Weight loss, visit-to-visit body weight variability and cognitive function in a cohort of older people with or at risk of atherosclerotic cardiovascular disease

Abstract

Background and Aims : Unintentional weight loss and higher variability in body weight are associated with increased risk of cardiovascular outcomes. We examined whether this extends to cognitive function in a cohort of older people with or at increased risk of atherosclerotic cardiovascular disease.Methods: We studied 4,309 participants from the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) with either existing atherosclerosis or at higher risk thereof. Body weight was measured every three months for 2.5 years. Weight loss was defined as an average slope across all weight measurements and as ≥5% decrease in baseline body weight during follow-up. Visit-to-visit variability was defined as the SD of weight measurements (kg) between visits. Four tests of cognitive function were examined: Stroop test, Letter-Digit Coding test (LDCT), immediate and delayed Picture-Word learning tests. All tests were performed at month 30.Results: Both larger visit-to-visit body weight variation and loss of ≥5% of baseline weight were independently associated with worse scores on all cognitive tests. Compared to participants who maintained stable weight, participants with significant weight loss scored 5.87 seconds (95%CI 3.78; 7.96) slower on the Stroop test and coded 1.74 digits less (95%CI -2.33; -1.14) on the LDCT. Furthermore, participants with high variability in body weight performed 4.60 seconds (95%CI 2.60; 6.59) slower on the Stroop test and coded 1.97 digits less (95%CI -2.53; -1.41) on the LDCT.Conclusions: In older people with or at increased risk of atherosclerotic cardiovascular disease, higher variability and loss of body weight are independent risk-factors for worse cognitive function. Background and Aims : Unintentional weight loss and higher variability in body weight are associated with increased risk of cardiovascular outcomes. We examined whether this extends to cognitive function in a cohort of older people with or at increased risk of atherosclerotic cardiovascular disease. Methods: We studied 4,309 participants from the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) with either existing atherosclerosis or at higher risk thereof. Body weight was measured every three months for 2.5 years. Weight loss was defined as an average slope across all weight measurements and as ≥5% decrease in baseline body weight during follow-up. Visit-to-visit variability was defined as the SD of weight measurements (kg) between visits. Four tests of cognitive function were examined: Stroop test, Letter-Digit Coding test (LDCT), immediate and delayed Picture-Word learning tests. All tests were performed at month 30. Results: Both larger visit-to-visit body weight variation and loss of ≥5% of baseline weight were independently associated with worse scores on all cognitive tests. Compared to participants who maintained stable weight, participants with significant weight loss scored 5.87 seconds (95%CI 3.78; 7.96) slower on the Stroop test and coded 1.74 digits less (95%CI -2.33; -1.14) on the LDCT. Furthermore, participants with high variability in body weight performed 4.60 seconds (95%CI 2.60; 6.59) slower on the Stroop test and coded 1.97 digits less (95%CI -2.53; -1.41) on the LDCT. Conclusions: In older people with or at increased risk of atherosclerotic cardiovascular disease, higher variability and loss of body weight are independent risk-factors for worse cognitive function.