Increasing weight loss per decade as people age from midlife to late life was associated with an increased risk of mild cognitive impairment (MCI), according to an article published online by JAMA Neurology.
MCI is a prodromal (early) stage of dementia with about 5 percent to 15 percent of people with MCI progressing to dementia per year. Changes in body mass index (BMI) and weight are associated with increased risk of dementia but overall study findings have been inconclusive. An association of declining weight and BMI with MCI could have implications for preventive strategies for MCI.
Rosebud O. Roberts, M.B., Ch.B., of the Mayo Clinic, Rochester, Minn., and coauthors studied participants 70 or older from the Mayo Clinic Study of Aging, which started in 2004. Height and weight in midlife (40 to 65 years old) were collected from medical records.
During an average of 4.4 years of follow-up, the authors identified 524 of 1,895 cognitively normal participants who developed MCI (about 50 percent were men and their average age was 78.5 years). Those who developed MCI were older, more likely to be carriers of the APOE*E4 allele and more likely to have diabetes, hypertension, stroke or coronary artery disease compared with study participants who remained cognitively normal.
Participants who developed MCI had a greater average weight change per decade from midlife than those who remained cognitively normal (-4.4 lbs vs. -2.6 lbs). A greater decline in weight per decade was associated with an increased risk of incident MCI, with a weight loss of 11 pounds per decade corresponding to a 24 percent increased risk of MCI, according to the results.
The authors note it was not possible to determine whether weight loss was intentional or unintentional.
“In summary, our findings suggest that an increasing rate of weight loss from midlife to late life is a marker for MCI and may help identify persons at increased risk of MCI,” the study concludes.
Source: Susan Barber Lindquist – JAMA Network
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Original Research: Abstract for “Decline in Weight and Incident Mild Cognitive Impairment” by Rabe E. Alhurani, MBBS; Maria Vassilaki, MD, PhD; Jeremiah A. Aakre, MPH; Michelle M. Mielke, PhD; Walter K. Kremers, PhD; Mary M. Machulda, PhD; Yonas E. Geda, MD, MSc; David S. Knopman, MD; Ronald C. Peterson, MD, PhD; and Rosebud O. Roberts, MB, ChB in JAMA Neurology. Published online February 1 2016 doi:10.1001/jamaneurol.2015.4756
Decline in Weight and Incident Mild Cognitive Impairment
Importance Unintentional weight loss has been associated with risk of dementia. Because mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI.
Objective To investigate the association of change in weight and BMI with risk of MCI.
Design, Setting, and Participants A population-based, prospective study of participants 70 years of age or older from the Mayo Clinic Study of Aging, which was initiated on October 1, 2004. Maximum weight and height in midlife (40-65 years of age) were retrospectively ascertained from the medical records of participants using a medical records–linkage system. The statistical analyses were performed between January and November 2015.
Main Outcomes and Measures Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and BMI with risk of MCI was investigated using proportional hazards models.
Results Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI (50.3% were men; mean age, 78.5 years). The mean (SD) rate of weight change per decade from midlife to study entry was greater for participants who developed incident MCI vs those who remained cognitively normal (−2.0 [5.1] vs −1.2 [4.9] kg; P = .006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR], 1.04 [95% CI, 1.02-1.06]; P < .001) after adjusting for sex, education, and apolipoprotein E (APOE) ε4 allele. A weight loss of 5 kg per decade corresponds to a 24% increase in risk of MCI (HR, 1.24). A higher decrease in BMI per decade was also associated with incident MCI (HR, 1.08 [95% CI, 1.03-1.13]; P = .003).
Conclusions and Relevance These findings suggest that increasing weight loss per decade from midlife to late life is a marker for MCI and may help identify persons at increased risk for MCI.
“Decline in Weight and Incident Mild Cognitive Impairment” by Rabe E. Alhurani, MBBS; Maria Vassilaki, MD, PhD; Jeremiah A. Aakre, MPH; Michelle M. Mielke, PhD; Walter K. Kremers, PhD; Mary M. Machulda, PhD; Yonas E. Geda, MD, MSc; David S. Knopman, MD; Ronald C. Peterson, MD, PhD; and Rosebud O. Roberts, MB, ChB in JAMA Neurology. Published online February 1 2016 doi:10.1001/jamaneurol.2015.4756