Association between body mass index, its change and cognitive impairment among Chinese older adults: a community-based, 9-year prospective cohort study
单位:[1]Department of Gastroenterology, Beijing Key Laboratoryfor Precancerous Lesion of Digestive Disease, NationalClinical Research Center for Digestive Disease, BeijingDigestive Disease Center, Beijing Friendship Hospital,Capital Medical University, Beijing 100050, China临床科室国家中心消化分中心消化内科首都医科大学附属北京友谊医院[2]Beijing Dementia Key Lab, National Clinical ResearchCenter for Mental Disorders, NHC Key Laboratory of MentalHealth (Peking University), Peking University Instituteof Mental Health (Sixth Hospital), Beijing 100191, China[3]School of Public Health, Zhejiang University Schoolof Medicine, Hangzhou 310058, Zhejiang, China[4]Department of Epidemiology, Harvard T.H. Chan Schoolof Public Health, Boston, MA 02115, USA[5]MindRank AI Ltd, Hangzhou 311113, Zhejiang, China[6]CAS Key Laboratory of Nutrition, Metabolism and FoodSafety, Shanghai Institute of Nutrition and Health, Universityof Chinese Academy of Sciences, Chinese Academyof Sciences, Shanghai 200031, China[7]Department of Nutrition, Harvard T.H. Chan Schoolof Public Health, Boston, MA 02115, USA
To examine the association of baseline body mass index (BMI) and BMI change with cognitive impairment among older adults in China. The study included data from the Chinese Longitudinal Healthy Longevity Study, a national community-based prospective cohort study from 2002 to 2018. Baseline BMI and BMI change were available for 12,027 adults aged older than 65 years. Cognitive impairment was defined as Chinese version of the Mini Mental State Examination score lower than 18. Multivariable Cox proportional hazard model was used. Among 12,027 participants (mean age was 81.23 years old and 47.48% were male), the proportion of underweight, normal, overweight and obese at baseline was 33.87%, 51.39%, 11.39% and 3.34%, respectively. During an average of 5.9 years' follow-up, 3086 participants (4.35 per 100 person-years) with incident cognitive impairment were identified. Compared with normal weight group, adjusted hazard ratio (AHR) for cognitive impairment was 0.86 (95% CI 0.75-0.99) among overweight group, whereas corresponding AHR was 1.02 (95% CI 0.94-1.10) in underweight and 1.01 (95% CI 0.80-1.28) in obese participants. Large weight loss (< -10%) was significantly associated with an increased risk of cognitive impairment (AHR, 1.42, 95% CI 1.29-1.56), compared to stable weight status group (-5% similar to 5%). In the restricted cubic spline models, BMI change showed a reverse J-shaped association with cognitive impairment. BMI-defined overweight, but not obesity, was associated with a lower risk of cognitive impairment among elderly Chinese adults, while large weight loss was associated with an increased risk. These findings are consistent with weight loss in the prodromal phase of dementia.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [82003539, 71490732]; Capital's Funds for Health Improvement and Research [CFH2020-3-4114]
第一作者单位:[1]Department of Gastroenterology, Beijing Key Laboratoryfor Precancerous Lesion of Digestive Disease, NationalClinical Research Center for Digestive Disease, BeijingDigestive Disease Center, Beijing Friendship Hospital,Capital Medical University, Beijing 100050, China
共同第一作者:
通讯作者:
通讯机构:[3]School of Public Health, Zhejiang University Schoolof Medicine, Hangzhou 310058, Zhejiang, China[7]Department of Nutrition, Harvard T.H. Chan Schoolof Public Health, Boston, MA 02115, USA
推荐引用方式(GB/T 7714):
Wu Shanshan,Lv Xiaozhen,Shen Jie,et al.Association between body mass index, its change and cognitive impairment among Chinese older adults: a community-based, 9-year prospective cohort study[J].EUROPEAN JOURNAL of EPIDEMIOLOGY.2021,36(10):1043-1054.doi:10.1007/s10654-021-00792-y.
APA:
Wu, Shanshan,Lv, Xiaozhen,Shen, Jie,Chen, Hui,Ma, Yuan...&Yuan, Changzheng.(2021).Association between body mass index, its change and cognitive impairment among Chinese older adults: a community-based, 9-year prospective cohort study.EUROPEAN JOURNAL of EPIDEMIOLOGY,36,(10)
MLA:
Wu, Shanshan,et al."Association between body mass index, its change and cognitive impairment among Chinese older adults: a community-based, 9-year prospective cohort study".EUROPEAN JOURNAL of EPIDEMIOLOGY 36..10(2021):1043-1054