Association between body mass index, its change and cognitive impairment among Chinese older adults: a community-based, 9-year prospective cohort study
Association between body mass index, its change and cognitive impairment among Chinese older adults: a community-based, 9-year prospective cohort study
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DOI：
10.1007/s10654-021-00792-y
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发表时间：
2021-08-09
影响因子：
13.6
通讯作者：
Yuan, Changzheng
中科院分区：
文献类型：
--
作者：
Wu, Shanshan;Lv, Xiaozhen;Yuan, Changzheng
探讨中国老年人基线体重指数（BMI）及其变化与认知障碍的关系。该研究包括来自中国纵向健康长寿研究的数据，这是一项2002年至2018年的全国性社区前瞻性队列研究。基线BMI和BMI变化对12027名65岁以上的成年人可用。认知障碍定义为中文版迷你精神状态测试得分低于18分。采用多变量Cox比例风险模型。在12027名参与者中（平均年龄81.23岁，男性47.48%），基线体重不足、正常、超重和肥胖的比例分别为33.87%、51.39%、11.39%和3.34%。在平均5.9年的随访期间，3086名参与者（每100人年4.35人）被确定为偶发性认知障碍。与正常体重组相比，超重组认知障碍的校正危险比（AHR）为0.86 (95% CI 0.75-0.99)，而体重不足组相应的AHR为1.02 (95% CI 0.94-1.10)，肥胖组相应的AHR为1.01 （95% CI 0.80-1.28）。与体重稳定组（-5%相似）相比，体重大幅减轻（< -10%）与认知障碍风险增加显著相关（AHR, 1.42, 95% CI 1.29-1.56）。在受限三次样条模型中，BMI变化与认知障碍呈反j型相关。在中国老年人中，bmi定义的超重（而非肥胖）与认知障碍风险较低有关，而体重大幅减轻则与风险增加有关。这些发现与痴呆症前驱期体重减轻相一致。
To examine the association of baseline body mass index (BMI) and BMI change with cognitive impairment among older adults in China. The study included data from the Chinese Longitudinal Healthy Longevity Study, a national community-based prospective cohort study from 2002 to 2018. Baseline BMI and BMI change were available for 12,027 adults aged older than 65 years. Cognitive impairment was defined as Chinese version of the Mini Mental State Examination score lower than 18. Multivariable Cox proportional hazard model was used. Among 12,027 participants (mean age was 81.23 years old and 47.48% were male), the proportion of underweight, normal, overweight and obese at baseline was 33.87%, 51.39%, 11.39% and 3.34%, respectively. During an average of 5.9 years' follow-up, 3086 participants (4.35 per 100 person-years) with incident cognitive impairment were identified. Compared with normal weight group, adjusted hazard ratio (AHR) for cognitive impairment was 0.86 (95% CI 0.75-0.99) among overweight group, whereas corresponding AHR was 1.02 (95% CI 0.94-1.10) in underweight and 1.01 (95% CI 0.80-1.28) in obese participants. Large weight loss (< -10%) was significantly associated with an increased risk of cognitive impairment (AHR, 1.42, 95% CI 1.29-1.56), compared to stable weight status group (-5% similar to 5%). In the restricted cubic spline models, BMI change showed a reverse J-shaped association with cognitive impairment. BMI-defined overweight, but not obesity, was associated with a lower risk of cognitive impairment among elderly Chinese adults, while large weight loss was associated with an increased risk. These findings are consistent with weight loss in the prodromal phase of dementia.