Gustafson Deborah, Rothenberg Elisabet, Blennow Kaj, Steen Bertil, Skoog Ingmar
Department of Nutrition and Food Sciences, Utah State University, Logan, USA.
Arch Intern Med. 2003 Jul 14;163(13):1524-8. doi: 10.1001/archinte.163.13.1524.
Overweight and obesity are epidemic in Western societies and constitute a major public health problem because of adverse effects on vascular health. Vascular factors may play a role in the development of a rapidly growing disease of late life, Alzheimer disease (AD). Using body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters), we examined whether overweight is a risk factor for dementia and AD.
The relationship between BMI and dementia risk was investigated in a representative cohort of 392 nondemented Swedish adults who were followed up from age 70 to 88 years, with the use of neuropsychiatric, anthropometric, and other measurements. Multivariate Cox proportional hazards regression analyses included BMI, blood pressure, cardiovascular disease, cigarette smoking, socioeconomic status, and treatment for hypertension.
During the 18-year follow-up (4184.8 risk-years), 93 participants were diagnosed as having dementia. Women who developed dementia between ages 79 and 88 years were overweight, with a higher average BMI at age 70 years (27.7 vs 25.7; P =.007), 75 years (27.9 vs 25.0; P<.001), and 79 years (26.9 vs 25.1; P =.02) compared with nondemented women. A higher degree of overweight was observed in women who developed AD at 70 years (29.3; P =.009), 75 years (29.6; P<.001), and 79 years (28.2; P =.003) compared with nondemented women. For every 1.0 increase in BMI at age 70 years, AD risk increased by 36%. These associations were not found in men.
Overweight is epidemic in Western societies. Our data suggest that overweight at high ages is a risk factor for dementia, particularly AD, in women. This may have profound implications for dementia prevention.
超重和肥胖在西方社会呈流行趋势，因其对血管健康有不利影响，构成了一个主要的公共卫生问题。血管因素可能在一种迅速发展的老年疾病——阿尔茨海默病（AD）的发病过程中起作用。我们使用体重指数（BMI，计算方法为体重千克数除以身高米数的平方）来研究超重是否为痴呆和AD的一个风险因素。
在一个由392名无痴呆的瑞典成年人组成的代表性队列中，从70岁到88岁进行随访，通过神经精神、人体测量及其他测量方法，研究BMI与痴呆风险之间的关系。多变量Cox比例风险回归分析纳入了BMI、血压、心血管疾病、吸烟、社会经济地位以及高血压治疗情况。
在18年的随访期（4184.8风险人年）内，93名参与者被诊断患有痴呆。79至88岁患痴呆的女性超重，与未患痴呆的女性相比，其70岁时的平均BMI更高（27.7对25.7；P = 0.007），75岁时（27.9对25.0；P<0.001），79岁时（26.9对25.1；P = 0.02）。70岁（29.3；P = 0.009）、75岁（29.6；P<0.001）和79岁（28.2；P = 0.003）患AD的女性与未患痴呆的女性相比，超重程度更高。70岁时BMI每增加1.0，AD风险增加36%。在男性中未发现这些关联。
超重在西方社会呈流行趋势。我们的数据表明，高龄女性超重是痴呆尤其是AD的一个风险因素。这可能对痴呆预防具有深远意义。
