Affiliations: [a] Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| [b] NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| [c] People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| [d] Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| [e] National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
Correspondence:
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Correspondence to: Wei Deng, Department of Biostatistics, School of Public Health, Fudan University, 130 Dong’An Rd., Shanghai 200032, China. Tel.: +86 21 54237707; E-mail: wdeng@shmu.edu.cn and Ding Ding, Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Rd., Shanghai 200040, China. Tel.: +86 21 5288 8158; E-mail: dingding@huashan.org.cn.
Note: [1] This article received a correction notice (Erratum) with the reference: 10.3233/JAD-229004, available at http://doi.org/10.3233/JAD-229004.
Abstract: Background:The relationship between body mass index (BMI) and dementia is inconclusive. Undesirable loss of fat-free mass is a risk factor for cognitive decline while obesity is also a risk factor for cardio-metabolic disorders among the older adults. Objective:This study aimed to examine the association between BMI and incident all-cause dementia among Chinese older adults using a prospective study. Methods:Participants were 1,627 community residents aged 60 or older without dementia from the Shanghai Aging Study. Cox regression models, incorporated with restricted cubic splines, were used to explore a nonlinear association between baseline BMI and risk of all-cause dementia as measured by hazard ratio (HR) using both frequentist and Bayesian approach. Results:We diagnosed 136 incident dementia cases during the mean follow-up of 5.3 years. Compared with moderate BMI (18.5–24.0 kg/m2), low BMI (< 18.5 kg/m2) were related to an increased risk of dementia with the HR as 3.38 (95% CI 1.50–7.63), while high BMI (≥24.0 kg/m2) showed a decreased risk of dementia without statistical significance (HR = 0.91, 95% CI 0.60 to 1.39). Sensitivity analysis in participants without central obesity indicated that the association was still significant with even higher HR. Bayesian approach presented the similar results. Conclusion:Our result indicates that low BMI may contribute to high risk of incident dementia, even in individuals without central obesity.
Keywords: Body mass index, cognitive dysfunction, dementia, proportional hazards models, prospective studies
