Adiposity indicators and dementia over 32 years in Sweden
Adiposity indicators and dementia over 32 years in Sweden
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DOI：
10.1212/wnl.0b013e3181c0d4b6
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发表时间：
2009-11-10
期刊：
影响因子：
9.9
通讯作者：
Skoog, I.
中科院分区：
文献类型：
--
作者：
Gustafson, D. R.;Backman, K.;Skoog, I.
背景：中年和晚年肥胖可能会增加痴呆的风险。也有报告称，老年痴呆症诊断后几年内体重指数（BMI）或体重下降。研究设计和分析的差异可能会提供不同的图片，这种关系。方法：32年的纵向体重，BMI，腰围，腰臀比（WHR）的数据，从前瞻性人口研究的妇女在瑞典，与痴呆症。从1968年开始，对1,462名年龄在38-60岁之间的非痴呆妇女进行了代表性样本的随访，随后在1974年，1980年，1992年和2000年，使用神经精神病学，人体测量学，临床和其他测量方法。考克斯比例风险回归模型通过基线因素估计痴呆事件风险。Logistic回归模型，包括在每次检查的措施，与痴呆症的幸存参与者32年后。虽然考克斯模型显示基线人体测量因素与痴呆风险之间没有关联，但逻辑模型显示中年WHR大于0.80使痴呆风险增加约两倍（比值比2.22，95%置信区间1.00-4.94，p = 0.049）。反向因果关系的证据观察到的体重，BMI，腰围在痴呆diagnosis.Conclusions：在70岁的幸存者中，中年腰臀比高可能会增加痴呆的几率。传统的考克斯模型没有证明这种关系。在痴呆症发作前几年改变人体测量参数表明这种看似简单的关系的动态性质。老年痴呆症的预防有中年和晚年的影响，以及与识别老年痴呆症风险因素有关的分析考虑。神经病学（R）2009; 73：1559-1566
Background: High midlife and late-life adiposity may increase risk for dementia. Late-life decrease in body mass index (BMI) or body weight within several years of a dementia diagnosis has also been reported. Differences in study designs and analyses may provide different pictures of this relationship.Methods: Thirty-two years of longitudinal body weight, BMI, waist circumference, and waist-to-hip ratio (WHR) data, from the Prospective Population Study of Women in Sweden, were related to dementia. A representative sample of 1,462 nondemented women was followed from 1968 at ages 38-60 years, and subsequently in 1974, 1980, 1992, and 2000, using neuropsychiatric, anthropometric, clinical, and other measurements. Cox proportional hazards regression models estimated incident dementia risk by baseline factors. Logistic regression models including measures at each examination were related to dementia among surviving participants 32 years later.Results: While Cox models showed no association between baseline anthropometric factors and dementia risk, logistic models showed that a midlife WHR greater than 0.80 increased risk for dementia approximately twofold ( odds ratio 2.22, 95% confidence interval 1.00-4.94, p = 0.049) among surviving participants. Evidence for reverse causality was observed for body weight, BMI, and waist circumference in years preceding dementia diagnosis.Conclusions: Among survivors to age 70, high midlife waist-to-hip ratio may increase odds of dementia. Traditional Cox models do not evidence this relationship. Changing anthropometric parameters in years preceding dementia onset indicate the dynamic nature of this seemingly simple relationship. There are midlife and late-life implications for dementia prevention, and analytical considerations related to identifying risk factors for dementia. Neurology (R) 2009; 73: 1559-1566