Adiposity indicators and dementia over 32 years in Sweden

D. R. Gustafson, K. Bäckman, M. Waern, S. Östling, X. Guo, P. Zandi, Michelle M Mielke, C. Bengtsson, I. Skoog

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

BACKGROUND: High midlife and late-life adiposity may increase risk for dementia. Late-life decrease in body mass index (BMI) or body weight within several years of a dementia diagnosis has also been reported. Differences in study designs and analyses may provide different pictures of this relationship. METHODS: Thirty-two years of longitudinal body weight, BMI, waist circumference, and waist-to-hip ratio (WHR) data, from the Prospective Population Study of Women in Sweden, were related to dementia. A representative sample of 1,462 nondemented women was followed from 1968 at ages 38-60 years, and subsequently in 1974, 1980, 1992, and 2000, using neuropsychiatric, anthropometric, clinical, and other measurements. Cox proportional hazards regression models estimated incident dementia risk by baseline factors. Logistic regression models including measures at each examination were related to dementia among surviving participants 32 years later. RESULTS: While Cox models showed no association between baseline anthropometric factors and dementia risk, logistic models showed that a midlife WHR greater than 0.80 increased risk for dementia approximately twofold (odds ratio 2.22, 95% confidence interval 1.00-4.94, p = 0.049) among surviving participants. Evidence for reverse causality was observed for body weight, BMI, and waist circumference in years preceding dementia diagnosis. CONCLUSIONS: Among survivors to age 70, high midlife waist-to-hip ratio may increase odds of dementia. Traditional Cox models do not evidence this relationship. Changing anthropometric parameters in years preceding dementia onset indicate the dynamic nature of this seemingly simple relationship. There are midlife and late-life implications for dementia prevention, and analytical considerations related to identifying risk factors for dementia.

Original languageEnglish (US)
Pages (from-to)1559-1566
Number of pages8
JournalNeurology
Volume73
Issue number19
DOIs
StatePublished - Nov 2009
Externally publishedYes

Fingerprint

Adiposity
Sweden
Dementia
Waist-Hip Ratio
Proportional Hazards Models
Body Mass Index
Logistic Models
Body Weight
Waist Circumference
Causality
Survivors
Odds Ratio
Prospective Studies
Confidence Intervals

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Gustafson, D. R., Bäckman, K., Waern, M., Östling, S., Guo, X., Zandi, P., ... Skoog, I. (2009). Adiposity indicators and dementia over 32 years in Sweden. Neurology, 73(19), 1559-1566. https://doi.org/10.1212/WNL.0b013e3181c0d4b6

Adiposity indicators and dementia over 32 years in Sweden. / Gustafson, D. R.; Bäckman, K.; Waern, M.; Östling, S.; Guo, X.; Zandi, P.; Mielke, Michelle M; Bengtsson, C.; Skoog, I.

In: Neurology, Vol. 73, No. 19, 11.2009, p. 1559-1566.

Research output: Contribution to journalArticle

Gustafson, DR, Bäckman, K, Waern, M, Östling, S, Guo, X, Zandi, P, Mielke, MM, Bengtsson, C & Skoog, I 2009, 'Adiposity indicators and dementia over 32 years in Sweden', Neurology, vol. 73, no. 19, pp. 1559-1566. https://doi.org/10.1212/WNL.0b013e3181c0d4b6
Gustafson DR, Bäckman K, Waern M, Östling S, Guo X, Zandi P et al. Adiposity indicators and dementia over 32 years in Sweden. Neurology. 2009 Nov;73(19):1559-1566. https://doi.org/10.1212/WNL.0b013e3181c0d4b6
Gustafson, D. R. ; Bäckman, K. ; Waern, M. ; Östling, S. ; Guo, X. ; Zandi, P. ; Mielke, Michelle M ; Bengtsson, C. ; Skoog, I. / Adiposity indicators and dementia over 32 years in Sweden. In: Neurology. 2009 ; Vol. 73, No. 19. pp. 1559-1566.
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AU - Waern, M.

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AU - Guo, X.

AU - Zandi, P.

AU - Mielke, Michelle M

AU - Bengtsson, C.

AU - Skoog, I.

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N2 - BACKGROUND: High midlife and late-life adiposity may increase risk for dementia. Late-life decrease in body mass index (BMI) or body weight within several years of a dementia diagnosis has also been reported. Differences in study designs and analyses may provide different pictures of this relationship. METHODS: Thirty-two years of longitudinal body weight, BMI, waist circumference, and waist-to-hip ratio (WHR) data, from the Prospective Population Study of Women in Sweden, were related to dementia. A representative sample of 1,462 nondemented women was followed from 1968 at ages 38-60 years, and subsequently in 1974, 1980, 1992, and 2000, using neuropsychiatric, anthropometric, clinical, and other measurements. Cox proportional hazards regression models estimated incident dementia risk by baseline factors. Logistic regression models including measures at each examination were related to dementia among surviving participants 32 years later. RESULTS: While Cox models showed no association between baseline anthropometric factors and dementia risk, logistic models showed that a midlife WHR greater than 0.80 increased risk for dementia approximately twofold (odds ratio 2.22, 95% confidence interval 1.00-4.94, p = 0.049) among surviving participants. Evidence for reverse causality was observed for body weight, BMI, and waist circumference in years preceding dementia diagnosis. CONCLUSIONS: Among survivors to age 70, high midlife waist-to-hip ratio may increase odds of dementia. Traditional Cox models do not evidence this relationship. Changing anthropometric parameters in years preceding dementia onset indicate the dynamic nature of this seemingly simple relationship. There are midlife and late-life implications for dementia prevention, and analytical considerations related to identifying risk factors for dementia.

AB - BACKGROUND: High midlife and late-life adiposity may increase risk for dementia. Late-life decrease in body mass index (BMI) or body weight within several years of a dementia diagnosis has also been reported. Differences in study designs and analyses may provide different pictures of this relationship. METHODS: Thirty-two years of longitudinal body weight, BMI, waist circumference, and waist-to-hip ratio (WHR) data, from the Prospective Population Study of Women in Sweden, were related to dementia. A representative sample of 1,462 nondemented women was followed from 1968 at ages 38-60 years, and subsequently in 1974, 1980, 1992, and 2000, using neuropsychiatric, anthropometric, clinical, and other measurements. Cox proportional hazards regression models estimated incident dementia risk by baseline factors. Logistic regression models including measures at each examination were related to dementia among surviving participants 32 years later. RESULTS: While Cox models showed no association between baseline anthropometric factors and dementia risk, logistic models showed that a midlife WHR greater than 0.80 increased risk for dementia approximately twofold (odds ratio 2.22, 95% confidence interval 1.00-4.94, p = 0.049) among surviving participants. Evidence for reverse causality was observed for body weight, BMI, and waist circumference in years preceding dementia diagnosis. CONCLUSIONS: Among survivors to age 70, high midlife waist-to-hip ratio may increase odds of dementia. Traditional Cox models do not evidence this relationship. Changing anthropometric parameters in years preceding dementia onset indicate the dynamic nature of this seemingly simple relationship. There are midlife and late-life implications for dementia prevention, and analytical considerations related to identifying risk factors for dementia.

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