Wei Junlun, Zhu Xinyue, Liu Jiaye, Gao Yun, Liu Xinjun, Wang Ke, Zheng Xiaofeng
Department of Endocrinology and Metabolism, Research Center for Islet Transplantation, West China Hospital, Sichuan University, Chengdu, China.
Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
Obes Rev. 2025 May;26(5):e13882. doi: 10.1111/obr.13882. Epub 2024 Dec 8.
Previous studies have demonstrated that adiposity, particularly obesity during midlife, may have a detrimental effect on cognitive function. This study aims to estimate the global prevalence of mild cognitive impairment (MCI) and dementia in elderly aged 60 years or above with overweight, obesity, and central obesity.
We searched PubMed, Embase, Web of Science, and Cochrane Library from inception to November 2023. DerSimonian-Laird random-effects model with Logit transformation was used. Sensitivity analysis, meta-regression, and subgroup analysis were employed to investigate determinants of the prevalence of MCI and dementia.
A total of 72 studies involving 2,980,947 elderly with distinct adiposity status were included. Pooled prevalence of MCI and dementia in elderly with overweight and obesity was 32.54% and 9.47%, respectively. Univariate meta-regression analysis indicated that the heterogeneity in dementia prevalence was attributable to variations in study size (R = 0.01, p < 0.05), while the multivariable analysis underscored that the income of country or area had the most significant predictive importance (60.3% and 90.3%) for both MCI and dementia prevalence. Subgroup analysis revealed regional disparities and diagnostic technique variations contributing to heterogeneity. Based on currently available but inadequate epidemiological data, the pooled prevalence of MCI and dementia in elderly with central obesity was calculated as 10.18% and 9.75%, respectively.
Strategies to address adiposity-associated cognitive impairment should consider multifaceted interventions beyond simple weight reduction. Macro-level initiatives such as improvement of income levels and micro-level interventions including the adoption of accurate diagnostic techniques also represent equally pivotal components.
先前的研究表明，肥胖，尤其是中年时期的肥胖，可能对认知功能产生不利影响。本研究旨在估计60岁及以上患有超重、肥胖和中心性肥胖的老年人中轻度认知障碍（MCI）和痴呆症的全球患病率。
我们检索了从创刊至2023年11月的PubMed、Embase、Web of Science和Cochrane图书馆。使用了带有Logit转换的DerSimonian-Laird随机效应模型。采用敏感性分析、meta回归和亚组分析来研究MCI和痴呆症患病率的决定因素。
共纳入72项研究，涉及2980947名具有不同肥胖状态的老年人。超重和肥胖老年人中MCI和痴呆症的合并患病率分别为32.54%和9.47%。单变量meta回归分析表明，痴呆症患病率的异质性可归因于研究规模的差异（R = 0.01，p < 0.05），而多变量分析强调，国家或地区的收入对MCI和痴呆症患病率具有最显著的预测重要性（分别为60.3%和90.3%）。亚组分析揭示了导致异质性的区域差异和诊断技术差异。基于目前可用但不充分的流行病学数据，中心性肥胖老年人中MCI和痴呆症的合并患病率分别计算为10.18%和9.75%。
应对与肥胖相关的认知障碍的策略应考虑超越单纯减重的多方面干预措施。宏观层面的举措，如提高收入水平，以及微观层面的干预措施，包括采用准确的诊断技术，同样是关键组成部分。
