Carrying extra weight around the mid-section during middle age increases a person's risk for dementia later in life, a new study says.
Researchers measured the abdominal density of more than 6,500 people between the ages of 40 and 45 in northern California.
When compared to people with a normal weight and belly size:
- those who were overweight with a large belly were 2.3 times more likely to develop dementia;
- those who were obese with a large belly were 3.6 times more likely to develop dementia.
By an average time frame of about 36 years, 16 per cent of the study's participants had been diagnosed with dementia.
In a statement, Rachel Whitmer, the study's author, said: "It is well known that being overweight in midlife and beyond increases risk factors for disease."
"However, where one carries the weight -- especially in midlife -- appears to be an important predictor for dementia risk."
Whitmer, a research scientist at the Kaiser Permanente Division of Research in Oakland, Ca., added that with these findings, researchers can next investigate if carrying extra abdominal weight in middle age has a direct influence on the body's mechanism for developing dementia.
It also appeared that a large abdomen increased the risk of dementia regardless of overall weight and other existing health conditions such as diabetes, stroke or heart disease.
The study appeared Wednesday in the online edition of Neurology, the medical journal of the American Academy of Neurology.
Abstract
Background: Numerous reports show that a centralized distribution of adiposity is a more dangerous risk factor for cardiovascular disease and diabetes than total body obesity. No studies have evaluated whether the same pattern exists with dementia. The objective was to evaluate the association between midlife central obesity and risk of dementia three decades later.
Methods: A longitudinal analysis was conducted of 6,583 members of Kaiser Permanente of Northern California who had their sagittal abdominal diameter (SAD) measured in 1964 to 1973. Diagnoses of dementia were from medical records an average of 36 years later, January 1, 1994, to June 16, 2006. Cox proportional hazard models adjusted for age, sex, race, education, marital status, diabetes, hypertension, hyperlipidemia, stroke, heart disease, and medical utilization were conducted.
Results: A total of 1,049 participants (15.9%) were diagnosed with dementia. Compared with those in the lowest quintile of SAD, those in the highest had nearly a threefold increased risk of dementia (hazard ratio, 2.72; 95% CI, 2.33-3.33), and this was only mildly attenuated after adding body mass index (BMI) to the model (hazard ratio, 1.92; 95% CI, 1.58-2.35). Those with high SAD (>25 cm) and normal BMI had an increased risk (hazard ratio, 1.89; 95% CI, 0.98-3.81) vs those with low SAD (<25 cm) and normal BMI (18.5-24.9 kg/m2), whereas those both obese (BMI >30 kg/m2) and with high SAD had the highest risk of dementia (HR, 3.60; 95% CI, 2.85-4.55).
Conclusions: Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. Fifty percent of adults have central obesity; therefore, mechanisms linking central obesity to dementia need to be unveiled.
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