Central obesity in midlife increases risk of dementia independently of diabetes and cardiovascular comorbidities
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Numerous studies have shown that central obesity is a more dangerous cardiovascular disease risk factor than overall obesity. In addition, midlife BMI was shown to predict both subsequent Alzheimer’s disease as well as vascular dementia. This longitudinal analysis of 6,583 members of Kaiser Permanente community in Northern California, whose sagittal abdominal diameter (SAD) was measured from 1964 to 1973, aimed to investigate the association between midlife central obesity and risk of dementia three decades later. Dementia was diagnosed from medical records an average 36 years later. In total, 15.9% of study participants developed dementia. Multivariable-adjusted Cox proportional hazard models analysis revealed that subjects in the highest quintile of SAD had a nearly threefold increased risk of dementia compared to those in the lowest SAD quintile, which was only mildly attenuated after adding BMI to the model. Moreover, those subjects with high SAD (>25 cm) and normal BMI had an increased risk of dementia compared to those with low SAD (<25 cm) and normal BMI, subjects with both high SAD and high BMI having the highest risk of dementia. In conclusion, central obesity in midlife increases the risk of dementia, independently of diabetes and other cardiovascular comorbidities.
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