China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Neurology, China-Japan Friendship Hospital, Beijing, China.
Brain Behav. 2024 Sep;14(9):e70006. doi: 10.1002/brb3.70006.
Midlife obesity is a significant risk factor for Alzheimer's disease, but the effects of obesity on cognitive function, either detrimental or beneficial, are controversial among older individuals. This study aims to assess this associations of body mass index (BMI) or waist circumference (WC) with cognitive function among United States older individuals.
A cross-sectional research study was conducted utilizing data from the 2011 to 2014 National Health and Nutrition Examination Survey (NHANES). Initially, the study compared differences in cognitive function among the normal weight, overweight, and obese groups. Subsequently, we examined the relationships between BMI or WC and cognitive function using multivariate linear regression. Finally, structural equation models were constructed to assess the relationships among body shape, lifestyle, and cognitive function pathways.
The study included 2254 individuals. Obese subjects had lower scores in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word list learning tasks (CERAD-WL) (χ = 7.804, p = .020) and digit symbol substitution test (χ = 8.869, p = .012). The regression analysis showed that WC was negatively connected with the CERAD-WL score after adjusting for confounding factors (β = -.029, p = .045). Moreover, WC had a mediating effect on the path from lifestyle to cognition (CERAD-WL). However, there was no difference in the CERAD delayed recall score and the animal fluency test between the obese and the other groups.
Obese older adults exhibited impaired cognitive abilities in terms of learning and working memory performance. The impact of lifestyle on cognition was mediated by obesity-related anthropometric indices. Sleep, physical activity, and diet influenced the degree of obesity, which subsequently determined cognitive function. Prioritizing weight management in elderly people is crucial for safeguarding cognitive function.
中年肥胖是阿尔茨海默病的一个重要危险因素，但肥胖对认知功能的影响（无论是有害的还是有益的）在老年人中仍存在争议。本研究旨在评估美国老年人的体重指数（BMI）或腰围（WC）与认知功能之间的关联。
本研究采用 2011 年至 2014 年国家健康和营养调查（NHANES）的数据进行横断面研究。首先，研究比较了正常体重、超重和肥胖组之间认知功能的差异。随后，我们使用多元线性回归分析了 BMI 或 WC 与认知功能之间的关系。最后，构建结构方程模型来评估身体形态、生活方式和认知功能途径之间的关系。
本研究共纳入 2254 名参与者。肥胖组在认知障碍症合作研究-词语学习测试（CERAD-WL）（χ²=7.804，p=.020）和数字符号替代测试（χ²=8.869，p=.012）中的得分较低。回归分析显示，在校正混杂因素后，WC 与 CERAD-WL 评分呈负相关（β=-.029，p=.045）。此外，WC 在生活方式与认知之间的路径上具有中介作用（CERAD-WL）。然而，肥胖组与其他组在 CERAD 延迟回忆评分和动物流畅性测试中无差异。
肥胖的老年人在学习和工作记忆表现方面表现出认知能力受损。生活方式对认知的影响受肥胖相关人体测量指标的影响。睡眠、身体活动和饮食影响肥胖程度，进而决定认知功能。优先管理老年人的体重对于保护认知功能至关重要。
