Greater weight loss during aging associated with increased risk of mild cognitive impairment

An overview of the original research article and commentaries

1. Alhurani, R. et al. Decline in Weight and Incident Mild Cognitive Impairment. JAMA Neurology. Published online: February 01 2016.

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.

Read the original research abstract here

2. Alzheimer’s Society. Greater weight loss during aging associated with increased risk of mild cognitive impairment, study suggests. Published 1 February 2016.

Increasing weight loss per decade as people aged from midlife to later life has been associated with an increased risk of mild cognitive impairment (MCI).

Researchers identified 524 of 1,895 cognitively normal participants who developed MCI. Others factors may have played a role, as those who developed MCI were older, more likely to be carriers of a specific gene, 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).
People with MCI are at an increased risk of developing dementia.

Read the full commentary here

3. Greater weight loss during aging associated with increased risk for mild cognitive impairment. ScienceDaily. Published 1 February 2016.

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.

Read the full commentary here

 

 

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