Interaction Between Body Mass Index and Central Adiposity and Risk of Incident Cognitive Impairment and Dementia: Results from the Women's Health Initiative Memory Study

被引：74

作者：

Kerwin, Diana R. ^{[1
]}

Gaussoin, Sarah A. ^{[2
]}

Chlebowski, Rowan T. ^{[4
]}

Kuller, Lewis H. ^{[5
]}

Vitolins, Mara ^{[2
]}

Coker, Laura H. ^{[2
]}

Kotchen, Jane M. ^{[6
]}

Nicklas, Barbara J. ^{[3
]}

Wassertheil-Smoller, Sylvia ^{[8
]}

Hoffmann, Raymond G. ^{[7
]}

Espeland, Mark A. ^{[2
]}

机构：

[1] Northwestern Univ, Feinberg Sch Med, Dept Med, Div Geriatr, Chicago, IL 60611 USA

[2] Wake Forest Univ, Bowman Gray Sch Med, Div Publ Hlth Sci, Winston Salem, NC USA

[3] Wake Forest Univ, Bowman Gray Sch Med, Ctr Human Genom, Winston Salem, NC USA

[4] Harbor Univ Calif Los Angeles Res & Educ Inst, Torrance, CA USA

[5] Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA

[6] Med Coll Wisconsin, Dept Populat Hlth, Milwaukee, WI 53226 USA

[7] Med Coll Wisconsin, Dept Pediat, Milwaukee, WI 53226 USA

[8] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10467 USA

来源：

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY | 2011年 / 59卷 / 01期

基金：

美国国家卫生研究院;

关键词：

dementia; cognitive impairment; obesity; central adiposity; women's health; RANDOMIZED CONTROLLED-TRIAL; ESTROGEN PLUS PROGESTIN; CONJUGATED EQUINE ESTROGENS; POSTMENOPAUSAL WOMEN; ALZHEIMERS-DISEASE; BLOOD-PRESSURE; OBESITY; WEIGHT; ASSOCIATION; OVERWEIGHT;

D O I：

10.1111/j.1532-5415.2010.03219.x

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

OBJECTIVES To assess the relationship between body mass index (BMI) and waist-hip ratio (WHR) and the clinical end points of cognitive impairment and probable dementia in a cohort of older women enrolled in the Women's Health Initiative Memory Study (WHIMS). DESIGN Prospective, randomized clinical trial of hormone therapies with annual cognitive assessments and anthropometrics. SETTING Fourteen U.S. clinical sites of the WHIMS. PARTICIPANTS Seven thousand one hundred sixty-three postmenopausal women aged 65 to 80 without dementia. MEASUREMENTS Annual cognitive assessments, average follow-up of 4.4 years, including classification of incident cognitive impairment and probable dementia. Height, weight, waist, and hip measurements were assessed at baseline, and a waist-hip ratio (WHR) of 0.8 or greater was used as a marker of central adiposity. RESULTS There were statistically significant interactions between BMI and WHR and incident cognitive impairment and probable dementia with and without adjustment for a panel of cognitive risk factors. Women with a WHR of 0.80 or greater with a BMI of 20.0 to 24.9 kg/m2 had a greater risk of cognitive impairment and probable dementia than more-obese women or women with a WHR less than 0.80, although women with a WHR less than 0.80 and a BMI of 20.0 to 24.9 kg/m2 had poorer scores on cognitive assessments. CONCLUSION WHR affects the relationship between BMI and risk of cognitive impairment and probable dementia in older women. Underweight women (BMI < 20.0 kg/m2) with a WHR less than 0.80 had a greater risk than those with higher BMIs. In normal-weight to obese women (20.0-29.9 kg/m2), central adiposity (WHR >= 0.80) is associated with greater risk of cognitive impairment and probable dementia than in women with higher BMI. These data suggest that central adiposity as a risk factor for cognitive impairment and probable dementia in normal-weight women.

引用

页码：107 / 112

页数：6

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