Interaction between body mass index and central adiposity and risk of incident cognitive impairment and dementia: Results from the women's health initiative memory study

Diana R. Kerwin, Sarah A. Gaussoin, Rowan T. Chlebowski, Lewis H. Kuller, Mara Vitolins, Laura H. Coker, Jane M. Kotchen, Barbara J. Nicklas, Sylvia Wassertheil-Smoller, Raymond G. Hoffmann, Mark A. Espeland

Research output: Contribution to journalArticle

54 Scopus citations

Abstract

OBJECTIVES: To assess the relationship between body mass index (BMI) and waist-hip ratio (WHR) and the clinical end points of cognitive impairment and probable dementia in a cohort of older women enrolled in the Women's Health Initiative Memory Study (WHIMS). DESIGN: Prospective, randomized clinical trial of hormone therapies with annual cognitive assessments and anthropometrics. SETTING: Fourteen U.S. clinical sites of the WHIMS. PARTICIPANTS: Seven thousand one hundred sixty-three postmenopausal women aged 65 to 80 without dementia. MEASUREMENTS: Annual cognitive assessments, average follow-up of 4.4 years, including classification of incident cognitive impairment and probable dementia. Height, weight, waist, and hip measurements were assessed at baseline, and a waist-hip ratio (WHR) of 0.8 or greater was used as a marker of central adiposity. RESULTS: There were statistically significant interactions between BMI and WHR and incident cognitive impairment and probable dementia with and without adjustment for a panel of cognitive risk factors. Women with a WHR of 0.80 or greater with a BMI of 20.0 to 24.9 kg/m2 had a greater risk of cognitive impairment and probable dementia than more-obese women or women with a WHR less than 0.80, although women with a WHR less than 0.80 and a BMI of 20.0 to 24.9 kg/m2 had poorer scores on cognitive assessments. CONCLUSION: WHR affects the relationship between BMI and risk of cognitive impairment and probable dementia in older women. Underweight women (BMI<20.0 kg/m2) with a WHR less than 0.80 had a greater risk than those with higher BMIs. In normal-weight to obese women (20.0-29.9 kg/m2), central adiposity (WHR ≥0.80) is associated with greater risk of cognitive impairment and probable dementia than in women with higher BMI. These data suggest that central adiposity as a risk factor for cognitive impairment and probable dementia in normal-weight women.

Original languageEnglish (US)
Pages (from-to)107-112
Number of pages6
JournalJournal of the American Geriatrics Society
Volume59
Issue number1
DOIs
StatePublished - Jan 1 2011

    Fingerprint

Keywords

  • central adiposity
  • cognitive impairment
  • dementia
  • obesity
  • women's health

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Kerwin, D. R., Gaussoin, S. A., Chlebowski, R. T., Kuller, L. H., Vitolins, M., Coker, L. H., Kotchen, J. M., Nicklas, B. J., Wassertheil-Smoller, S., Hoffmann, R. G., & Espeland, M. A. (2011). Interaction between body mass index and central adiposity and risk of incident cognitive impairment and dementia: Results from the women's health initiative memory study. Journal of the American Geriatrics Society, 59(1), 107-112. https://doi.org/10.1111/j.1532-5415.2010.03219.x