Li Qin, Zhan Jiehong, Feng Yuxue, Liao Zixuan, Li Xiaofeng
Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurology, The Fifth People's Hospital of Chongqing, Chongqing, China.
J Alzheimers Dis Rep. 2024 Jan 9;8(1):9-24. doi: 10.3233/ADR-230163. eCollection 2024.
The association of body mass index (BMI) with cognition and Alzheimer's disease (AD) biomarkers of the elderly remains inconclusive.
To investigate the relationship between BMI and cognition as well as AD biomarkers in the elderly with different cognitive status.
Participants with cognitively normal (CN) were included as the CN group. Participants with mild cognitive impairment and mild dementia were included as the cognitive impairment (CI) group. The relationship between BMI and AD biomarkers (cerebrospinal fluid Aβ and p-tau181, hippocampal volume [HV]), global cognition (Mini-Mental State Examination [MMSE]), memory, and executive function were explored.
In the CI group, BMI was associated with MMSE (β= 0.03, = 0.009), Aβ (β= 0.006, = 0.029), p-tau181/Aβ ratio (β= -0.001, = 0.011), and HV (β= 0.05, < 0.001). However in the CN group, BMI exhibited associations with p-tau181 (β= 0.012, = 0.014) and memory composite score (β= -0.04, = 0.038), but not with p-tau181/Aβ ratio and HV. Moreover, mediation analysis showed that in the CI group, the positive effect of BMI on HV and MMSE score was partially mediated by diastolic blood pressure.
The association of BMI with cognition and AD biomarkers varies across different cognitive status. In particular, a lower BMI was associated with worse cognition, higher Aβ burden, and lower HV in individuals with CI. Clinical practice should strengthen the monitoring and management of BMI in patients with AD.
体重指数（BMI）与老年人认知及阿尔茨海默病（AD）生物标志物之间的关联尚无定论。
探讨不同认知状态老年人中BMI与认知及AD生物标志物之间的关系。
将认知正常（CN）的参与者纳入CN组。将轻度认知障碍和轻度痴呆的参与者纳入认知障碍（CI）组。探讨BMI与AD生物标志物（脑脊液Aβ和p-tau181、海马体积[HV]）、整体认知（简易精神状态检查表[MMSE]）、记忆和执行功能之间的关系。
在CI组中，BMI与MMSE（β = 0.03，P = 0.009）、Aβ（β = 0.006，P = 0.029）、p-tau181/Aβ比值（β = -0.001，P = 0.011）及HV（β = 0.05，P < 0.001）相关。然而，在CN组中，BMI与p-tau181（β = 0.012，P = 0.014）及记忆综合评分（β = -0.04，P = 0.038）相关，但与p-tau181/Aβ比值及HV无关。此外，中介分析表明，在CI组中，BMI对HV和MMSE评分的正向作用部分由舒张压介导。
BMI与认知及AD生物标志物的关联在不同认知状态下有所不同。特别是，CI个体中较低的BMI与较差的认知、较高的Aβ负担及较低的HV相关。临床实践应加强对AD患者BMI的监测和管理。
