Korean J Fam Pract. 2018; 8(1): 118-124  https://doi.org/10.21215/kjfp.2018.8.1.118
Obesity and the Risk of Dementia: A Meta-Analysis of Prospective Cohort Studies
Su-Jung Park1, Hae-Jin Ko1,*, Chang-Ho Youn1, A-Sol Kim2, Hana Moon2, Hyo-Jeong Eun1
1Department of Family Medicine, Kyungpook National University School of Medicine, 2Department of Family Medicine, Kyungpook National University Medical Center, Daegu, Korea
Hae-Jin Ko
Tel: +82-53-200-5791, Fax: +82-53-200-5480
E-mail: liveforme@daum.net
ORCID: http://orcid.org/0000-0003-4460-1476
Received: March 15, 2017; Accepted: April 26, 2017; Published online: February 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Obesity and dementia are important public health issues. Several studies have reported that obesity may increase the risk of dementia, but this has not reached a consistent conclusion. To evaluate the effect of obesity on the risk of dementia, we performed a meta-analysis of prospective cohort studies.
Methods: We systematically searched relevant studies on PubMed, Scopus, Cochrane Library, and CINAHL, which were published until November 2016. We selected prospective cohort studies about mid-life or late-life obesity and dementia based on predetermined inclusion criteria. The adjusted hazard ratio (HR) and 95% confidence interval (CI) were extracted from each study and analyzed using a random-effects model.
Results: A total of 12 studies were included in the final analysis. Compared to normal weight, mid-life or late-life obesity significantly increased the risk of dementia (HR 1.525, 95% CI 1.022–2.276; I2=93.108%, P<0.001). In subgroup analysis, mid-life obesity increased the risk of dementia (HR 1.924, 95% CI 2.714–3.728), but late-life obesity did not show a significant result (HR 0.788, 95% CI 0.447–1.389). There were no significant differences in other subgroup analyses according to type of dementia and quality of studies. No apparent publication bias was found.
Conclusion: This study concludes that late-life and especially mid-life obesity is associated with the increased risk of dementia. It is important to control mid-life obesity to prevent late-life dementia.
Keywords: Overweight; Obesity; Dementia; Alzheimer Disease; Vascular Dementia
References
  1. Prince M, Guerchet M, Prina M. The epidemiology and impact of dementia:current state and future trends. Geneva: World Health Organization;2015.
  2. Organization WH. Dementia: a public health priority. Geneva: World Health Organization; 2012.
  3. Chapman DP, Williams SM, Strine TW, Anda RF, Moore MJ. Dementia and its implications for public health. Prev Chronic Dis 2006; 3: A34.
    Pubmed KoreaMed
  4. Rizzi L, Rosset I, Roriz-Cruz M. Global epidemiology of dementia: Alzheimer’s and vascular types. Biomed Res Int 2014; 2014: 908915.
    Pubmed KoreaMed CrossRef
  5. Mangialasche F, Kivipelto M, Solomon A, Fratiglioni L. Dementia prevention:current epidemiological evidence and future perspective. Alzheimers Res Ther 2012; 4: 6.
    Pubmed KoreaMed CrossRef
  6. Castro AV, Kolka CM, Kim SP, Bergman RN. Obesity, insulin resistance and comorbidities? Mechanisms of association. Arq Bras Endocrinol Metabol 2014; 58: 600-9.
    Pubmed KoreaMed CrossRef
  7. Formiguera X, Cantón A. Obesity: epidemiology and clinical aspects. Best Pract Res Clin Gastroenterol 2004; 18: 1125-46.
    CrossRef
  8. Arnoldussen IA, Kiliaan AJ, Gustafson DR. Obesity and dementia: adipokines interact with the brain. Eur Neuropsychopharmacol 2014; 24: 1982-99.
    Pubmed KoreaMed CrossRef
  9. Kiliaan AJ, Arnoldussen IA, Gustafson DR. Adipokines: a link between obesity and dementia? Lancet Neurol 2014; 13: 913-23.
    CrossRef
  10. Whitmer RA, Gunderson EP, Barrett-Connor E, Quesenberry CP Jr, Yaffe K. Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study. BMJ 2005; 330: 1360.
    Pubmed KoreaMed CrossRef
