Body mass index in midlife and dementia: systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies

Emiliano Albanese, Lenore J. Launer, Matthias Egger, Martin J. Prince, Panteleimon Giannakopoulos, Frank J. Wolters, Kieren Egan

Research output: Contribution to journalReview article

32 Citations (Scopus)

Abstract

INTRODUCTION: We conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia.

METHODS: We searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity.

RESULTS: We included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95% confidence interval [CI], 1.08-1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95% CI, 0.96-1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95% CI, 1.13-1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007).

DISCUSSION: Obesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.

LanguageEnglish
Pages165-178
Number of pages14
JournalAlzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Volume8
DOIs
Publication statusPublished - 20 Jun 2017

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Regression analysis
Longitudinal Studies
Dementia
Meta-Analysis
Body Mass Index
Regression Analysis
Thinness
Obesity
Confidence Intervals
Databases
Population

Keywords

  • dementia
  • body mass index
  • BMI
  • obesity
  • meta-analysis

Cite this

Albanese, Emiliano ; Launer, Lenore J. ; Egger, Matthias ; Prince, Martin J. ; Giannakopoulos, Panteleimon ; Wolters, Frank J. ; Egan, Kieren. / Body mass index in midlife and dementia : systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies. In: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring. 2017 ; Vol. 8. pp. 165-178.
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abstract = "INTRODUCTION: We conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia.METHODS: We searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity.RESULTS: We included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95{\%} confidence interval [CI], 1.08-1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95{\%} CI, 0.96-1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95{\%} CI, 1.13-1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007).DISCUSSION: Obesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.",
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Body mass index in midlife and dementia : systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies. / Albanese, Emiliano; Launer, Lenore J.; Egger, Matthias; Prince, Martin J.; Giannakopoulos, Panteleimon; Wolters, Frank J.; Egan, Kieren.

In: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, Vol. 8, 20.06.2017, p. 165-178.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Body mass index in midlife and dementia

T2 - Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring

AU - Albanese, Emiliano

AU - Launer, Lenore J.

AU - Egger, Matthias

AU - Prince, Martin J.

AU - Giannakopoulos, Panteleimon

AU - Wolters, Frank J.

AU - Egan, Kieren

PY - 2017/6/20

Y1 - 2017/6/20

N2 - INTRODUCTION: We conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia.METHODS: We searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity.RESULTS: We included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95% confidence interval [CI], 1.08-1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95% CI, 0.96-1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95% CI, 1.13-1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007).DISCUSSION: Obesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.

AB - INTRODUCTION: We conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia.METHODS: We searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity.RESULTS: We included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95% confidence interval [CI], 1.08-1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95% CI, 0.96-1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95% CI, 1.13-1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007).DISCUSSION: Obesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.

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