Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
QUICK SEARCH:   [advanced]


     

Published online before print March 26, 2008, doi:10.1212/01.wnl.0000306313.89165.ef)
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
01.wnl.0000306313.89165.efv1
71/14/1057    most recent
Right arrow Correspondence:
Submit a response
Right arrow Correspondence:
View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Whitmer, R. A.
Right arrow Articles by Yaffe, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Whitmer, R. A.
Right arrow Articles by Yaffe, K.
Related Collections
Right arrowRelated Articles
Received August 15, 2007
Accepted December 14, 2007

Central obesity and increased risk of dementia more than three decades later

R. A. Whitmer PhD*, D. R. Gustafson PhD, E. Barrett-Connor MD, M. N. Haan DrPH, E. P. Gunderson PhD, and K. Yaffe MD

From Kaiser Permanente Division of Research (R.A.W., E.P.G.), Oakland, CA; Goteberg University (D.R.G.), Goteberg, Sweden; the Department of Family Medicine (E.B.-C.), University of California, La Jolla; the Department of Epidemiology (M.N.H.), University of Michigan, Ann Arbor; and the Departments of Psychiatry, Neurology and Epidemiology (K.Y.), University of California, San Francisco.


* To whom correspondence should be addressed. E-mail: rachel.whitmer{at}kp.org.

Background: Numerous reports show that a centralized distribution of adiposity is a more dangerous risk factor for cardiovascular disease and diabetes than total body obesity. No studies have evaluated whether the same pattern exists with dementia. The objective was to evaluate the association between midlife central obesity and risk of dementia three decades later.

Methods: A longitudinal analysis was conducted of 6,583 members of Kaiser Permanente of Northern California who had their sagittal abdominal diameter (SAD) measured in 1964 to 1973. Diagnoses of dementia were from medical records an average of 36 years later, January 1, 1994, to June 16, 2006. Cox proportional hazard models adjusted for age, sex, race, education, marital status, diabetes, hypertension, hyperlipidemia, stroke, heart disease, and medical utilization were conducted.

Results: A total of 1,049 participants (15.9%) were diagnosed with dementia. Compared with those in the lowest quintile of SAD, those in the highest had nearly a threefold increased risk of dementia (hazard ratio, 2.72; 95% CI, 2.33–3.33), and this was only mildly attenuated after adding body mass index (BMI) to the model (hazard ratio, 1.92; 95% CI, 1.58–2.35). Those with high SAD (>25 cm) and normal BMI had an increased risk (hazard ratio, 1.89; 95% CI, 0.98–3.81) vs those with low SAD (<25 cm) and normal BMI (18.5–24.9 kg/m2), whereas those both obese (BMI >30 kg/m2) and with high SAD had the highest risk of dementia (HR, 3.60; 95% CI, 2.85–4.55).

Conclusions: Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. Fifty percent of adults have central obesity; therefore, mechanisms linking central obesity to dementia need to be unveiled.


Related Articles

Impaired insulin secretion increases the risk of Alzheimer disease
E. Rönnemaa, B. Zethelius, J. Sundelöf, J. Sundström, M. Degerman-Gunnarsson, C. Berne, L. Lannfelt, and L. Kilander
Neurology 2008 71: 1065-1071. [Abstract] [Full Text] [PDF]

Childhood cognitive ability and risk of late-onset Alzheimer and vascular dementia
Brian McGurn, Ian J. Deary, and John M. Starr
Neurology 2008 71: 1051-1056. [Abstract] [Full Text] [PDF]

Go to the head of the class to avoid vascular dementia and skip diabetes and obesity
David S. Knopman
Neurology 2008 71: 1046-1047. [Full Text] [PDF]



This article has been cited by other articles:


Home page
 NeurologyHome page
G. Tsivgoulis, A. V. Alexandrov, V. G. Wadley, F. W. Unverzagt, R.C.P. Go, C. S. Moy, B. Kissela, and G. Howard
Association of higher diastolic blood pressure levels with cognitive impairment
Neurology, August 25, 2009; 73(8): 589 - 595.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
T. F. Hughes, A. R. Borenstein, E. Schofield, Y. Wu, and E. B. Larson
Association between late-life body mass index and dementia: The Kame Project
Neurology, May 19, 2009; 72(20): 1741 - 1746.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
R. A. Whitmer, A. J. Karter, K. Yaffe, C. P. Quesenberry Jr, and J. V. Selby
Hypoglycemic Episodes and Risk of Dementia in Older Patients With Type 2 Diabetes Mellitus
JAMA, April 15, 2009; 301(15): 1565 - 1572.
[Abstract] [Full Text] [PDF]

Home page
 J Gerontol A Biol Sci Med SciHome page
A. Dahl, L. B. Hassing, E. Fransson, S. Berg, M. Gatz, C. A. Reynolds, and N. L. Pedersen
Being Overweight in Midlife Is Associated With Lower Cognitive Ability and Steeper Cognitive Decline in Late Life
J Gerontol A Biol Sci Med Sci, April 6, 2009; (2009) glp035v1.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
E. Cereda, M. C. Sacchi, A. E. Malavazos, R.A. Whitmer, D.R. Gustafson, E. Barrett-Connor, M.N. Haan, E.P. Gunderson, and K. Yaffe
Central obesity and increased risk of dementia more than three decades later
Neurology, March 17, 2009; 72(11): 1030 - 1031.
[Full Text] [PDF]

Home page
 Arch NeurolHome page
S. Craft
The Role of Metabolic Disorders in Alzheimer Disease and Vascular Dementia: Two Roads Converged
Arch Neurol, March 1, 2009; 66(3): 300 - 305.
[Abstract] [Full Text] [PDF]

Home page
 Arch NeurolHome page
A. M. Kanaya, K. Lindquist, T. B. Harris, L. Launer, C. Rosano, S. Satterfield, K. Yaffe, and for the Health ABC Study
Total and Regional Adiposity and Cognitive Change in Older Adults: The Health, Aging and Body Composition (ABC) Study
Arch Neurol, March 1, 2009; 66(3): 329 - 335.
[Abstract] [Full Text] [PDF]

Home page
 Arch NeurolHome page
A. L. Fitzpatrick, L. H. Kuller, O. L. Lopez, P. Diehr, E. S. O'Meara, W. T. Longstreth Jr, and J. A. Luchsinger
Midlife and Late-Life Obesity and the Risk of Dementia: Cardiovascular Health Study
Arch Neurol, March 1, 2009; 66(3): 336 - 342.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
D. S. Knopman
Go to the head of the class to avoid vascular dementia and skip diabetes and obesity
Neurology, September 30, 2008; 71(14): 1046 - 1047.
[Full Text] [PDF]

Correspondence:

Read all Correspondence

Central obesity and increased risk of dementia more than three decades later
Emanuele Cereda, et al.
Neurology Online, 26 Jun 2008 [Full text]
Central obesity and increased risk of dementia more than three decades later
Nikolaos Tezapsidis, et al.
Neurology Online, 26 Jun 2008 [Full text]
Central obesity and increased risk of dementia more than three decades later
Azeez Farooki
Neurology Online, 26 Jun 2008 [Full text]
Reply from the authors
Rachael A. Whitmer, et al.
Neurology Online, 26 Jun 2008 [Full text]

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Copyright © 2008 by AAN Enterprises, Inc.