Associations of Brain Structure With Adiposity and Changes in Adiposity in a Middle-Aged and Older Biracial Population

B. Gwen Windham, Seth T. Lirette, Myriam Fornage, Emelia J. Benjamin, Kirby G. Parker, Stephen T. Turner, Clifford R. Jack, Michael E. Griswold, Thomas H. Mosley

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Studies of adiposity and brain pathology in African Americans (AA) are sparse despite higher rates of obesity, dementia, and dementia-associated brain pathology in AA. This study examined relations of adiposity to white matter hyperintensities (WMH) and total brain volume (TBV) in AA and non-Hispanic whites (NHW).

Methods: Waist circumference (WC) and body mass index (BMI) were measured in the Genetic Epidemiology Network of Arteriopathy study at Visits 1 (mean age 57 [±11]) and 2 (mean age 61 [±10], mean 5.2 years later). Brain MRIs were obtained shortly after Visit 2 in 1,702 participants (64% women, 48% AA). Multilevel linear regression using generalized estimating equation estimated associations of adiposity (cross-sectional) or adiposity changes with WMH (accounting for intracranial size) or TBV adjusting for demographics, cardiovascular risk factors, and incorporating adiposity-by-race interactions. Adiposity-by-age interactions were examined.

Results: Concurrent TBV was inversely associated with BMI (β = -2.76 [95% confidence interval (CI): -4.99, -0.53]) and WC (β = -2.19 [CI: -4.04, -0.34]). Concurrent WMH were negatively associated with BMI (β = -0.04 [CI: -0.06, -0.01]) and, among NHW, with WC (β = -0.04 [CI: -0.06, -0.02]) but not with changes in BMI or WC. BMI increases were associated with lower TBV (β = -16.20, [CI: -30.34, -2.06]) in AA but not in NHW (β = -2.76 [CI: -14.02, 8.51]), although race-by-adiposity interactions were not supported. WC increases were not associated with MRI outcomes.

Conclusion: Greater measures of obesity and increases in measures of obesity, which are common in mid-life, could be detrimental to brain health, particularly in AA.

Original languageEnglish (US)
Pages (from-to)825-831
Number of pages7
JournalThe journals of gerontology. Series A, Biological sciences and medical sciences
Issue number6
StatePublished - Jun 1 2017


  • Longitudinal
  • MRI
  • Obesity
  • Race

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology


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