Evaluation of Adiposity and Cognitive Function in Adults
Open accessAbstract
Importance: Excess adipose tissue increases other cardiovascular risk factors, which may be associated with vascular brain injury and cognitive impairment. However, the extent to which the amount and distribution of adipose tissue may be associated with lower cognitive scores, independent of its association with cardiovascular risk factors, is not well characterized. Objective: To investigate the association of adiposity on vascular brain injury and cognitive scores. Design, Setting, and Participants: A total of 9189 participants from the Canadian Alliance for Healthy Hearts and Minds (CAHHM) and the Prospective Urban Rural Epidemiological-Mind (PURE-MIND) cohort studies were included in this cross-sectional analysis. Of these adults, 9166 underwent bioelectrical impedance analysis to assess body fat (BF) percentage, and 6773 underwent magnetic resonance imaging to assess vascular brain injury and measure visceral adipose tissue (VAT) volume. Participants from CAHHM were recruited from January 1, 2014, to December 31, 2018, and PURE-MIND participants were recruited from January 1, 2010, to December 31, 2018. Both CAHHM and PURE-MIND comprise multisite, population-based cohorts. Participants from CAHHM are from Canada, and PURE-MIND participants are from Canada or Poland. Data analysis was performed from May 3 to November 24, 2021. Exposures: The percentage of BF and VAT were modeled as sex-specific quartiles. Vascular brain injury was defined as high white matter hyperintensities or silent brain infarction. Multivariable mixed models were used to examine factors associated with reduced cognitive scores. Main Outcomes and Measures: Cognitive function was assessed using the Digital Symbol Substitution Test (DSST; scores range from 0 to 133, with lower scores indicating lower cognitive function) and Montreal Cognitive Assessment (scores range from 0 to 30, with a score of ≥26 denoting normal cognitive function). Reduced cognition was defined as a DSST score less than 1 SD below the mean. Cardiovascular risk was assessed using the INTERHEART Risk Score (IHRS; scores range from 0 to 48; low risk is defined as a score of 0 to 9, moderate risk as 10 to 16, and high risk as 17 or higher). Results: A total of 9189 adults (mean [SD] age, 57.8 [8.8] years; 5179 [56.4%] women; and 1013 [11.0%] East and Southeast Asian; 295 [3.2%] South Asian; 7702 [83.8%] White European; and 179 [1.9%] other, including Black, Indigenous, mixed, and unknown ethnicity) participated in the study. Visceral adipose tissue was highly correlated with body adiposity measured by BF percentage (r = 0.76 in women; r = 0.70 in men). Cardiovascular risk factors increased with increasing BF percentage with the fourth quartile IHRS at 13.8 (95% CI, 13.5-14.0; P < .001 for trend) and with VAT with the fourth quartile IHRS at 13.3 (95% CI, 13.0-13.5; P < .001 for trend). Vascular brain injury increased with increasing BF percentage with the fourth quartile value at 8.6% (95% CI, 7.5%-9.8%; P = .007 for trend) and with increasing VAT with fourth quartile value at 7.2% (95% CI, 6.0-8.4; P = .05 for trend). Cognitive scores were lower with increasing BF percentage with the fourth quartile score of 70.9 (95% CI, 70.4-71.5; P < .001 for trend) and for VAT with the fourth quartile score of 72.8 (95% CI, 72.1-73.4; P < .001 for trend). For every 1-SD increase in BF percentage (9.2%) or VAT (36 mL), the DSST score was lower by 0.8 points (95% CI, 0.4-1.1; P < .001) for BF percentage and lower by 0.8 points (95% CI, 0.4-1.2; P < .001) for VAT, adjusted for cardiovascular risk factors and vascular brain injury. The population attributable risk for reduced DSST score for higher BF percentage was 20.5% (95% CI, 7.0%-33.2%) and for VAT was 19.6% (95% CI, 2.0%-36.0%). Higher BF percentage and VAT were not associated with Montreal Cognitive Assessment scores. Conclusions and Relevance: In this cross-sectional study, generalized and visceral adiposity were associated with reduced cognitive scores, after adjustment for cardiovascular risk factors, educational level, and vascular brain injury. These results suggest that strategies to prevent or reduce adiposity may preserve cognitive function.
