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Body mass index and risk of dementia: Analysis of individual-level data from 1.3 million individuals
University College London, London, UK; University of Helsinki, Helsinki, Finland; Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
University of Helsinki, Helsinki, Finland.
University College London, London, UK; University of Edinburgh, Edinburgh, UK.
University of Bristol, Bristol, UK.
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2018 (English)In: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 14, no 5, p. 601-609Article in journal (Refereed) Published
Abstract [en]

Introduction: Higher midlife body mass index (BMI) is suggested to increase the risk of dementia, but weight loss during the preclinical dementia phase may mask such effects. Methods: We examined this hypothesis in 1,349,857 dementia-free participants from 39 cohort studies. BMI was assessed at baseline. Dementia was ascertained at follow-up using linkage to electronic health records (N = 6894). We assumed BMI is little affected by preclinical dementia when assessed decades before dementia onset and much affected when assessed nearer diagnosis. Results: Hazard ratios per 5-kg/m2 increase in BMI for dementia were 0.71 (95% confidence interval = 0.66-0.77), 0.94 (0.89-0.99), and 1.16 (1.05-1.27) when BMI was assessed 10 years, 10-20 years, and >20 years before dementia diagnosis. Conclusions: The association between BMI and dementia is likely to be attributable to two different processes: a harmful effect of higher BMI, which is observable in long follow-up, and a reverse-causation effect that makes a higher BMI to appear protective when the follow-up is short. 

Place, publisher, year, edition, pages
2018. Vol. 14, no 5, p. 601-609
Keywords [en]
Bias, Body mass index, Cohort study, Dementia, Obesity
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:miun:diva-32715DOI: 10.1016/j.jalz.2017.09.016ISI: 000432438800003PubMedID: 29169013OAI: oai:DiVA.org:miun-32715DiVA, id: diva2:1175968
Note

Available online 21 November 2017

Available from: 2018-01-19 Created: 2018-01-19 Last updated: 2018-07-19Bibliographically approved

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Knutsson, Anders

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