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Serum Leptin and Risk of Cognitive Decline in Elderly Italians

Article type: Research Article

Authors: Littlejohns, Thomas J.a | Kos, Katarinaa | Henley, William E.a | Cherubini, Antoniob | Ferrucci, Luigic | Lang, Iain A.a | Langa, Kenneth M.d; e | Melzer, Davida | Llewellyn, David J.a; *

Affiliations: [a] The University of Exeter Medical School, Exeter, UK | [b] Geriatrics, IRCCS-INRCA, Ancona, Italy (A.C.) | [c] National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA | [d] The Division of General Medicine, Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA | [e] The Institute for Social Research and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA

Correspondence: [*] Correspondence to: David J. Llewellyn, University of Exeter Medical School, College House, Heavitree Road, Exeter, EX1 2LU, UK. Tel.: +44 1392 726018; E-mail: [email protected].

Keywords: Adipokines, cognitive decline, cohort analysis, epidemiology, leptin

DOI: 10.3233/JAD-141836

Journal: Journal of Alzheimer's Disease, vol. 44, no. 4, pp. 1231-1239, 2015

Accepted 17 October 2014
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Published: 19 February 2015
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Supplementary Materials:

Supplementary Tables.

Abstract

Background:

US studies suggest that leptin, a fat-derived hormone, may be protective against the development of dementia.

Objective:

To investigate the complex relationship between leptin levels and cognitive decline in elderly Italians.

Methods:

We studied circulating fasting leptin levels in 809 elderly adults free from dementia who participated in the prospective Italian population-based InCHIANTI study between 1998 and 2009 (mean follow-up of 8.0 years). Global cognitive decline was defined as a reduction of ≥5 points on the Mini-Mental State Examination (MMSE). Trail-Making Tests A and B were also incorporated, with cognitive decline defined as discontinued testing or the worst 10% of change from baseline. We also investigated whether any association could be explained by midlife weight and whether cognitive decline was associated with changing leptin levels.

Results:

The multivariate adjusted relative risk ([RR]; 95% confidence interval [CI]) of cognitive decline on the MMSE was 0.84 (95% CI 0.73–0.97) in relation to baseline sex-standardized log-leptin levels. High leptin levels showed a non-significant trend toward a reduced risk of decline on the Trail-Making Tests A (RR = 0.85, 95% CI 0.71–1.02) and B (RR = 0.90, 0.79–1.02). Adjusting for midlife weight or change in weight did not alter the pattern of results, and cognitive decline was not associated with changing leptin levels.

Conclusions:

High leptin levels were independently associated with a reduced risk of cognitive decline in elderly Italians.

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