Interaction Between Body Mass Index and Central Adiposity and Risk of Incident Cognitive Impairment and Dementia: Results from the Women's Health Initiative Memory Study

• Published in: Journal of the American Geriatrics Society (JAGS) 2011-01, Vol.59 (1), p.107-112
• Main Authors: Kerwin, Diana R., Gaussoin, Sarah A., Chlebowski, Rowan T., Kuller, Lewis H., Vitolins, Mara, Coker, Laura H., Kotchen, Jane M., Nicklas, Barbara J., Wassertheil-Smoller, Sylvia, Hoffmann, Raymond G., Espeland, Mark A.
• Format: Article
• Language: English
• Subjects: Abdomen; Aged; Aged, 80 and over; Biological and medical sciences; Body fat; Body Mass Index; central adiposity; Cognition & reasoning; Cognition Disorders - epidemiology; cognitive impairment; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Dementia - epidemiology; Female; Follow-Up Studies; General aspects; Humans; Medical sciences; Metabolic diseases; Neurology; Obesity; Obesity, Abdominal - epidemiology; Older people; Proportional Hazards Models; Prospective Studies; Risk Factors; Thinness - epidemiology; United States - epidemiology; Waist-Hip Ratio; Women; women's health
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2010.03219.x

OBJECTIVES: To assess the relationship between body mass index (BMI) and waist–hip ratio (WHR) and the clinical end points of cognitive impairment and probable dementia in a cohort of older women enrolled in the Women's Health Initiative Memory Study (WHIMS). DESIGN: Prospective, randomized clinical trial of hormone therapies with annual cognitive assessments and anthropometrics. SETTING: Fourteen U.S. clinical sites of the WHIMS. PARTICIPANTS: Seven thousand one hundred sixty‐three postmenopausal women aged 65 to 80 without dementia. MEASUREMENTS: Annual cognitive assessments, average follow‐up of 4.4 years, including classification of incident cognitive impairment and probable dementia. Height, weight, waist, and hip measurements were assessed at baseline, and a waist–hip ratio (WHR) of 0.8 or greater was used as a marker of central adiposity. RESULTS: There were statistically significant interactions between BMI and WHR and incident cognitive impairment and probable dementia with and without adjustment for a panel of cognitive risk factors. Women with a WHR of 0.80 or greater with a BMI of 20.0 to 24.9 kg/m2 had a greater risk of cognitive impairment and probable dementia than more‐obese women or women with a WHR less than 0.80, although women with a WHR less than 0.80 and a BMI of 20.0 to 24.9 kg/m2 had poorer scores on cognitive assessments. CONCLUSION: WHR affects the relationship between BMI and risk of cognitive impairment and probable dementia in older women. Underweight women (BMI