Body mass index and risk of dementia: Analysis of individual‐level data from 1.3 million individuals

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  • Mika Kivimäki
    Department of Epidemiology and Public Health University College London London UK
  • Ritva Luukkonen
    Clinicum, Department of Public Health, Faculty of Medicine University of Helsinki Helsinki Finland
  • G. David Batty
    Department of Epidemiology and Public Health University College London London UK
  • Jane E. Ferrie
    School of Social and Community Medicine University of Bristol Bristol UK
  • Jaana Pentti
    Clinicum, Department of Public Health, Faculty of Medicine University of Helsinki Helsinki Finland
  • Solja T. Nyberg
    Clinicum, Department of Public Health, Faculty of Medicine University of Helsinki Helsinki Finland
  • Martin J. Shipley
    Department of Epidemiology and Public Health University College London London UK
  • Lars Alfredsson
    Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
  • Eleonor I. Fransson
    Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
  • Marcel Goldberg
    Population‐based Epidemiologic Cohort Unit, UMS 011 Inserm Villejuif France
  • Anders Knutsson
    Department of Health Sciences Mid Sweden University Sundsvall Sweden
  • Markku Koskenvuo
    Clinicum, Department of Public Health, Faculty of Medicine University of Helsinki Helsinki Finland
  • Eeva Kuosma
    Clinicum, Department of Public Health, Faculty of Medicine University of Helsinki Helsinki Finland
  • Maria Nordin
    Division of Epidemiology, Stress Research Institute Stockholm University Stockholm Sweden
  • Sakari B. Suominen
    Folkhälsan Research Center Folkhälsan Helsinki Finland
  • Töres Theorell
    Division of Epidemiology, Stress Research Institute Stockholm University Stockholm Sweden
  • Eero Vuoksimaa
    Clinicum, Department of Public Health, Faculty of Medicine University of Helsinki Helsinki Finland
  • Peter Westerholm
    Occupational and Environmental Medicine Uppsala University Uppsala Sweden
  • Hugo Westerlund
    Division of Epidemiology, Stress Research Institute Stockholm University Stockholm Sweden
  • Marie Zins
    Population‐based Epidemiologic Cohort Unit, UMS 011 Inserm Villejuif France
  • Miia Kivipelto
    Department of Neurobiology Karolinska Institute Stockholm Sweden
  • Jussi Vahtera
    Turku University Hospital Turku Finland
  • Jaakko Kaprio
    Clinicum, Department of Public Health, Faculty of Medicine University of Helsinki Helsinki Finland
  • Archana Singh‐Manoux
    Department of Epidemiology and Public Health University College London London UK
  • Markus Jokela
    Department of Psychology Umeå University Umeå Sweden

説明

<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Hazard ratios per 5‐kg/m<jats:sup>2</jats:sup> 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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>

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