Association of metabolic obesity phenotypes with cognitive decline in the ELSA ‐Brasil study
Authors' conclusion
Metabolic dysfunction may be a stronger predictor of subsequent cognitive decline than excess body weight. Dementia prevention strategies may benefit from early identification and management of metabolic dysfunction across all weight categories.
Study context
- Population
- Adults aged 35–74 years in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil); mean age 51.1 years, 55% women, 53% Whitebaseline 15,105
- Participants
- 12,795 adults
- Exposure
- Metabolic obesity phenotypes
- Outcome
- Cognitive decline (global cognition Z-scores from memory, verbal fluency and TMT-B tests)
- Follow-up
- Median 8 years
Methodological detailslongitudinal, three waves (2008-2019), mediation analysis
- Longitudinal
- Three waves (2008-2019)
- Mediation analysis
Main finding
As reported in the abstract
Metabolically unhealthy phenotypes, across all body mass index (BMI) categories: faster cognitive decline, β range (all p < 0.001)
−0.037 to −0.053
Metabolically healthy overweight: not associated, β
0.016
95% CI −0.002, 0.034p = 0.081
Metabolically healthy obesity: not associated, β
0.000
95% CI −0.027, 0.026p = 0.981
Observational data: associations, not effects.
Further findings
C-reactive protein (CRP) mediation
- No evidence of CRP mediation
BMI and cognitive decline
- BMI not associated with cognitive decline, β
- −0.001 (95% CI −0.002, 0.000; p = 0.170)
Waist-to-hip ratio (WHR) and cognitive decline
- WHR associated with cognitive decline, β
- −0.020 (95% CI −0.026, −0.014, p < 0.001)
Original publication
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