Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), 31000 Toulouse, France.
UPS/Inserm UMR1027, University of Toulouse III, 31000 Toulouse, France.
Nutrients. 2019 Jun 18;11(6):1371. doi: 10.3390/nu11061371.
This study aimed to analyze associations between weight variation patterns and changes in cognitive function and hippocampal volume among non-demented, community-dwelling elderly. Sample was formed of 1394 adults >70 years (63.9% female), all volunteers from the Multidomain Alzheimer Preventive Trial (MAPT). Weight loss was defined as ≥5% of body weight decrease in the first year of follow-up; weight gain as ≥5% of weight increase; and stability if <5% weight variation. Cognition was examined by a Z-score combining four tests. Measures were assessed at baseline, 6, 12, 24, 36, 48, and 60 months of follow-up. Hippocampal volume was evaluated with magnetic resonance imaging in 349 subjects in the first year and at 36 months. Mixed models were performed. From the 1394 participants, 5.5% ( = 76) presented weight loss, and 9.0% ( = 125) presented weight gain. Cognitive Z-score decreased among all groups after 5 years, but decline was more pronounced among those who presented weight loss (adjusted between-group mean difference vs. stable: -0.24, 95%CI: -0.41 to -0.07; = 0.006). After 3 years, hippocampal atrophy was observed among all groups, but no between-group differences were found. In conclusion, weight loss ≥5% in the first year predicted higher cognitive decline over a 5 year follow-up among community-dwelling elderly, independently of body mass index.
本研究旨在分析体重变化模式与认知功能和海马体积变化在非痴呆、社区居住的老年人中的关联。样本由 1394 名年龄>70 岁的成年人组成(63.9%为女性),均为多领域阿尔茨海默病预防试验(MAPT)的志愿者。体重减轻定义为随访第一年体重下降≥5%;体重增加定义为体重增加≥5%;体重变化<5%则为稳定。认知功能通过四个测试的 Z 分数综合评估。在基线、6、12、24、36、48 和 60 个月的随访时进行评估。在第一年和 36 个月时,通过磁共振成像评估 349 名受试者的海马体体积。采用混合模型进行分析。在 1394 名参与者中,5.5%(=76)出现体重减轻,9.0%(=125)出现体重增加。所有组在 5 年后的认知 Z 评分均下降,但体重减轻组的下降更为明显(与稳定组相比,调整后的组间平均差异为-0.24,95%CI:-0.41 至-0.07;=0.006)。3 年后,所有组均出现海马体萎缩,但组间无差异。总之,在 1 年内体重减轻≥5%可预测社区居住的老年人在 5 年随访期间认知能力下降更高,这与体重指数无关。