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Association of anthropometry and weight change with risk of dementia and its major subtypes: a meta-analysis consisting 2.8 million adults with 57,294 cases of dementia

Journal article
Authors Crystal Lee
Mark Woodward
David Batty
Alexa Beiser
Steven Bell
Claudine Berr
Espen Bjertness
John Chalmers
Robert Clarke
Jean- Francois Dartigues
Kendra Davis-Plourde
Stéphanie Debette
Emanuele Di Angelantonio
Catherine Feart
Ruth Frikke-Schmidt
John Gregson
Mary Haan
Linda Hassing
Kathleen Hayden
Marieke Hoevenaar-Blom
Jaakko Kaprio
Mika Kivimaki
Georgios Lappas
Eric Larson
Erin LeBlanc
Published in Obesity Reviews
ISSN 1467-7881
Publication year 2020
Published at Department of Psychology
Language en
Links https://doi.org/10.1111/obr.12989
Subject categories Gerontology, specializing in Medical and Health Sciences, Geriatrics, Psychiatry, Epidemiology, Public health science

Abstract

Uncertainty exists regarding the relation of body size and weight change with dementia risk. As populations continue to age and the global obesity epidemic shows no sign of waning, reliable quantification of such associations is important. We examined the relationship of body mass index, waist circumference, and annual percent weight change with risk of dementia and its subtypes by pooling data from 19 prospective cohort studies and four clinical trials using meta-analysis. Compared with body mass index-defined lower-normal weight (18.5–22.4 kg/m2), the risk of all-cause dementia was higher among underweight individuals but lower among those with upper-normal (22.5–24.9 kg/m2) levels. Obesity was associated with higher risk in vascular dementia. Similarly, relative to the lowest fifth of waist circumference, those in the highest fifth had non-significant higher vascular dementia risk. Weight loss was associated with higher all-cause dementia risk relative to weight maintenance. Weight gain was weakly associated with higher vascular dementia risk. The relationship between body size, weight change and dementia is complex and exhibits nonlinear associations depending on dementia subtype under scrutiny. Weight loss was associated with an elevated risk most likely due to reverse causality and/or pathophysiological changes in the brain, although the latter remains speculative.

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