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Adiposity is associated with reduced cognitive function.
“Recent evidence has demonstrated an association between adiposity and reduced cognitive function”
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Cites
The metabolic phenotype in obesity: Fat mass, body fat distribution, and adipose tissue function
Goossens, G. H. (2017) · Obesity Facts · doi:10.1159/000471488 · Cited by 8,481 · see citing works
O'Donnell, M. J., Xavier, D., Liu, L., Zhang, H., Chin, S. L., Rao-Melacini, P., Rangarajan, S., Islam, S., Pais, P., McQueen, M. J., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60834-3 · Cited by 3,448 · see citing works
Self-citationAlzheimer Disease Genetics Consortium (ADGC), Kunkle, B. W., The European Alzheimer’s Disease Initiative (EADI), Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium (CHARGE), Genetic and Environmental Risk in AD/Defining Genetic, P. A. E. R. F. A. D. C. (., Grenier-Boley, B., Sims, R., Bis, J. C., Damotte, V., Naj, A. C., et al. (2019) · Nature Genetics · doi:10.1038/s41588-019-0358-2 · Cited by 2,946 · see citing works
Yusuf, S., Hawken, S., Ôunpuu, S., Bautista, L., Franzosi, M. G., Commerford, P., Lang, C. C., Rumboldt, Z., Onen, C. L., Lisheng, L., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67663-5 · Cited by 2,903 · see citing works
Self-citationVisceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement
Neeland, I. J., Ross, R., Després, J.-P., Matsuzawa, Y., Yamashita, S., Shai, I., Seidell, J., Magni, P., Santos, R. D., Arsenault, B., et al. (2019) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30084-1 · Cited by 1,603 · see citing works
Self-citationThe Emerging Risk Factors Collaboration (2011) · The Lancet · doi:10.1016/s0140-6736(11)60105-0 · Cited by 1,216 · see citing works
Normative data for the Montreal Cognitive Assessment (MoCA) in a population-based sample
Rossetti, H. C., Lacritz, L. H., Cullum, C. M., & Weiner, M. (2011) · Neurology · doi:10.1212/wnl.0b013e318230208a · Cited by 805 · see citing works
Gorelick, P. B. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2010.05726.x · Cited by 361 · see citing works
Serum inflammatory proteins and cognitive decline in older persons
Dik, M. G., Jonker, C., Hack, C. E., Smit, J. H., Comijs, H. C., & Eikelenboom, P. (2005) · Neurology · doi:10.1212/01.wnl.0000158281.08946.68 · Cited by 338 · see citing works
Brain morphology links systemic inflammation to cognitive function in midlife adults
Marsland, A. L., Gianaros, P. J., Kuan, D. C.-H., Sheu, L. K., Krajina, K., & Manuck, S. B. (2015) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2015.03.015 · Cited by 321 · see citing works
Timpson, N. J., Nordestgaard, B. G., Harbord, R. M., Zacho, J., Frayling, T. M., Tybjærg-Hansen, A., & Davey Smith, G. (2011) · International Journal of Obesity · doi:10.1038/ijo.2010.137 · Cited by 310 · see citing works
McGorrian, C., Yusuf, S., Islam, S., Jung, H., Rangarajan, S., Avezum, Á., Prabhakaran, D., Almahmeed, W. A., Rumboldt, Z., Budaj, A., et al. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq448 · Cited by 279 · see citing works
Self-citationFramingham Stroke Risk Profile and Lowered Cognitive Performance
Elias, M. F., SULLIVAN, L. M., D’Agostino, R. B., Elias, P. K., Beiser, A., Au, R., Seshadri, S. S., DeCarli, C. S., & Wolf, P. A. (2004) · Stroke · doi:10.1161/01.str.0000103141.82869.77 · Cited by 242 · see citing works
Early cerebral small vessel disease and brain volume, cognition, and gait
