0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation |

Decline in Weight and Incident Mild Cognitive Impairment Mayo Clinic Study of Aging

Rabe E. Alhurani, MBBS1,2; Maria Vassilaki, MD, PhD3; Jeremiah A. Aakre, MPH4; Michelle M. Mielke, PhD2,3; Walter K. Kremers, PhD4; Mary M. Machulda, PhD5; Yonas E. Geda, MD, MSc3,6; David S. Knopman, MD2; Ronald C. Peterson, MD, PhD2,3; Rosebud O. Roberts, MB, ChB2,3
[+] Author Affiliations
1Mayo Clinic Graduate School of Medicine, Rochester, Minnesota
2Department of Neurology, Mayo Clinic, Rochester, Minnesota
3Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
4Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
5Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
6Departments of Psychiatry and Psychology and of Neurology, Mayo Clinic, Scottsdale, Arizona
JAMA Neurol. 2016;73(4):439-446. doi:10.1001/jamaneurol.2015.4756.
Text Size: A A A
Published online

Importance  Unintentional weight loss has been associated with risk of dementia. Because mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI.

Objective  To investigate the association of change in weight and BMI with risk of MCI.

Design, Setting, and Participants  A population-based, prospective study of participants 70 years of age or older from the Mayo Clinic Study of Aging, which was initiated on October 1, 2004. Maximum weight and height in midlife (40-65 years of age) were retrospectively ascertained from the medical records of participants using a medical records–linkage system. The statistical analyses were performed between January and November 2015.

Main Outcomes and Measures  Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and BMI with risk of MCI was investigated using proportional hazards models.

Results  Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI (50.3% were men; mean age, 78.5 years). The mean (SD) rate of weight change per decade from midlife to study entry was greater for participants who developed incident MCI vs those who remained cognitively normal (−2.0 [5.1] vs −1.2 [4.9] kg; P = .006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR], 1.04 [95% CI, 1.02-1.06]; P < .001) after adjusting for sex, education, and apolipoprotein E (APOE) ε4 allele. A weight loss of 5 kg per decade corresponds to a 24% increase in risk of MCI (HR, 1.24). A higher decrease in BMI per decade was also associated with incident MCI (HR, 1.08 [95% CI, 1.03-1.13]; P = .003).

Conclusions and Relevance  These findings suggest that increasing weight loss per decade from midlife to late life is a marker for MCI and may help identify persons at increased risk for MCI.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Figures

Place holder to copy figure label and caption
Figure.
Hazard Ratios for Midlife Weight Quartiles by the Rate of Weight Change per Decade

The estimates are based on a model adjusted for sex, years of education, APOE*E4, and weight at study entry, with age as the time scale. The mean (SD) maximum weight measurements in midlife were 62.0 (5.1) kg for the first quartile (Q1), 75.9 (3.6) kg for the second quartile (Q2), 86.8 (2.9) kg for the third quartile (Q3), and 103.7 (11.8) kg for the fourth quartile (Q4). The observed median (fifth and 95th percentile) rates of weight change from midlife to study entry for the 4 weight quartiles were −0.4 (−6.5 to 5.2) kg per decade for Q1, −1.0 (−8.2 to 5.2) kg per decade for Q2, −1.7 (−9.4 to 6.0) kg per decade for Q3, and −2.3 (−14.4 to 7.7) kg per decade for Q4. We provided the fifth and 95th percentiles to give a broader sense of the distribution of weight change for each midlife weight quartile.

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

1,841 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Original Article: Does This Adult Patient Have Septic Arthritis?

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Original Article: Will This Patient Fall?

brightcove.createExperiences();