  11. Dahl AK, Löppönen M, Isoaho R, Berg S, Kivelä SL. Overweight and obesity in old age are not associated with greater dementia risk. J Am Geriatr Soc 2008; 56: 2261-6.
    Pubmed CrossRef
  12. Pedditizi E, Peters R, Beckett N. The risk of overweight/obesity in mid-life and late life for the development of dementia: a systematic review and metaanalysis of longitudinal studies. Age Ageing 2016; 45: 14-21.
    Pubmed CrossRef
  13. Wells G, Shea B, O’connell D, Peterson J, Welch V, Losos M, et al. The NewcastleOttawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses [Internet]. 2008 [cited 2016 Dec 23].
  14. DerSimonian R, Kacker R. Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials 2007; 28: 105-14.
    Pubmed CrossRef
  15. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21: 1539-58.
    Pubmed CrossRef
  16. Gustafson DR, Bäckman K, Waern M, Ostling S, Guo X, Zandi P, et al. Adiposity indicators and dementia over 32 years in Sweden. Neurology 2009;73: 1559-66.
    Pubmed KoreaMed CrossRef
  17. Hughes TF, Borenstein AR, Schofield E, Wu Y, Larson EB. Association between late-life body mass index and dementia: The Kame Project. Neurology 2009; 72: 1741-6.
    Pubmed KoreaMed CrossRef
  18. Beydoun MA, Lhotsky A, Wang Y, Dal Forno G, An Y, Metter EJ, et al. Association of adiposity status and changes in early to mid-adulthood with incidence of Alzheimer’s disease. Am J Epidemiol 2008; 168: 1179-89.
    Pubmed KoreaMed CrossRef
  19. Power BD, Alfonso H, Flicker L, Hankey GJ, Yeap BB, Almeida OP. Body adiposity in later life and the incidence of dementia: the health in men study. PLoS One 2011; 6: e17902.
    Pubmed KoreaMed CrossRef
  20. Whitmer RA, Gunderson EP, Quesenberry CP Jr, Zhou J, Yaffe K. Body mass index in midlife and risk of Alzheimer disease and vascular dementia. Curr Alzheimer Res 2007; 4: 103-9.
    Pubmed CrossRef
  21. Whitmer RA, Gustafson DR, Barrett-Connor E, Haan MN, Gunderson EP, Yaffe K. Central obesity and increased risk of dementia more than three decades later. Neurology 2008; 71: 1057-64.
    Pubmed CrossRef
  22. Atti AR, Palmer K, Volpato S, Winblad B, De Ronchi D, Fratiglioni L. Latelife body mass index and dementia incidence: nine-year follow-up data from the Kungsholmen Project. J Am Geriatr Soc 2008; 56: 111-6.
    Pubmed CrossRef
  23. Fitzpatrick AL, Kuller LH, Lopez OL, Diehr P, O’Meara ES, Longstreth WT Jr, et al. Midlife and late-life obesity and the risk of dementia: cardiovascular health study. Arch Neurol 2009; 66: 336-42.
    Pubmed KoreaMed CrossRef
  24. Xu WL, Atti AR, Gatz M, Pedersen NL, Johansson B, Fratiglioni L. Midlife overweight and obesity increase late-life dementia risk: a population-based twin study. Neurology 2011; 76: 1568-74.
    Pubmed KoreaMed CrossRef
  25. Kivipelto M, Ngandu T, Fratiglioni L, Viitanen M, Kåreholt I, Winblad B, et al. Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Arch Neurol 2005; 62: 1556-60.
    Pubmed CrossRef
  26. Albanese E, Davis B, Jonsson PV, Chang M, Aspelund T, Garcia M, et al. Overweight and obesity in midlife and brain structure and dementia 26 years later: The AGES-Reykjavik Study. Am J Epidemiol 2015; 181: 672-9.
    Pubmed KoreaMed CrossRef
  27. Solfrizzi V, Scafato E, Capurso C, D’Introno A, Colacicco AM, Frisardi V, et al. Metabolic syndrome, mild cognitive impairment, and progression to dementia. The Italian longitudinal study on aging. Neurobiol Aging 2011; 32:1932-41.
    Pubmed CrossRef
  28. McGuire MJ, Ishii M. Leptin dysfunction and Alzheimer’s disease: evidence from cellular, animal, and human studies. Cell Mol Neurobiol 2016; 36: 20317.
    Pubmed KoreaMed CrossRef
  29. Gustafson D, Rothenberg E, Blennow K, Steen B, Skoog I. An 18-year followup of overweight and risk of Alzheimer disease. Arch Intern Med 2003;163: 1524-8.
    Pubmed CrossRef
  30. Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev 2011; 12: e426-37.
    Pubmed CrossRef


This Article

e-submission

Archives