Weight Trajectory over 20 Years and Likelihood of Mild Cognitive Impairment or Dementia Among Older Women

the Study of Osteoporotic Fractures (SOF) Research Group

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7 Scopus citations

Abstract

Objectives: The association between weight change and cognition is controversial. We examined the association between 20-year weight change and cognitive function in late life. Design: Cohort study. Setting: Study of Osteoporotic Fractures (SOF). Participants: One thousand two hundred eighty-nine older, community-dwelling women (mean baseline age 68 (65–81) and 88 (82–102) at cognitive testing). Measurements: Study of Osteoporotic Fractures participants had body weight measured repeatedly over 20 years (mean 8 weights). Adjudicated cognitive status was classified as normal (n = 775) or mild cognitive impairment (MCI)/dementia (n = 514) at Year 20. Logistic models were used to evaluate whether absolute weight change, rate of weight loss per year, presence of abrupt, unrecovered weight loss, and weight variability were associated with MCI or dementia. Results: Women with greater rate of weight loss over 20 years had increased chance of developing MCI or dementia. In age/education/clinic-adjusted “base” models, each 0.5 kg/yr decrease resulted in 30% increased odds of MCI/dementia (OR = 1.30 [95% CI: 1.14, 1.49]). After adjustment for age, education, clinic, depression, and walking speed, there was 17% (OR = 1.17 [95% CI: 1.02, 1.35]) increased odds of MCI/dementia for each 0.5 kg/yr decrease in weight. In base models, variability in weight was significant. Each 1% average deviation from each woman's predicted weight curve was associated with 11% increased odds of MCI/dementia (OR = 1.11 [95% CI: 1.04, 1.18]). The estimate was attenuated after full adjustment (OR = 1.06 [95% CI: 0.99, 1.14]). The presence of an abrupt weight decline was not associated with MCI/dementia. Conclusions: Rate of weight loss over 20 years was associated with development of MCI or dementia in women surviving past 80 years, suggesting that nutritional status, social-environmental factors, and/or adipose tissue function and structure may affect cognitive function with aging.

Original languageEnglish (US)
Pages (from-to)511-519
Number of pages9
JournalJournal of the American Geriatrics Society
Volume65
Issue number3
DOIs
StatePublished - Mar 1 2017

Bibliographical note

Funding Information:
We thank Amie M. Weitz of the Kaiser Permanente Center for Health Research for help with manuscript preparation. We thank Katherine K. Essick of the Kaiser Permanente Center for Health Research for editorial assistance. Conflict of Interest: Dr. LeBlanc's institute has received research funding from Amgen, Astrazeneca, and Bristol Meyers Squibb for unrelated projects on which she was investigator. The Study of Osteoporotic Fractures (SOF) is supported by the National Institutes of Health. The National Institute on Aging (NIA) provides support under the following grant numbers: R01 ag005407, R01 ar35582, R01 ar35583, R01 ar35584, R01 ag005394, R01 ag027574, and R01 ag027576. Author Contributions: LeBlanc: conception and design and interpretation of data; drafting the article and revising it for important intellectual content; and final approval of the version to be published. Rizzo and Pedula: acquisition of data and analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; and final approval of the version to be published. Yaffe: conception and design and acquisition of data and interpretation of data; revising article for important intellectual content; and final approval of the version to be published. Ensrund, Cauley, and Hillier: conception and design and interpretation of data; revising article for important intellectual content; and final approval of the version to be published. Cawthon and Cummings: interpretation of data; revising article critically for important intellectual content; and final approval of the version to be published. Sponsor's Role: The sponsor played no role in the design, methods, subject recruitment, data collections, analysis, or preparation of the paper.

Publisher Copyright:
© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society

Keywords

  • cognitive dysfunction
  • dementia
  • weight trajectory

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