Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study

doi:10.1136/bmj.38446.466238.E0

BMJ 2005;330:1360 (11 June), doi:10.1136/bmj.38446.466238.E0 (published 29 April 2005)

Paper

Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study

Rachel A Whitmer, gerontological epidemiologist¹, Erica P Gunderson, obesity epidemiologist¹, Elizabeth Barrett-Connor, professor², Charles P Quesenberry, Jr, senior biostatistician¹, Kristine Yaffe, associate professor³

¹ Division of Research, Kaiser Permanente, Oakland, CA 94612, USA, ² Department of Epidemiology, University of California, La Jolla, CA, USA, ³ Department of Psychiatry, University of California, San Francisco, CA, USA

Correspondence to: R A Whitmer raw{at}dor.kaiser.org

Objective To evaluate any association between obesity in middleage, measured by body mass index and skinfold thickness, andrisk of dementia later in life.

Design Analysis of prospective data from a multiethnic populationbased cohort.

Setting Kaiser Permanente Northern California Medical Group,a healthcare delivery organisation.

Participants 10 276 men and women who underwent detailed healthevaluations from 1964 to 1973 when they were aged 40-45 andwho were still members of the health plan in 1994.

Main outcome measures Diagnosis of dementia from January 1994to April 2003. Time to diagnosis was analysed with Cox proportionalhazard models adjusted for age, sex, race, education, smoking,alcohol use, marital status, diabetes, hypertension, hyperlipidaemia,stroke, and ischaemic heart disease.

Results Dementia was diagnosed in 713 (6.9%) participants. Obesepeople (body mass index $≥$ 30) had a 74% increased risk of dementia(hazard ratio 1.74, 95% confidence interval 1.34 to 2.26), whileoverweight people (body mass index 25.0-29.9) had a 35% greaterrisk of dementia (1.35, 1.14 to 1.60) compared with those ofnormal weight (body mass index 18.6-24.9). Compared with thosein the lowest fifth, men and women in the highest fifth of thedistribution of subscapular or tricep skinfold thickness hada 72% and 59% greater risk of dementia, respectively (1.72,1.36 to 2.18, and 1.59, 1.24 to 2.04).

Conclusions Obesity in middle age increases the risk of futuredementia independently of comorbid conditions.

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to StumbleUpon StumbleUpon Add to Technorati Technorati What's this?

Find additional patient-related information at:

: Middle Age Obesity and the Risk of Dementia
: Shaping America\'s Health--Association for Weight Management and Obesity Prevention

Relevant Articles

Physical control and coordination in childhood and adult obesity: longitudinal birth cohort study: Walter Osika and Scott M Montgomery
BMJ 2008 337: a699. [Abstract] [Full Text] [PDF]

Obesity in middle age and future risk of dementia: Problem is probably greater for women: Alan J Goble
BMJ 2005 331: 454. [Extract] [Full Text]

Obesity in middle age and future risk of dementia: Dietary fat and sugar may hold the clue: Naji Tabet
BMJ 2005 331: 454-455. [Extract] [Full Text]

Obesity in middle age and future risk of dementia: Midlife obesity increases risk of future dementia: George Razay and Anthea Vreugdenhil
BMJ 2005 331: 455. [Extract] [Full Text]

Obesity increases the risk of dementia
BMJ 2005 330: 0. [Full Text]

Prognosis in obesity: M E J Lean
BMJ 2005 330: 1339-1340. [Extract] [Full Text] [PDF]

Adult socioeconomic, educational, social, and psychological outcomes of childhood obesity: a national birth cohort study: Russell M Viner and Tim J Cole
BMJ 2005 330: 1354. [Abstract] [Full Text] [PDF]

Early life risk factors for obesity in childhood: cohort study: John J Reilly, Julie Armstrong, Ahmad R Dorosty, Pauline M Emmett, A Ness, I Rogers, Colin Steer, Andrea Sherriff for the Avon Longitudinal Study of Parents and Children Study Team
BMJ 2005 330: 1357. [Abstract] [Full Text] [PDF]

Weight loss in people with Alzheimer's disease: a prospective population based analysis: Diane Cronin-Stubbs, Laurel A Beckett, Paul A Scherr, Terry S Field, Marilyn J Chown, David M Pilgrim, David A Bennett, and Denis A Evans
BMJ 1997 314: 178. [Extract] [Full Text]

This article has been cited by other articles:

Gustafson, D. R., Backman, K., Waern, M., Ostling, S., Guo, X., Zandi, P., Mielke, M. M., Bengtsson, C., Skoog, I. (2009). Adiposity indicators and dementia over 32 years in Sweden. Neurology 73: 1559-1566 [Abstract] [Full text]
Bennett, D. A., Whitmer, R. A. (2009). NSAID exposure and risk of Alzheimer disease: Is timing everything?. Neurology 72: 1884-1885 [Full text]
Whitmer, R. A., Karter, A. J., Yaffe, K., Quesenberry, C. P. Jr, Selby, J. V. (2009). Hypoglycemic Episodes and Risk of Dementia in Older Patients With Type 2 Diabetes Mellitus. JAMA 301: 1565-1572 [Abstract] [Full text]
Dahl, A., Hassing, L. B., Fransson, E., Berg, S., Gatz, M., Reynolds, C. A., Pedersen, N. L. (2009). Being Overweight in Midlife Is Associated With Lower Cognitive Ability and Steeper Cognitive Decline in Late Life. J Gerontol A Biol Sci Med Sci 0: glp035v1-glp035 [Abstract] [Full text]
Yaffe, K., Weston, A. L., Blackwell, T., Krueger, K. A. (2009). The Metabolic Syndrome and Development of Cognitive Impairment Among Older Women. Arch Neurol 66: 324-328 [Abstract] [Full text]
Kanaya, A. M., Lindquist, K., Harris, T. B., Launer, L., Rosano, C., Satterfield, S., Yaffe, K., for the Health ABC Study, (2009). Total and Regional Adiposity and Cognitive Change in Older Adults: The Health, Aging and Body Composition (ABC) Study. Arch Neurol 66: 329-335 [Abstract] [Full text]
Fitzpatrick, A. L., Kuller, L. H., Lopez, O. L., Diehr, P., O'Meara, E. S., Longstreth, W. T. Jr, Luchsinger, J. A. (2009). Midlife and Late-Life Obesity and the Risk of Dementia: Cardiovascular Health Study. Arch Neurol 66: 336-342 [Abstract] [Full text]
Sabia, S., Kivimaki, M., Shipley, M. J, Marmot, M. G, Singh-Manoux, A. (2009). Body mass index over the adult life course and cognition in late midlife: the Whitehall II Cohort Study. Am. J. Clin. Nutr. 89: 601-607 [Abstract] [Full text]
West, N. A., Haan, M. N. (2009). Body Adiposity in Late Life and Risk of Dementia or Cognitive Impairment in a Longitudinal Community-Based Study. J Gerontol A Biol Sci Med Sci 0: gln006v1-gln006 [Abstract] [Full text]
Beydoun, M. A., Lhotsky, A., Wang, Y., Forno, G. D., An, Y., Metter, E. J., Ferrucci, L., O'Brien, R., Zonderman, A. B. (2008). Association of Adiposity Status and Changes in Early to Mid-Adulthood With Incidence of Alzheimer's Disease. Am J Epidemiol 168: 1179-1189 [Abstract] [Full text]
Knopman, D. S. (2008). Go to the head of the class to avoid vascular dementia and skip diabetes and obesity. Neurology 71: 1046-1047 [Full text]
Whitmer, R. A., Gustafson, D. R., Barrett-Connor, E., Haan, M. N., Gunderson, E. P., Yaffe, K. (2008). Central obesity and increased risk of dementia more than three decades later. Neurology 71: 1057-1064 [Abstract] [Full text]
Osika, W., Montgomery, S. M (2008). Physical control and coordination in childhood and adult obesity: longitudinal birth cohort study. BMJ 337: a699-a699 [Abstract] [Full text]
Tsukuda, K., Mogi, M., Li, J.-M., Iwanami, J., Min, L.-J., Sakata, A., Fujita, T., Iwai, M., Horiuchi, M. (2008). Diabetes-Associated Cognitive Impairment Is Improved by a Calcium Channel Blocker, Nifedipine. Hypertension 51: 528-533 [Abstract] [Full text]
Berry, L. L., Parish, J. T., Janakiraman, R., Ogburn-Russell, L., Couchman, G. R., Rayburn, W. L., Grisel, J. (2008). Patients' Commitment to Their Primary Physician and Why It Matters. Ann Fam Med 6: 6-13 [Abstract] [Full text]
Tsukuda, K., Mogi, M., Li, J.-M., Iwanami, J., Min, L.-J., Sakata, A., Fujita, T., Iwai, M., Horiuchi, M. (2007). Amelioration of Cognitive Impairment in the Type-2 Diabetic Mouse by the Angiotensin II Type-1 Receptor Blocker Candesartan. Hypertension 50: 1099-1105 [Abstract] [Full text]
van den Berg, E., Biessels, G. J., de Craen, A. J.M, Gussekloo, J., Westendorp, R.G.J. (2007). The metabolic syndrome is associated with decelerated cognitive decline in the oldest old. Neurology 69: 979-985 [Abstract] [Full text]
Knopman, D. S., Edland, S. D., Cha, R. H., Petersen, R. C., Rocca, W. A. (2007). Incident dementia in women is preceded by weight loss by at least a decade. Neurology 69: 739-746 [Abstract] [Full text]
Luchsinger, J. A., Patel, B., Tang, M.-X., Schupf, N., Mayeux, R. (2007). Measures of Adiposity and Dementia Risk in Elderly Persons. Arch Neurol 64: 392-398 [Abstract] [Full text]
Gorospe, E. C., Dave, J. K. (2007). The risk of dementia with increased body mass index. Age Ageing 36: 23-29 [Abstract] [Full text]
Regan, C., Katona, C., Walker, Z., Hooper, J., Donovan, J., Livingston, G. (2006). Relationship of vascular risk to the progression of Alzheimer disease. Neurology 67: 1357-1362 [Abstract] [Full text]
Luchsinger, J. A. (2006). A Work in Progress: The Metabolic Syndrome. Sci Aging Knowl Environ 2006: pe19-pe19 [Abstract] [Full text]
Llorente, M. D., Urrutia, V. (2006). Diabetes, Psychiatric Disorders, and the Metabolic Effects of Antipsychotic Medications. Clin. Diabetes 24: 18-24 [Abstract] [Full text]
Muir, M. (2005). Hygieia. J. Epidemiol. Community Health 59: 1104-1104 [Full text]
Razay, G., Vreugdenhil, A. (2005). Obesity in middle age and future risk of dementia: Midlife obesity increases risk of future dementia. BMJ 331: 455-455 [Full text]
Goble, A. J (2005). Obesity in middle age and future risk of dementia: Problem is probably greater for women. BMJ 331: 454-454 [Full text]
Tabet, N. (2005). Obesity in middle age and future risk of dementia: Dietary fat and sugar may hold the clue. BMJ 331: 454-455 [Full text]
(2005). Middle-Age Obesity and Dementia. JWatch Psychiatry 2005: 12-12 [Full text]
(2005). Middle-Age Obesity and Dementia. JWatch General 2005: 6-6 [Full text]
Lean, M E J (2005). Prognosis in obesity. BMJ 330: 1339-1340 [Full text]