Smith, E. E., O'Donnell, M., Dagenais, G., Lear, S. A., Wielgosz, A., Sharma, M., Poirier, P., Stotts, G., Black, S. E., Strother, S., et al. (2015) · Annals of Neurology · doi:10.1002/ana.24320 · Cited by 207 · see citing works
Self-citationLee, J., Pedley, A., Hoffmann, U., Massaro, J. M., & Fox, C. S. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.06.067 · Cited by 199 · see citing works
Role of Adiposity-Driven Inflammation in Depressive Morbidity
Capuron, L., Lasselin, J., & Castanon, N. (2017) · Neuropsychopharmacology · doi:10.1038/npp.2016.123 · Cited by 182 · see citing works
Association of Plasma Total Homocysteine Levels With Subclinical Brain Injury
Seshadri, S. S., Wolf, P. A., Beiser, A., Selhub, J., Au, R., Jacques, P. F., Yoshita, M., Rosenberg, I. H., D’Agostino, R. B., & DeCarli, C. S. (2008) · Archives of Neurology · doi:10.1001/archneur.65.5.642 · Cited by 176 · see citing works
Central Adiposity, Systemic Inflammation, and the Metabolic Syndrome
Elks, C. M., & Francis, J. (2010) · Current Hypertension Reports · doi:10.1007/s11906-010-0096-4 · Cited by 166 · see citing works
Chu, A. Y., Deng, X., Fisher, V. A., Drong, A., Zhang, Y., Feitosa, M. F., Liu, C.-T., Weeks, O., Choh, A. C., Duan, Q., et al. (2016) · Nature Genetics · doi:10.1038/ng.3738 · Cited by 134 · see citing works
Total and Regional Adiposity and Cognitive Change in Older Adults
Kanaya, A. M. (2009) · Archives of Neurology · doi:10.1001/archneurol.2008.570 · Cited by 132 · see citing works
West, N. A., & Haan, M. N. (2009) · The Journals of Gerontology Series A · doi:10.1093/gerona/gln006 · Cited by 107 · see citing works
Management of Obesity in Cardiovascular Practice
Després, J.-P., Carpentier, A. C., Tchernof, A., Neeland, I. J., & Poirier, P. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.05.035 · Cited by 87 · see citing works
Self-citationCentral Obesity, Leptin and Cognitive Decline: The Sacramento Area Latino Study on Aging
Hazzouri, A. Z. A., Haan, M. N., Whitmer, R. A., Yaffe, K. S., & Neuhaus, J. M. (2012) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000339957 · Cited by 66 · see citing works
on behalf of the CAHHM Study Investigators, Anand, S. S., Tu, J. V., Awadalla, P., Black, S. E., Boileau, C., Busseuil, D., Desai, D., Després, J., de Souza, R. J., et al. (2016) · BMC Public Health · doi:10.1186/s12889-016-3310-8 · Cited by 55 · see citing works
Self-citationOverall and abdominal adiposity in midlife and subsequent cognitive function
Kesse‐Guyot, E., Andreeva, V. A., Touvier, M., Jeandel, C., Ferry, M., Herçberg, S., & Galan, P. (2014) · The journal of nutrition health & aging · doi:10.1007/s12603-014-0508-2 · Cited by 39 · see citing works
Obesity, Visceral Adipose Tissue, and Cognitive Function in Childhood
Raine, L. B., Khan, N. A., Drollette, E. S., Pontifex, M. B., Kramer, A. F., & Hillman, C. H. (2017) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2017.05.023 · Cited by 37 · see citing works
Syme, C. A., Pelletier, S., Shin, J., Abrahamowicz, M., Leonard, G. T., Perron, M., Richer, L., Veillette, S., Gaudet, D., Pike, G. B., et al. (2018) · International Journal of Obesity · doi:10.1038/s41366-018-0202-2 · Cited by 27 · see citing works
Chiba, I., Lee, S., Bae, S., Makino, K., Shinkai, Y., & Shimada, H. (2020) · The journal of nutrition health & aging · doi:10.1007/s12603-020-1330-7 · Cited by 26 · see citing works
Are large simple trials for dementia prevention possible?
