Cova Ilaria, Clerici Francesca, Maggiore Laura, Pomati Simone, Cucumo Valentina, Ghiretti Roberta, Galimberti Daniela, Scarpini Elio, Mariani Claudio, Caracciolo Barbara
Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, x2018;Luigi Sacco' Hospital, University of Milan, Milan, Italy.
Dement Geriatr Cogn Disord. 2016;41(3-4):172-80. doi: 10.1159/000444216. Epub 2016 Mar 31.
To examine the relationship between body mass index (BMI) and progression to dementia and Alzheimer's disease (AD) in mild cognitive impairment (MCI).
Two hundred and twenty-eight MCI subjects (mean age 74.04 ± 6.94 years; 57% female) from a memory clinic were followed for 2.40 ± 1.58 years. Baseline height and weight were used to calculate the BMI. The main outcome was progression to dementia (DSM-IV criteria) and AD (NINCDS-ADRDA criteria). Cox proportional hazard models were used to assess the longitudinal association of BMI with dementia and AD, adjusting for a comprehensive set of covariates, including vascular risk factors/diseases and neuroimaging profiles.
Out of 228 subjects with MCI, 117 (51.3%) progressed to dementia. Eighty-nine (76%) of the incident dementia cases had AD. In both unadjusted and multi-adjusted models, a higher BMI was associated with a reduced risk of dementia (multi-adjusted HR 0.9; 95% CI 0.8-0.9) and AD (multi-adjusted HR 0.9; 95% CI 0.8-0.9). Being underweight increased the risk of all types of dementia (multi-adjusted HR 2.5; 95% CI 1.2-5.1) but was not specifically associated with AD (multi-adjusted HR 2.2; 95% CI 0.9-5.3).
BMI predicted progression of MCI to dementia and AD. In particular, a higher BMI was associated with a lower risk of dementia and AD, and underweight was associated with a higher risk of dementia. BMI assessment may improve the prognostic accuracy of MCI in clinical practice.
研究轻度认知障碍（MCI）患者体重指数（BMI）与痴呆及阿尔茨海默病（AD）进展之间的关系。
对来自记忆门诊的228例MCI患者（平均年龄74.04±6.94岁；57%为女性）进行了2.40±1.58年的随访。采用基线身高和体重计算BMI。主要结局是进展为痴呆（依据《精神疾病诊断与统计手册》第四版标准）和AD（依据美国国立神经疾病与中风研究所-阿尔茨海默病及相关疾病协会标准）。使用Cox比例风险模型评估BMI与痴呆及AD的纵向关联，并对包括血管危险因素/疾病和神经影像学特征在内的一系列综合协变量进行校正。
在228例MCI患者中，117例（51.3%）进展为痴呆。89例（76%）新发痴呆病例为AD。在未校正和多因素校正模型中，较高的BMI均与痴呆风险降低相关（多因素校正风险比[HR]为0.9；95%置信区间[CI]为0.8 - 0.9）以及与AD风险降低相关（多因素校正HR为0.9；95% CI为0.8 - 0.9）。体重过轻会增加各类痴呆的风险（多因素校正HR为2.5；95% CI为1.2 - 5.1），但与AD无特异性关联（多因素校正HR为2.2；95% CI为0.9 - 5.3）。
BMI可预测MCI进展为痴呆和AD。特别是，较高的BMI与较低的痴呆和AD风险相关，而体重过轻则与较高的痴呆风险相关。BMI评估可能会提高临床实践中MCI的预后准确性。
