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Long‐term adiposity is associated with poorer cognitive performance in middle‐aged adults at high risk of Alzheimer’s disease
Author(s) -
West Rebecca,
RavonaSpringer Ramit,
SharvitGi Inbal,
Golan Sapir,
Heymann Anthony,
Beeri Michal Schnaider
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.041829
Subject(s) - overweight , body mass index , cognition , episodic memory , psychology , cognitive decline , executive functions , gerontology , disease , medicine , dementia , demography , psychiatry , sociology
Background The impact of adiposity on cognition in older adults is well‐established. Alzheimer’s disease (AD) neuropathology begins accumulating years prior to symptoms; investigation of potential AD risk factors, such as adiposity, in middle‐aged adults may illuminate novel pathways underlying the earliest stages of cognitive decline. We examined the relationship of body mass index (BMI), and long‐term trajectories of BMI, with cognitive functioning in middle‐aged adults, participants of the Israel Registry of Alzheimer’s Prevention (IRAP Study), all members of the Israeli HMO‐ Maccabi Health Services, who are exquisitely well‐characterized for cardiovascular risk factors. Methods IRAP follows middle‐aged offspring of AD patients (FH+; N=379) and offspring of non‐demented parents (FH‐; N=89). We examined relationships of BMI with global cognition and specific cognitive domains (executive functions, episodic memory, language, working memory). Linear regressions adjusting for age, sex, education, total cholesterol, systolic and diastolic blood pressure, glucose, creatinine, and diabetes status assessed associations of BMI (mean of all BMI measures in Maccabi for each participant) with cognition. Additionally, ANCOVAs were used to examine the association of long‐term trajectories of BMI (“normal, N=239; “overweight,” N= 115; and “obese, N=21” identified using SAS macro PROC TRJ), with cognition. Results Higher BMI was significantly associated with lower executive functions (p=.015), episodic memory (p=.032), and global cognition (p=.032), but not language (p= .729) or working memory (p=.391). Significant differences in cognition were identified for the BMI long‐term trajectories for executive functions (normal BMI=.12, overweight M=‐.24, obese M=‐.32, p=.007) episodic memory (.07, ‐.10, ‐.66, p=.021) and global cognition (normal M=.08, overweight M=‐.10, obese M=‐.40, p=.036), but not language (p=.181) or working memory (p=.855). Controlling for FH status did not alter these results. Conclusion Higher BMI was associated with lower executive functions, episodic memory, and global cognition in cognitively normal middle‐aged adults. This result is reinforced by the finding that long‐term trajectories of BMI (∼20 years of BMI measurements) were associated with these same cognitive functions; participants with long‐term normal BMI had the highest levels of cognition while those with long‐term obesity had the lowest. Adiposity may have a detrimental impact on the brain already in middle‐aged cognitively normal adults.