TY - JOUR
T1 - Interaction between body mass index and central adiposity and risk of incident cognitive impairment and dementia
T2 - Results from the women's health initiative memory study
AU - Kerwin, Diana R.
AU - Gaussoin, Sarah A.
AU - Chlebowski, Rowan T.
AU - Kuller, Lewis H.
AU - Vitolins, Mara
AU - Coker, Laura H.
AU - Kotchen, Jane M.
AU - Nicklas, Barbara J.
AU - Wassertheil-Smoller, Sylvia
AU - Hoffmann, Raymond G.
AU - Espeland, Mark A.
PY - 2011/1
Y1 - 2011/1
N2 - 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.
AB - 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.
KW - central adiposity
KW - cognitive impairment
KW - dementia
KW - obesity
KW - women's health
UR - http://www.scopus.com/inward/record.url?scp=78651403233&partnerID=8YFLogxK
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U2 - 10.1111/j.1532-5415.2010.03219.x
DO - 10.1111/j.1532-5415.2010.03219.x
M3 - Article
C2 - 21226681
AN - SCOPUS:78651403233
SN - 0002-8614
VL - 59
SP - 107
EP - 112
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 1
ER -