Late-Life Body Mass Index, Rapid Weight Loss, Apolipoprotein E ε4 and the Risk of Cognitive Decline and Incident Dementia.
Late-Life Body Mass Index, Rapid Weight Loss, Apolipoprotein E ε4 and the Risk of Cognitive Decline and Incident Dementia.
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DOI：
10.1007/s12603-017-0906-3
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Jefferson AL
中科院分区：
文献类型：
--
作者：
Bell SP;Liu D;Samuels LR;Shah AS;Gifford KA;Hohman TJ;Jefferson AL
为了检查晚年体重指数（BMI）和快速体重减轻对轻度认知功能障碍（MCI）和阿尔茨海默病（AD）的影响，前瞻性纵向队列研究国家阿尔茨海默病协调中心（NACC）统一数据集，包括34个过去和现在的美国国家老龄化研究所资助的AD中心，6940名老年人（n=5061名认知正常（NC）; n=1879名MCI）在基线时评估BMI（kg/m2）和改良的FSRP评分（性别、年龄、收缩压、抗高血压药物、糖尿病、吸烟、流行心血管疾病、房颤）。认知和体重每年进行评估。校正年龄、性别、种族、教育程度、随访时间和改良FSRP相关晚年BMI的多变量二元logistic回归分析，以评估从NC至MCI或AD以及从MCI至AD的诊断转换风险。次要分析将晚年BMI与快速体重减轻（12个月内下降>5%）和载脂蛋白E（APOE）ε4的诊断转换相关。在平均3.8年的随访期间，12%的NC参与者转化为MCI或AD，49%的MCI参与者转化为AD。较高的基线BMI与诊断转换的可能性降低相关，因此基线BMI每增加一个单位，NC（OR=0.977，95%CI 0.958-0.996，p=0.015）和MCI参与者（OR=0.962，95%CI 0.942-0.983，p<0.001）的诊断转换都会降低。在快速体重减轻的情况下，较高的基线BMI的保护作用并不持久，但在调整APOE后仍然存在。较高的晚年BMI与较低的MCI和AD发病风险相关，但在快速体重减轻的情况下没有保护作用。
To examine the effect of late-life body mass index (BMI) and rapid weight loss on incident mild cognitive impairment (MCI) and Alzheimer’s disease (AD) Prospective longitudinal cohort study National Alzheimer’s Coordinating Center (NACC) Uniform Data Set, including 34 past and current National Institute on Aging-funded AD Centers across the United States 6940 older adults (n=5061 normal cognition (NC); n=1879 MCI) BMI (kg/m2) and modified Framingham Stroke Risk Profile (FSRP) score (sex, age, systolic blood pressure, anti-hypertension medication, diabetes mellitus, cigarette smoking, prevalent cardiovascular disease, atrial fibrillation) were assessed at baseline. Cognition and weight were assessed annually. Multivariable binary logistic regression, adjusting for age, sex, race, education, length of follow-up, and modified FSRP related late-life BMI to risk of diagnostic conversion from NC to MCI or AD and from MCI to AD. Secondary analyses related late-life BMI to diagnostic conversion in the presence of rapid weight loss (>5% decrease in 12 months) and apolipoprotein E (APOE) ε4. During a mean 3.8-year follow-up period, 12% of NC participants converted to MCI or AD and 49% of MCI participants converted to AD. Higher baseline BMI was associated with a reduced probability of diagnostic conversion, such that for each one-unit increase in baseline BMI there was a reduction in diagnostic conversion for both NC (OR=0.977, 95%CI 0.958–0.996, p=0.015) and MCI participants (OR=0.962, 95%CI 0.942–0.983, p<0.001). The protective effect of higher baseline BMI did not persist in the setting of rapid weight loss but did persist when adjusting for APOE. Higher late-life BMI is associated with a lower risk of incident MCI and AD but is not protective in the presence of rapid weight loss.
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影响因子：
158.5
作者：
Calle, EE;Thun, MJ;Heath, CW
通讯作者：
Heath, CW
影响因子：
105.7
作者：
Harris, TB;Launer, LJ;Feldman, JJ
通讯作者：
Feldman, JJ
影响因子：
158.5
作者：
MANSON, JE;WILLETT, WC;SPEIZER, FE
通讯作者：
SPEIZER, FE
影响因子：
--
作者：
Kivipelto, M;Ngandu, T;Nissinen, A
通讯作者：
Nissinen, A
影响因子：
4.2
作者：
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ADNI