Variability in body weight precedes diagnosis in dementia: A nationwide cohort study

Background While there have been disagreements concerning whether obesity and increase in body weight elevate the risk of dementia, variability in body weight has been recently recognized as a new biometric associated with a high risk for a number of diseases. This nationwide, population-based cohort study examined the association between body weight variability and dementia. Methods A total of 2,812,245 adults (mean age, 51.7 years; standard deviation, 8.6) without a history of dementia who underwent at least three health examinations between 2005 and 2012 in a nationwide cohort were followed-up until the date of dementia diagnosis (based on prescribed drugs and disease code) or until 2016 (median follow-up duration, 5.38 years; interquartile range, 5.16-5.61). Cox regression models were used to evaluate the risk of Alzheimer's disease and vascular dementia according to body weight variability. Results The hazard ratios (95% confidence intervals) of the highest quartiles of variability were 1.42 (1.35-1.49) for Alzheimer's disease and 1.47 (1.32-1.63) for vascular dementia compared to the lowest quartile group as a reference. This association was consistent in various subgroup analyses and sensitivity analyses. Conclusions Body weight variability could predict Alzheimer's disease and vascular dementia, which may provide new insights into the prevention and management of dementia.