Rapid Responses:

Read all Rapid Responses

Common factor is loss of DHEA...: James M. Howard
bmj.com, 2 May 2005 [Full text]
Query: Brian S. Ferguson
bmj.com, 3 May 2005 [Full text]
Weight in middle age and risk of dementia: a mind-body connection?: Laura A. Coleman, et al.
bmj.com, 5 May 2005 [Full text]
A Problem For Women: Alan J Goble
bmj.com, 12 May 2005 [Full text]
Running from dementia: Celia M. Ross
bmj.com, 13 May 2005 [Full text]
Dementia risk after reduction in obesity: Morton Levine
bmj.com, 17 May 2005 [Full text]
Mid-life obesity and Alzheimer's disease: a case control study.: George Razay, et al.
bmj.com, 17 May 2005 [Full text]
Possibility of Depression?: julie A Hoster
bmj.com, 19 May 2005 [Full text]
Obesity, dementia and free radicals: Naji Tabet
bmj.com, 16 Jun 2005 [Full text]
Association between obesity and dementia may be spurious: Janneke N Belo, et al.
bmj.com, 30 Sep 2005 [Full text]
Re: Association between obesity and dementia may be spurious: Rachel A. Whitmer, et al.
bmj.com, 5 Oct 2005 [Full text]
Will dementia really increase by 400%?: Victor J. Schoenbach
bmj.com, 18 Mar 2007 [Full text]
There may be another common factor.: Nigel G Kinbrum
bmj.com, 30 Mar 2007 [Full text]
Re: A Problem For Women: Rachel Whitmer
bmj.com, 17 May 2008 [Full text]
Obesity and IGF/GH levels.: Edoardo Cervoni
bmj.com, 3 Jul 2008 [Full text]