BMJ, doi: 10.1136/bmj.38446.466238.E0, (Published 29 April 2005)

PAPERS

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

Rachel A Whitmer 1, Erica P Gunderson 1, Elizabeth Barrett-Connor 2, Charles P Quesenberry Jr1, Kristine Yaffe 3

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

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

Design Analysis of prospective data from a multiethnic population based cohort.

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

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

Main outcome measures Diagnosis of dementia from January 1994 to April 2003. Time to diagnosis was analysed with Cox proportional hazard 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. Obese people (body mass index ≥30) had a 74% increased risk of dementia (hazard ratio 1.74, 95% confidence interval 1.34 to 2.26), while overweight people (body mass index 25.0-29.9) had a 35% greater risk of dementia (1.35, 1.14 to 1.60) compared with those of normal weight (body mass index 18.6-24.9). Compared with those in the lowest fifth, men and women in the highest fifth of the distribution of subscapular or tricep skinfold thickness had a 72% and 60% 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 future dementia independently of comorbid conditions.


(Accepted 31 March 2005)

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

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Rapid Responses:

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