Department of Psychology, Wayne State University, Detroit, MI, USA.
Department of Psychology, Marquette University, Milwaukee, WI, USA.
J Alzheimers Dis. 2021;81(1):189-199. doi: 10.3233/JAD-201360.
Body mass index (BMI) has been identified as an important modifiable lifestyle risk factor for dementia, but less is known about how BMI might interact with Apolipoprotein E ɛ4 (APOE ɛ4) carrier status to predict conversion to mild cognitive impairment (MCI) and dementia.
The aim of this study was to investigate the interaction between APOE ɛ4 status and baseline (bBMI) and five-year BMI change (ΔBMI) on conversion to MCI or dementia in initially cognitively healthy older adults.
The associations between bBMI, ΔBMI, APOE ɛ4 status, and conversion to MCI or dementia were investigated among 1,289 cognitively healthy elders from the National Alzheimer's Coordinating Center (NACC) database.
After five years, significantly more carriers (30.6%) converted to MCI or dementia than noncarriers (17.6%), p < 0.001, OR = 2.06. Neither bBMI (OR = 0.99, 95%CI = 0.96-1.02) nor the bBMI by APOE interaction (OR = 1.02, 95%CI = 0.96-1.08) predicted conversion. Although ΔBMI also did not significantly predict conversion (OR = 0.90, 95%CI = 0.78-1.04), the interaction between ΔBMI and carrier status was significant (OR = 0.72, 95%CI = 0.53-0.98). For carriers only, each one-unit decline in BMI over five years was associated with a 27%increase in the odds of conversion (OR = 0.73, 95%CI = 0.57-0.94).
A decline in BMI over five years, but not bBMI, was strongly associated with conversion to MCI or dementia only for APOE ɛ4 carriers. Interventions and behaviors aimed at maintaining body mass may be important for long term cognitive health in older adults at genetic risk for AD.
体重指数（BMI）已被确定为痴呆的重要可改变生活方式风险因素，但对于 BMI 如何与载脂蛋白 E ɛ4（APOE ɛ4）状态相互作用以预测向轻度认知障碍（MCI）和痴呆的转化知之甚少。
本研究旨在探讨 APOE ɛ4 状态与基线（bBMI）和五年 BMI 变化（ΔBMI）之间的相互作用，以预测最初认知健康的老年人向 MCI 或痴呆的转化。
在国家阿尔茨海默病协调中心（NACC）数据库中，对 1289 名认知健康的老年人进行了 bBMI、ΔBMI、APOE ɛ4 状态与向 MCI 或痴呆转化之间的关联研究。
五年后，携带者（30.6%）向 MCI 或痴呆的转化率明显高于非携带者（17.6%），p<0.001，OR=2.06。bBMI（OR=0.99，95%CI=0.96-1.02）和 APOE 相互作用（OR=1.02，95%CI=0.96-1.08）均不能预测转化率。虽然 ΔBMI 也不能显著预测转化率（OR=0.90，95%CI=0.78-1.04），但 ΔBMI 和携带者状态之间的相互作用是显著的（OR=0.72，95%CI=0.53-0.98）。仅对于携带者，五年内 BMI 下降一个单位与转化的几率增加 27%相关（OR=0.73，95%CI=0.57-0.94）。
五年内 BMI 的下降，而不是 bBMI，与 APOE ɛ4 携带者向 MCI 或痴呆的转化密切相关。旨在维持体重的干预和行为对于 AD 遗传风险的老年人大脑认知健康的长期可能很重要。
