Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study
Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study
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DOI：
10.1136/bmj.38446.466238.e0
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发表时间：
2005-06-11
影响因子：
105.7
通讯作者：
Yaffe, K
中科院分区：
文献类型：
--
作者：
Whitmer, RA;Gunderson, EP;Yaffe, K
目的 评估通过体重指数和皮褶厚度测量的中年肥胖与晚年痴呆风险之间的关联。设计对基于多种族人群的队列的前瞻性数据进行分析。设置医疗服务机构 Kaiser Permanente 北加州医疗集团。参与者 10 276 名男性和女性，他们在 1964 年至 1973 年老年期间接受了详细的健康评估 40-45 岁且 1994 年仍是健康计划成员。主要结果指标 1994 年 1 月至 2003 年 4 月诊断痴呆。使用 Cox 比例风险模型分析诊断时间，并根据年龄、性别、种族、教育、吸烟、饮酒、婚姻状况、糖尿病、高血压、高脂血症、中风和缺血性心脏病进行调整。结果 713 名患者（6.9%）被诊断为痴呆。 参与者。与体重正常（体重指数>=30）的人相比，肥胖者（体重指数>=30）患痴呆症的风险增加74%（风险比1.74，95%置信区间1.34至2.26），而超重者（体重指数25.0-29.9）患痴呆症的风险增加35%（1.35、1.14至1.60）。 18.6-24.9）。与最低五分之一的人相比，肩胛下或三头肌皮褶厚度分布最高五分之一的男性和女性患痴呆症的风险分别高出 72% 和 59%（1.72、1.36 至 2.18 和 1.59、1.24 至 2.04）。 结论 中年肥胖会增加未来患痴呆症的风险，与合并症无关。
Objective To evaluate any association between obesity in middle age, measured by body mass index and skinfold thickness, and risk of dementia later in life.Design Analysis of prospective data from a multiethnic population based cohort.Setting Kaiser Permanente Northern California Medical Group, a healthcare delivery organisation.Participants 10 276 men and women who underwent detailed health evaluations from 1964 to 1973 when they were aged 40-45 and who were still members of the health plan in 1994.Main outcome measures Diagnosis of dementia from January 1994 to April 2003. Time to diagnosis was analysed with Cox proportional hazard models adjusted for age, sex, race, education, smoking, alcohol use, marital status, diabetes, hypertension, hyperlipidaemia, stroke, and ischaemic heart disease.Results Dementia was diagnosed in 713 (6.9%) participants. Obese people (body mass index >= 30) had a 74% increased risk of dementia (hazard ratio 1.74, 95% confidence interval 1.34 to 2.26), while overweight people (body mass index 25.0-29.9) had a 35% greater risk of dementia (1.35, 1.14 to 1.60) compared with those of normal weight (body mass index 18.6-24.9). Compared with those in the lowest fifth, men and women in the highest fifth of the distribution of subscapular or tricep skinfold thickness had a 72% and 59% greater risk of dementia, respectively (1.72, 1.36 to 2.18, and 1.59, 1.24 to 2.04).Conclusions Obesity in middle age increases the risk of future dementia independently of comorbid conditions.