Unstable Body Mass Index and Progression to Probable Alzheimer’s Disease Dementia in Patients with Amnestic Mild Cognitive Impairment

Article type: Research Article

Authors: Ye, Byoung Seok^a | Jang, Eun Young^b | Kim, Seong Yoon^c | Kim, Eun-Joo^d | Park, Sun Ah^e | Lee, Yunhwan^f | Hong, Chang Hyung^g | Choi, Seong Hye^h | Yoon, Boraⁱ | Yoon, Soo Jin^j | Na, Hae Ri^k | Lee, Jae-Hong^l | Jeong, Jee H.^m | Kim, Hee Jin^b | Na, Duk L.^b | Seo, Sang Won^{b; n; o; *}

Affiliations: [a] Department of Neurology, Yonsei University College of Medicine, Seoul, Korea | [b] Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea | [c] Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea | [d] Department of Neurology, Pusan National University School of Medicine, Pusan, Korea | [e] Department of Neurology, Soonchunhyang University College of Medicine, Bucheon, Korea | [f] Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea | [g] Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea | [h] Department of Neurology, Inha University School of Medicine, Incheon, Korea | [i] Department of Neurology, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, Korea | [j] Department of Neurology, Eulji University College of Medicine, Daejeon, Korea | [k] Department of Neurology, Bobath Memorial Hospital, Seongnam, Korea | [l] Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea | [m] Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea | [n] Neuroscience Center, Samsung Medical Center | [o] Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University

Correspondence: [*] Correspondence to: Sang Won Seo, MD, PhD, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Kangnam-ku, 06351 Seoul, Republic of Korea. Tel.: +82 2 3410 1233; Fax: +82 2 3410 0052; E-mail: [email protected]

Abstract: Background and Objective:We investigated the influence of body mass index (BMI) status at baseline and changes in BMI over a follow-up period on the development of dementia in amnestic mild cognitive impairment (aMCI) patients. Methods:The longitudinal data of 747 aMCI patients were used to investigate the relationships among baseline BMI status, subsequent changes in BMI (median follow-up duration: 1.6 years, interquartile range: 1.0–2.3 years), and risk of progression to probable Alzheimer’s disease dementia (pADD). The aMCI patients were classified into underweight, normal weight, overweight, and obese subgroups, and further categorized into increased BMI, stable BMI, and decreased BMI subgroups during follow-up using a 4% mean annual change in BMI cut-off value. Results:Compared to the normal weight group, the underweight group had a higher risk of pADD (hazard ratio [HR]: 1.89, 95% confidence interval [CI]: 1.07–3.37) while the obese group had a lower risk (HR: 0.70, 95% CI: 0.49–0.999). After controllingfor baseline BMI status, the decreased BMI (HR: 2.29, 95% CI: 1.41–3.72) and increased BMI (HR: 3.96, 95% CI: 2.62–6.00) groups were at increased risk of progression to pADD. Conclusions:Our findings suggested that underweight at baseline was associated with a higher risk of progression to pADD, while obesity at baseline predicted a lower risk. Furthermore, significant changes in BMI during the follow-up period reflected an increased risk of progression to pADD, regardless of BMI status at baseline.

Keywords: Alzheimer’s disease, amnestic mild cognitive impairment, body mass index, dementia, progression

DOI: 10.3233/JAD-150556

Journal: Journal of Alzheimer's Disease, vol. 49, no. 2, pp. 483-491, 2016