Hui Chen1, Tianjing Zhou1, Jie Guo2, John S Ji3, Liyan Huang1, Weili Xu2,4, Guangmin Zuo1, Xiaozhen Lv5, Yan Zheng6, Albert Hofman7,8, Yuan Ma7, Changzheng Yuan1,9. 1. School of Public Health, Zhejiang University School of Medicine, Hangzhou, China. 2. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. 3. Vanke School of Public Health, Tsinghua University, Beijing, China. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China. 5. Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China. 6. Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, China. 7. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 8. Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands. 9. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Abstract
BACKGROUND: Body weight variability (BWV) refers to intraindividual weight loss and gain over a period. The association of long-term BWV with dementia remains unclear and whether this association is beyond body weight change is undetermined. METHODS: In the Health and Retirement Study, a total of 5 547 dementia-free participants (56.7% women; mean [SD] age, 71.1 [3.2] years) at baseline (2008) were followed up to 8 years (mean = 6.8 years) to detect incident dementia. Body weight was self-reported biennially from 1992 to 2008. BWV was measured as the coefficient of variation utilizing the body weight reported 9 times across 16 years before baseline. Cox-proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS: Among the 5 547 participants, a total of 427 incident dementia cases were identified during follow-up. Greater long-term BWV was significantly associated with a higher risk of dementia (HR comparing extreme quartiles: 2.01, 95% CI: 1.48-2.72; HR of each SD increment: 1.21, 95% CI: 1.10-1.32; p-trend < .001) independent of mean body weight and body weight change. This significant association was even observed for BWV estimated approximately 15 years preceding dementia diagnosis (HR of each SD increment: 1.13, 95% CI: 1.03-1.23) and was more pronounced for that closer to diagnosis. CONCLUSION: Our prospective study suggested that greater BWV may be a novel risk factor for dementia.
BACKGROUND: Body weight variability (BWV) refers to intraindividual weight loss and gain over a period. The association of long-term BWV with dementia remains unclear and whether this association is beyond body weight change is undetermined. METHODS: In the Health and Retirement Study, a total of 5 547 dementia-free participants (56.7% women; mean [SD] age, 71.1 [3.2] years) at baseline (2008) were followed up to 8 years (mean = 6.8 years) to detect incident dementia. Body weight was self-reported biennially from 1992 to 2008. BWV was measured as the coefficient of variation utilizing the body weight reported 9 times across 16 years before baseline. Cox-proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS: Among the 5 547 participants, a total of 427 incident dementia cases were identified during follow-up. Greater long-term BWV was significantly associated with a higher risk of dementia (HR comparing extreme quartiles: 2.01, 95% CI: 1.48-2.72; HR of each SD increment: 1.21, 95% CI: 1.10-1.32; p-trend < .001) independent of mean body weight and body weight change. This significant association was even observed for BWV estimated approximately 15 years preceding dementia diagnosis (HR of each SD increment: 1.13, 95% CI: 1.03-1.23) and was more pronounced for that closer to diagnosis. CONCLUSION: Our prospective study suggested that greater BWV may be a novel risk factor for dementia.
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