Cited by 797Dementia and Cognitive Impairment ResearchMenopause: Health Impacts and TreatmentsCancer Risks and Factors

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Midlife and Late-Life Obesity and the Risk of Dementia: Cardiovascular Health Study

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Fitzpatrick, Annette L., Kuller, Lewis H., Lopez, Oscar L., Diehr, Paula, O’Meara, Ellen S., Longstreth, W. T., Luchsinger, José A.·2009·Archives of Neurology

DOI 10.1001/archneurol.2008.582PMC PMC3513375

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Abstract

BACKGROUND: While high adiposity in middle age appears to be related to greater dementia risk, studies exploring this association in the elderly are conflicting. OBJECTIVE: To evaluate associations between midlife and late-life obesity and risk of dementia. DESIGN: Prospective study with mean follow-up of 5.4 years (1992-1994 through 1999). SETTING: Community-dwelling sample in 4 US sites recruited from Medicare eligibility files. PARTICIPANTS: A total of 2798 adults without dementia (mean age, 74.7 years; 59.1% women) participating in the Cardiovascular Health Study who underwent magnetic resonance imaging were measured for height and weight at baseline at age 65 years or older (late life), and self-reported weight at age 50 years (midlife). Body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) was calculated at both times. MAIN OUTCOME MEASURES: Dementia, Alzheimer disease, and vascular dementia classified by a multidisciplinary committee using standardized criteria. RESULTS: Classification resulted in 480 persons with incident dementia, 245 with Alzheimer disease (no vascular dementia), and 213 with vascular dementia (with or without Alzheimer disease). In evaluations of midlife obesity, an increased risk of dementia was found for obese (BMI >30) vs normal-weight (BMI 20-25) persons, adjusted for demographics (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.03-1.87) and for cardiovascular risk factors (1.36; 0.94-1.95). The risk estimates were reversed in assessments of late-life BMI. Underweight persons (BMI <20) had an increased risk of dementia (1.62; 1.02-2.64), whereas being overweight (BMI >25-30) was not associated (0.92; 0.72-1.18) and being obese reduced the risk of dementia (0.63; 0.44-0.91) compared with those with normal BMI. CONCLUSION: These results help explain the "obesity paradox" as differences in dementia risk across time are consistent with physical changes in the trajectory toward disability.

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Authors: Fitzpatrick, A. L., Kuller, L. H., Lopez, O. L., Diehr, P., O’Meara, E. S., Longstreth, W. T., & Luchsinger, J. A.
Affiliations: University of Washington (US)
University of Pittsburgh (US)
ORCID: Kuller, Lewis H.
O’Meara, Ellen S.
Venue: Archives of Neurology
Publisher: American Medical Association (AMA)
Published: 2009-03-01
Volume: 66
Issue: 3
Pages: 336-42
ISSN: 0003-9942 (ISSN-L)
DOI: 10.1001/archneurol.2008.582
PMC: PMC3513375
OpenAlex: W2077468399
Cited by: 796
References: 42
Citations by year: 2026: 43 · 2025: 42 · 2024: 55 · 2023: 48 · 2022: 54 · 2021: 52 · 2020: 49 · 2019: 55 · 2018: 41 · 2017: 48 · 2016: 47 · 2015: 45 · 2014: 51 · 2013: 50 · 2012: 38
FWCI: 23.65
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Archives of Neurology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (n01hc085082-026, n01hc085081-021, n01hc045133-001, n01hc085079-024, n01hc015103-009, n01hc085084-005, n01hc085085-011, n01hc085083-027, n01hc085080-026, n01hc085086-022, n01hc55222-0-0-0, n01hc075150-004, n01hc035129-010)
National Institute on Aging (5R01 AG 15928-02, R01AG015928)
National Heart, Lung, and Blood Institute (N01-HC-85081, N01HC85085, N01 HC085086, N01HC-85083, N01HC15103, N01 HC085079, N01 HC085083, N01HC85082, N01HC‐75150, N01 HC85086, N01 HC085080, N01 HC035129, N01HC85080, N01 HC015103, N01 HC55222, U01HL080295, N01 HC055222, N01 HC085081, N01 HC075150, N01 HC045133, N01-HC85079, N01-HC85084)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Keywords: obesity, dementia, midlife obesity, body mass index, Alzheimer's disease, vascular dementia, obesity paradox, underweight, cardiovascular risk factors, aging
MeSH terms: Aged, Aged, 80 and over, Aging, Alzheimer Disease, Anthropometry, Evaluation Studies as Topic, Female, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Middle Aged, Obesity, Prospective Studies, Risk, Dementia, Vascular, Body Mass Index, Survival Analysis

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Midlife and Late-Life Obesity and the Risk of Dementia: Cardiovascular Health Study

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