMI increases.ConclusionsOur findings suggested that higher BMI in patients with MCI were associated with better cognitive performance. The effects of the APOE genotype and sex in the associations between BMI and cognition were distinguishing. Therefore, according to physical status, APOE ε4 genotype, and sex‐specific strategies in the assessments and treatments may be necessary in elderly patients with MCI.