Abstract
BackgroundMidlife body weight status has been found to affect late life dementia outcomes. A cohort projections model was developed to assess the impact of midlife body mass index (BMI) profile on dementia in older Australians.MethodsA baseline projection using age-sex specific dementia prevalence rates was constructed and the results of scenarios that took account of midlife BMI were compared with those from population ageing only.ResultsThis modelling predicts that if the rising trend in midlife obesity and declining trend in midlife normal weight in Australia are to be taken into account in projecting future numbers of Australians with dementia then the number of people aged 65 or more years with dementia, by 2050, would be 14% higher than that expected from demographic ageing only. If midlife obesity prevalence was decreased to 20% and normal weight increased to 40% over the period of 2015–2025, then dementia cases among persons aged 65–69 years would be lower by about 10% in 2050 compared with the “doing nothing to stop current trends in obesity” projection.ConclusionThe rising tide of obesity in Australian adults will increase the dementia epidemic expected in future years.
Highlights
The modelling began with estimating dementia prevalence by age, sex and midlife body mass index (BMI) status using information on age-sex specific dementia prevalence and prevalence ratios associated with four BMI groups: underweight, normal weight, overweight and obesity
Column 1 shows the numbers of older persons who would be living with dementia according to the ageing-only scenario and as expected these numbers are vastly different depending on the prevalence rates chosen
If the rising trend in midlife obesity and declining trend in midlife normal weight were to be taken into account, by 2050, the number of people with dementia would be 14% higher than that expected purely from demographic ageing
Summary
Columns 2 to 7 compare the outcomes of three BMI-factored scenarios against the ageing-only scenario. Modifying the midlife BMI profile from 2015 would begin to show some impact from 2035. The impact can barely be noticed when the entire older population aged 65 years and over is considered because a large fraction of older people had already crossed their midlife when the intervention began (columns 4–7). Taking the 65–69 year age group as an example, the impact of modifying midlife BMI profile becomes apparent in individuals of this age after 2035 (Figure 1). Compared with Scenario 1 (ageingonly), Scenario 2 (BMI factored baseline) would produce 8–9% more prevalent cases of dementia, and Scenario 3 (BMI stabilised at 2015 level) would produce 6% more cases in people in their late 60s. Scenario 4 (BMI-improved) would reduce dementia prevalence cases close to the level expected from the ageing-only scenario. Compared with Scenario 2 (doing nothing to the prevailing obesity trend), Scenario 4 intervention
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