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Body Mass Index in Midlife and Risk of Alzheimer Disease and Vascular Dementia

Whitmer, Rachel, Gunderson, Erica, Quesenberry, Charles, Zhou, Jufen, Yaffe, Kristine·2007·Current Alzheimer Research
DOI 10.2174/156720507780362047
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Abstract

Prior work has suggested that obesity and overweight as measured by body mass index (BMI) increases risk of dementia. It is unknown if there is a difference in the risk of developing Alzheimer disease (AD) versus vascular dementia (VaD) associated with high body weight. The goal of this study was to examine the association between midlife BMI and risk of both AD and VaD an average of 36 years later in a large (N= 10,136) and diverse cohort of members of a health care delivery system. Participants aged 40-45 participated in health exams between 1964 and 1968. AD and VaD diagnoses were obtained from Neurology visits between January 1, 1994 and June 15, 2006. Those with diagnoses of general dementia from primary care providers were excluded from the study. BMI was analyzed in WHO categories of underweight, overweight and obese, as well as in subdivisions of WHO categories. All models were fully adjusted for age, education, race, sex, marital status, smoking, hyperlipidemia, hypertension, diabetes, ischemic heart disease and stroke. Cox proportional hazard models showed that compared to those with a normal BMI (18.5-24.9), those obese (BMI > or = 30) at midlife had a 3.10 fold increase in risk of AD (fully adjusted model, Hazard Ratio=3.10, 95% CI 2.19-4.38), and a five fold increase in risk of VaD (fully adjusted model, HR=5.01, 95% CI 2.98-8.43) while those overweight ( BMI > or = 25 and <30) had a two fold increase in risk of AD and VaD (fully adjusted model, HR=2.09, 95% CI 1.69-2.60 for AD and HR=1.95, 95% CI 1.29-2.96 for VaD). These data suggest that midlife BMI is strongly predictive of both AD and VaD, independent of stroke, cardiovascular and diabetes co morbidities. Future studies need to unveil the mechanisms between adiposity and excess risk of AD and VaD.

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  • Whitmer and colleagues reported that overweight raised AD and VaD risk similarly (about twofold), while obesity was linked more strongly to VaD (fivefold) than to AD (threefold).

    “In the study of Whitmer et al.15 overweight (BMI between 25 and 30) increased the risk of AD and VaD to the same extent (approximately a two- fold increased risk), whereas obesity (BMI ≥ 30) was more strongly related to VaD, indicating a five-fold risk, as compared to a three-fold risk of AD.”

    From Overweight in midlife and risk of dementia: a 40-year follow-up study (2009) · cites this paper as [15]

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Authors
Whitmer, R., Gunderson, E., Quesenberry, C., Zhou, J., & Yaffe, K.
Affiliations
  • Kaiser Permanente (US)
  • University of California, San Francisco (US)
ORCID
Venue
Current Alzheimer Research
Publisher
Bentham Science Publishers Ltd.
Published
2007-04-01
Volume
4
Issue
2
Pages
103-109
ISSN
1567-2050 (ISSN-L)
DOI
10.2174/156720507780362047
OpenAlex
W2139377504
Cited by
430
References
0
Citations by year
2026: 8 · 2025: 12 · 2024: 20 · 2023: 18 · 2022: 17 · 2021: 26 · 2020: 27 · 2019: 16 · 2018: 23 · 2017: 29 · 2016: 26 · 2015: 20 · 2014: 46 · 2013: 29 · 2012: 30
FWCI
11.81
Type
journal article
Language
en
Open access
closed
Locations
  • Current Alzheimer Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Institute on Aging (AG027504, R03AG027504)
  • National Institute of Diabetes and Digestive and Kidney Diseases (K01DK066308, DK066308)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Keywords
body mass index, midlife obesity, overweight, Alzheimer's disease, vascular dementia, dementia risk, adiposity, stroke, cardiovascular comorbidity, diabetes mellitus
MeSH terms
Adult, Alzheimer Disease, Body Weight, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk, Dementia, Vascular, Body Mass Index, Incidence, Proportional Hazards Models

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