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

doi:10.1016/j.dadm.2017.05.007

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

Computer And Information Sciences

Research output: Contribution to journal › Review article › peer-review

200 Citations (Scopus)

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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.

Original language	English
Pages (from-to)	165-178
Number of pages	14
Journal	Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Volume	8
DOIs	https://doi.org/10.1016/j.dadm.2017.05.007
Publication status	Published - 20 Jun 2017

Keywords

dementia
body mass index
BMI
obesity
meta-analysis

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10.1016/j.dadm.2017.05.007Licence: CC BY-NC-ND 4.0

Albanese-etal-AD-2017-Body-mass-index-in-midlife-and-dementiaFinal published version, 910 KBLicence: CC BY-NC-ND 4.0

Kieren Egan
- kieren.eganstrath.acuk
- Computer And Information Sciences - Senior Research Fellow
- Digital Health & Wellness Research Group (DHaWG)
Person: Research Only

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Albanese, E., Launer, L. J., Egger, M., Prince, M. J., Giannakopoulos, P., Wolters, F. J., & Egan, K. (2017). Body mass index in midlife and dementia: systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 8, 165-178. https://doi.org/10.1016/j.dadm.2017.05.007

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

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.",

keywords = "dementia, body mass index, BMI, obesity, meta-analysis",

author = "Emiliano Albanese and Launer, {Lenore J.} and Matthias Egger and Prince, {Martin J.} and Panteleimon Giannakopoulos and Wolters, {Frank J.} and Kieren Egan",

year = "2017",

month = jun,

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doi = "10.1016/j.dadm.2017.05.007",

language = "English",

volume = "8",

pages = "165--178",

journal = "Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring",

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Albanese, E, Launer, LJ, Egger, M, Prince, MJ, Giannakopoulos, P, Wolters, FJ & Egan, K 2017, 'Body mass index in midlife and dementia: systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies', Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, vol. 8, pp. 165-178. https://doi.org/10.1016/j.dadm.2017.05.007

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

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - Body mass index in midlife and dementia

T2 - systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies

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.

KW - dementia

KW - body mass index

KW - BMI

KW - obesity

KW - meta-analysis

U2 - 10.1016/j.dadm.2017.05.007

DO - 10.1016/j.dadm.2017.05.007

M3 - Review article

C2 - 28761927

SN - 2352-8729

VL - 8

SP - 165

EP - 178

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

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

ER -

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

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