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Cited by 323Dementia and Cognitive Impairment ResearchNutrition and Health in AgingAlzheimer's disease research and treatments

The Association of Weight Change in Alzheimer's Disease with Severity of Disease and Mortality: A Longitudinal Analysis

White, Heidi, Pieper, Carl, Schmader, Ken·1998·Journal of the American Geriatrics Society
DOI 10.1111/j.1532-5415.1998.tb04537.x
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Abstract

OBJECTIVE : To describe weight loss in relation to the severity of Alzheimer's disease (AD), to identify confounders that might account for weight loss, and to investigate the association of weight change with mortality. METHODS : This study included 666 subjects with AD from the Consortium to Establish a Registry for Alzheimer's Disease, a longitudinal study of subjects with AD studied for ≤6 years. Body weight was measured on entry and at annual follow‐up examinations as part of standardized clinical assessments. Hierarchical linear models were used to estimate weight change per change in stage of AD, as measured by the Clinical Dementia Rating scale, and to assess the impact of possible confounders on the tendency for weight loss. Linear correlation of the trajectories of weight and CDR over time were used to determine the association between weight change and stage change. The association between weight change and mortality was modeled using the Cox proportional hazards model. RESULTS : Each change in stage of AD was associated with an estimated average weight loss of nearly 2 lb ( P = .0001). The correlation between change in stage of AD and weight change was statistically significant (r = −0.09, P = .005), which indicates a greater tendency toward weight loss with progression of AD. Weight loss of 2:5% in any year before death was a significant predictor of mortality. When weight loss in the year before death or censoring was analyzed as a continuous variable, it was a significant predictor of mortality. Additionally, the relative risk of death increased as weight loss increased. In contrast, weight gain decreased the risk of mortality. CONCLUSION : The risk of weight loss tends to increase with severity and progression of AD. Weight loss is a predictor of mortality among subjects with AD, whereas weight gain appears to have a protective effect.

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  • Weight loss commonly occurs before dementia diagnosis and early in the disease, which can obscure the overweight-dementia association in older samples.

    “Overweight should be measured in midlife in order to reveal the association to subsequent dementia because people often lose weight prior to diagnosis 9 and early in the dementia phase 10.”

    From Overweight in midlife and risk of dementia: a 40-year follow-up study (2009) · cites this paper as [10]

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Authors
White, H., Pieper, C., & Schmader, K.
Affiliations
  • Duke University (US)
  • Duke Medical Center (US)
Corresponding author
White, Heidi
ORCID
Pieper, Carl
Venue
Journal of the American Geriatrics Society
Publisher
Wiley
Published
1998-10
Volume
46
Issue
10
Pages
1223-1227
ISSN
  • 0002-8614 (ISSN-L)
  • 1532-5415
DOI
10.1111/j.1532-5415.1998.tb04537.x
OpenAlex
W2007472466
Cited by
323
References
34
Citations by year
2026: 6 · 2025: 6 · 2024: 7 · 2023: 8 · 2022: 14 · 2021: 11 · 2020: 15 · 2019: 8 · 2018: 15 · 2017: 13 · 2016: 17 · 2015: 17 · 2014: 18 · 2013: 12 · 2012: 20
FWCI
3.75
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 6052 d)
Locations
  • Journal of the American Geriatrics Society (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Aging (5P60-AG11268, AG06790, U01AG006790, P60AG011268)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Keywords
Alzheimer's disease, weight loss, weight gain, disease severity, mortality, Clinical Dementia Rating, disease progression, predictors of death, weight change
MeSH terms
Aged, Alzheimer Disease, Educational Status, Female, Humans, Longitudinal Studies, Male, Predictive Value of Tests, Severity of Illness Index, Weight Loss, Confounding Factors, Epidemiologic, Proportional Hazards Models

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