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Body mass index and risk of dementia: Analysis of individual-level data from 1.3 million individuals
Department of Epidemiology and Public Health, University College London, London, United Kingdom / Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland / Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Department of Epidemiology and Public Health, University College London, London, United Kingdom / Centre for Cognitive Ageing and Cognitive Epidemiology, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom.
School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
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2018 (English)In: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 14, no 5, p. 601-609Article in journal (Refereed) Published
Abstract [en]

Introduction: Higher midlife body mass index (BMI) is suggested to increase the risk of dementia, but weight loss during the preclinical dementia phase may mask such effects. Methods: We examined this hypothesis in 1,349,857 dementia-free participants from 39 cohort studies. BMI was assessed at baseline. Dementia was ascertained at follow-up using linkage to electronic health records (N = 6894). We assumed BMI is little affected by preclinical dementia when assessed decades before dementia onset and much affected when assessed nearer diagnosis. Results: Hazard ratios per 5-kg/m(2) increase in BMI for dementia were 0.71 (95% confidence interval = 0.66-0.77), 0.94 (0.89-0.99), and 1.16 (1.05-1.27) when BMI was assessed 10 years, 10-20 years, and >20 years before dementia diagnosis. Conclusions: The association between BMI and dementia is likely to be attributable to two different processes: a harmful effect of higher BMI, which is observable in long follow-up, and a reverse-causation effect that makes a higher BMI to appear protective when the follow-up is short. (C) 2017 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.

Place, publisher, year, edition, pages
Elsevier, 2018. Vol. 14, no 5, p. 601-609
Keywords [en]
Body mass index, Dementia, Cohort study, Bias, Obesity
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
URN: urn:nbn:se:his:diva-15589DOI: 10.1016/j.jalz.2017.09.016ISI: 000432438800003PubMedID: 29169013Scopus ID: 2-s2.0-85036621583OAI: oai:DiVA.org:his-15589DiVA, id: diva2:1218632
Available from: 2018-06-14 Created: 2018-06-14 Last updated: 2018-06-15

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Suominen, Sakari

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