Obesity and cognitive decline in adults: Effect of methodological choices and confounding by age in a longitudinal study
Obesity and cognitive decline in adults: Effect of methodological choices and confounding by age in a longitudinal study
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DOI：
10.1007/s12603-016-0757-3
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发表时间：
2017-05-01
影响因子：
5.8
通讯作者：
Kohler, S.
中科院分区：
文献类型：
--
作者：
Deckers, Kay;van Boxtel, M. P. J.;Kohler, S.
肥胖与认知障碍或痴呆的风险增加有关，但最近的研究结果相互矛盾，可能是由于方法上的差异。本研究试图通过跟踪12年以上肥胖个体的认知轨迹并研究肥胖状态的影响来澄清这些不一致（基线时肥胖与随访时肥胖事件）、慢性、定义、潜在混杂因素（如年龄、心血管因素）和非线性相关。12年随访的纵向研究。基于社区。1，来自马斯特里赫特老龄化研究（1992-2004）的807名认知健康个体（年龄24-83岁），在基线和6年和12年随访时评估记忆、执行功能和处理速度。肥胖定义为体重指数（BMI）≥ 30.0 kg/m2或腰围（WC）男性> 102 cm，女性> 88 cm。基线时，545人肥胖（BMI：329（18%）; WC：494（27%）;两者均为：278（15%）。他们的记忆力、执行功能和处理速度下降得更快。慢性肥胖者比那些恢复正常体重的人表现出更少的广泛损害。与WC相比，BMI定义的肥胖在认知领域的关联较弱。在随访中，190人出现肥胖，他们在基线时的执行功能表现较差，但与正常体重的参与者相比，下降幅度较小。然而，年龄分层和事后分析表明，大多数这些协会是混淆的年龄。这项研究表明，肥胖和认知能力下降之间的关联是混淆的年龄对下降率的影响。今后的研究应考虑到这一点。
Obesity has been associated with increased risk of cognitive impairment or dementia, but recent findings are contradictory, possibly due to methodological differences. The present study tries to clarify these inconsistencies by following the cognitive trajectories of individuals with obesity over 12 years and studying the effect of obesity status (obesity at baseline versus incident obesity at follow-up), chronicity, definition, potential confounding (e.g. age, cardiovascular factors), and non-linear associations.Longitudinal study with 12 years follow-up.Community based.1,807 cognitively healthy individuals (aged 24-83) from the Maastricht Aging Study (1992-2004).Memory, executive function and processing speed were assessed at baseline and at 6- and 12-year follow-up. Obesity was defined as having a body mass index (BMI) of >= 30.0 kg/m(2) or waist circumference (WC) of > 102 cm for men and > 88 cm for women.At baseline, 545 persons were obese (BMI: 329 (18%); WC: 494 (27%); both: 278 (15%). They showed faster decline in memory, executive function, and processing speed. Chronic obese showed less widespread impairment than those who regained normal weight. Associations across cognitive domains were weaker for obesity defined by BMI than for WC. At follow-up, 190 developed obesity, and they performed worse on executive function at baseline, but showed less decline compared with participants with normal weight. Yet, age-stratification and post-hoc analyses showed that most of these associations were confounded by age.This study shows that the association between obesity and cognitive decline was confounded by the effect of age on rate of decline. Future studies should take this into account.