Intended for healthcare professionals


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

BMJ 2005; 330 doi: (Published 09 June 2005) Cite this as: BMJ 2005;330:1360
  1. Rachel A Whitmer (raw{at}, gerontological epidemiologist1,
  2. Erica P Gunderson, obesity epidemiologist1,
  3. Elizabeth Barrett-Connor, professor2,
  4. Charles P Quesenberry Jr, senior biostatistician1,
  5. Kristine Yaffe, associate professor3
  1. 1 Division of Research, Kaiser Permanente, Oakland, CA 94612, USA,
  2. 2 Department of Epidemiology, University of California, La Jolla, CA, USA,
  3. 3 Department of Psychiatry, University of California, San Francisco, CA, USA
  1. Correspondence to: R A Whitmer
  • Accepted 31 March 2005


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 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 future dementia independently of comorbid conditions.


  • Contributors RAW was responsible for study design and analysis and drafted the paper and is guarantor. EPG, EB-C, and KY revised the paper for intellectual content and design. CPQ revised the paper for intellectual content, statistical design, and analyses.

  • Funding UCSF-Kaiser Building Interdisciplinary Research Careers in Women's Health Scholarship (5 K12AR47659) from the National Institutes of Health, Office of Women's Health.

  • Competing interests None declared.

  • Ethical approval The study was approved by the internal review board of the Kaiser Permanente Medical Foundation.

View Full Text