Whiteley, W. N., Anand, S. S., Bangdiwala, S. I., Bosch, J., Canavan, M. D., Chertkow, H. M., Gerstein, H. C., Gorelick, P. B., O'Donnell, M. J., Paré, G., et al. (2019) · Age and Ageing · doi:10.1093/ageing/afz152 · Cited by 23 · see citing works
Self-citationWang, X., Luan, D., Xin, S., Liu, Y., & Gao, Q. (2019) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317519865428 · Cited by 20 · see citing works
Anand, S. S., Tu, J. V., Desai, D., Awadalla, P., Robson, P. J., Jacquemont, S., Dummer, T., Le, N., Parker, L., Poirier, P., et al. (2019) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jez226 · Cited by 19 · see citing works
Self-citationAnand, S. S., Friedrich, M. G., Desai, D., Schulze, K. M., Awadalla, P., Busseuil, D., Dummer, T., Jacquemont, S., DICK, A. J., Kelton, D. F., et al. (2020) · Stroke · doi:10.1161/strokeaha.119.028179 · Cited by 17 · see citing works
Self-citationMorys, F., Dadar, M., & Dagher, A. (2020) · bioRxiv · doi:10.1101/2020.06.26.174086 · Cited by 10 · see citing works
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Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases
Loh, J. S., Mak, W. Q., Tan, L. K. S., Ng, C. X., Chan, H. H., Yeow, S. H., Foo, J. B., Ong, Y. S., How, C. W., & Khaw, K. Y. (2024) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-024-01743-1 · Cited by 1,193 · see citing works
Song, Z.-H., Liu, J., Wang, X.-F., Simó, R., Zhang, C., & Zhou, J.-B. (2023) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2023.101082 · Cited by 14 · see citing works
- Authors
- Anand, S. S., Friedrich, M. G., Lee, D. S., Awadalla, P., Després, J. P., Desai, D., de Souza, R. J., Dummer, T., Parraga, G., Larose, E., Lear, S. A., Teo, K. K., Poirier, P., Schulze, K. M., Szczesniak, D., Tardif, J.-C., Vena, J., Zatonska, K., Yusuf, S., Smith, E. E., & Canadian Alliance of Healthy Hearts and Minds (CAHHM) and the Prospective Urban and Rural Epidemiological (PURE) Study Investigators
- Affiliations
- Population Health Research Institute (CA)
- McGill University (CA)
- University Health Network (CA)
- Ontario Institute for Cancer Research (CA)
- Université Laval (CA)
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- BC Cancer Agency (CA)
- Department of Medical Biophysics, Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Medicine, University of Laval, Quebec City, Quebec, Canada
- Simon Fraser University (CA)
- Institut universitaire de cardiologie et de pneumologie de Québec (CA)
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
- Montreal Heart Institute (CA)
- Alberta Health Services (CA)
- Department of Social Medicine, Wroclaw Medical University, Wrocław, Poland
- University of Calgary (CA)
- Corresponding author
- Anand, Sonia S.
- ORCID
- Venue
- JAMA Network Open
- Publisher
- American Medical Association (AMA)
- Published
- 2022-02-01
- Volume
- 5
- Issue
- 2
- Pages
- e2146324
- ISSN
- 2574-3805 (ISSN-L)
- PMC
- PMC8808326
- OpenAlex
- W4210324959
- Cited by
- 125
- References
- 33
- Citations by year
- 2026: 28 · 2025: 33 · 2024: 30 · 2023: 23 · 2022: 11
- FWCI
- 15.81
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JAMA Network Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Pfizer
- AstraZeneca
- Sanofi
- Heart and Stroke Foundation of Canada
- Alberta Health Services
- Hamilton Health Sciences
- University of Ottawa
- McMaster University
- Institute for Clinical Evaluative Sciences
- Amarin Corporation
- Alberta Cancer Foundation
- Michael Smith Health Research BC
- Dalhousie University
- University of Toronto
- Simon Fraser University
- Uniwersytet Medyczny im. Piastów Slaskich we Wroclawiu
- Institut de Cardiologie de Montréal
- Partenariat Canadien Contre Le Cancer
- Esperion Therapeutics
- Canadian Institutes of Health Research (143255_1, FDN154317, FDN143313)
- Robarts Research Institute
- Department of Medicine, University of Toronto
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- adiposity, cognitive function, vascular brain injury, white matter hyperintensities, silent cerebral infarction, visceral adipose tissue, body fat percentage, cardiovascular risk, cognitive impairment, Montreal Cognitive Assessment, sex differences, neuroimaging biomarkers
- MeSH terms
- Adult, Aged, Canada, Cognition, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Poland, Prospective Studies, Risk Assessment, Obesity, Abdominal, Cognitive Dysfunction
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