Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.
Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Eur J Epidemiol. 2020 Sep;35(9):843-850. doi: 10.1007/s10654-020-00665-w. Epub 2020 Jul 29.
The risk of dementia seems to be established already early in life, which leads to the question if overweight early in life is an important risk factor for dementia as it appears to be later in life. We examined the association between body mass index (BMI) at entry to adult life and subsequent risk of dementia in men and assessed whether the relationship differed by levels of intelligence and education. The study population consisted of 377,598 Danish men born 1939-1959 with measures of height, weight, intelligence test score (ITS), and educational level (EL) at conscript board examinations around the age of 19 years. Dementia outcomes were obtained from National Patient and Prescription Registries between 1969 and 2016. The association between BMI and dementia was analysed using Cox proportional hazard regression including interactions between BMI and ITS and EL, respectively. During the follow-up through age 77 years, 6144 (1.6%) developed dementia. The frequency was highest in men with lowest BMI, lowest ITS and lowest EL. Young adult BMI below the mean of 21.8 kg/m was inversely associated with subsequent dementia, whereas there was no association with higher levels of BMI. Adjustment for young adult ITS and EL attenuated the risk estimates slightly, and interaction analyses showed that the shape of the association between BMI and dementia was unaffected by the levels of ITS and EL. Regardless of levels of ITS and EL, young adult BMI below the mean is inversely associated with subsequent dementia, whereas there is no association with higher levels of BMI.
痴呆症的风险似乎在生命早期就已经确立，这就引出了一个问题，即生命早期超重是否是痴呆症的一个重要风险因素，就像生命后期超重一样。我们研究了成年早期体重指数（BMI）与男性随后痴呆风险之间的关系，并评估了这种关系是否因智力和教育水平的不同而有所不同。该研究人群由 377598 名丹麦男性组成，他们于 1939-1959 年出生，在 19 岁左右的兵役委员会考试中测量了身高、体重、智力测试分数（ITS）和教育水平（EL）。痴呆症的结果是从 1969 年至 2016 年从国家患者和处方登记处获得的。使用 Cox 比例风险回归分析了 BMI 和痴呆症之间的关系，包括 BMI 和 ITS 以及 EL 之间的交互作用。在通过 77 岁的随访期间，有 6144 人（1.6%）患上了痴呆症。在 BMI 最低、ITS 和 EL 最低的男性中，发病率最高。年轻成年人 BMI 低于平均水平 21.8kg/m2 与随后发生痴呆症呈负相关，而 BMI 较高者则无此关联。调整年轻成年人的 ITS 和 EL 略微减弱了风险估计，交互分析表明，BMI 与痴呆症之间的关联形状不受 ITS 和 EL 水平的影响。无论 ITS 和 EL 水平如何，年轻成年人 BMI 低于平均水平与随后发生痴呆症呈负相关，而 BMI 较高者则无此关联。
