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

 

 

Why modern life is making dementia in your 40s more likely

From background radiation to chemicals in the food chain, environmental changes are contributing to a rapid global rise in neurological disease

brain mri

My interest in neurological disease was triggered by a second friend dying ofmotor neurone disease (MND), which in purely statistical terms was exceptional. It is suggested there is an incidence of about one in 50,000 who are affected by MND and most die. No one knows 50,000 people, so was it a statistical fluke?

This raised the question of whether there were increases not only in MND, but in neurological disorders as a whole, including the dementias. Using World Health Organisation mortality data, which – while not perfect – is the best information available as it is collated in a standard and uniform way, myself and colleagues at the faculty of health and social sciences at Bournemouth University set out to investigate this.

Our first study, focusing on the changing pattern of neurological deaths from 1979 up to 1997, found that dementias were starting 10 years earlier – affecting more people in their 40s and 50s – and that there was a noticeable increase in neurological deaths in people up to the age of 74. In a follow-up study, taking us to 2010 and across 21 western countries, these increases were confirmed.

The results were controversial. As one newspaper headline reported: “Modern living leads to brain disease”, which in a somewhat simplistic way reflected what our research uncovered about the impact of the changing environment in which we live on our neurological health.

Read the full article via Why modern life is making dementia in your 40s more likely | Colin Pritchard | Comment is free | The Guardian.

Eight nutrients to protect the aging brain — ScienceDaily

Eight nutrients to protect the aging brain

Brain health is the second most important component in maintaining a healthy lifestyle according to a 2014 AARP study. As people age they can experience a range of cognitive issues from decreased critical thinking to dementia and Alzheimer’s disease. Researchers write about eight nutrients that may help keep your brain in good shape.

via Eight nutrients to protect the aging brain — ScienceDaily.

Link between relationships and health is ignored in the NHS, finds Relate – Alzheimer’s Society

Link between relationships and health is ignored in the NHS, finds Relate

The charity Relate is today (Tuesday 24th March) calling for relationships to be put at the heart of the NHS to improve health and wellbeing and reduce pressure on the public purse.

A report by the charity and think tank, New Philanthropy Capital, finds that the link between relationships and health is too often ignored in the NHS. Relate is calling for good quality relationships with families, partners and friends to be put at the heart of the health service. They argue that this will improve health and wellbeing for the 15 million people in the UK living with long-term physical or mental health conditions.

via Link between relationships and health is ignored in the NHS, finds Relate – Alzheimer’s Society.

Demanding jobs may increase survival in those with fronto-temporal dementia, new research suggests – Alzheimer’s Society

Demanding jobs may increase survival in those with fronto-temporal dementia, new research suggests

People with more demanding jobs may live longer after developing fronto-temporal dementia than people with less skilled jobs, according to a new study published in Neurology today (22 April 2015).

Researchers at Pennsylvania State University reviewed the medical charts of 83 people who had an autopsy after death, 34 of whom had fronto-temporal dementia. Occupations were ranked by US census categories from manual jobs such as factory workers to professional and technical jobs such as lawyers and engineers.

The 34 people with fronto-temporal dementia had an average survival time of about seven years. The people with more challenging jobs were more likely to have longer survival times than those with less challenging jobs

via Demanding jobs may increase survival in those with fronto-temporal dementia, new research suggests – Alzheimer’s Society.

Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies

Objective: Dementia has a multifactorial etiology, but the importance of individual health and lifestyle related risk factors is often uncertain or based on few studies. The goal of this paper is to identify the major modifiable risk factors for dementia as a first step in developing an effective preventive strategy and promoting healthy late life cognitive functioning.

Methods: A mixed-method approach combined findings from a systematic literature review and a Delphi consensus study. The literature search was conducted in PubMed and updated an earlier review by the United States National Institutes of Health from 2010. We reviewed the available evidence from observational epidemiological studies. The online Delphi study asked eight international experts to rank and weigh each risk factor for its importance for dementia prevention.

Results: Out of 3127 abstracts, 291 were included in the review. There was good agreement between modifiable risk factors identified in the literature review and risk factors named spontaneously by experts. After triangulation of both methods and re-weighting by experts, strongest support was found for depression, (midlife) hypertension, physical inactivity, diabetes, (midlife) obesity, hyperlipidemia, and smoking, while more research is needed for coronary heart disease, renal dysfunction, diet, and cognitive activity.

Conclusions: Findings provide good support for several somatic and lifestyle factors and will be used to inform the design of a new multicenter trial into dementia prevention.

International Journal of Geriatric Psychiatry. Volume 30, Issue 3, pages 234–246