Challenging the obesity paradox in cognitive function: Weight‐adjusted waist index as an obesity indicator in older adults
Authors' conclusion
Elevated WWI and WC, but not BMI, were significantly associated with an increased risk of incident cognitive impairment. The findings suggested that WWI may be a more precise indicator of the association between obesity and cognitive impairment.
Study context
- Population
- Older adults aged ≥65 years with normal cognition, Chinese Longitudinal Healthy Longevity Survey
- Participants
- 5,001 adults
- Exposure
- WWI quartiles; WWI, waist circumference (WC) and body mass index (BMI)
- Outcome
- Incident cognitive impairment
- Follow-up
- Median 4 years
Methodological detailslongitudinal, time-varying Cox proportional hazards regression, restricted-cubic-spline curves, subgroup and sensitivity analyses
- Longitudinal
- Time-varying Cox proportional hazards regression
- Restricted-cubic-spline curves
- Subgroup and sensitivity analyses
Main finding
As reported in the abstract
Incident cognitive impairment by WWI
Each group vs Q1Hazard ratio (95% CI)
Q4
1.70(1.29–2.24)
Q3
1.43(1.08–1.90)
- WWI as continuous variable, HR (95% CI 1.06-1.23), multivariable-adjusted
- 1.14
Observational data: associations, not effects.
Further findings
WC and BMI and incident cognitive impairment
- WC showed a similar trend; BMI showed no significant association
Subgroup and sensitivity analyses
- Associations persisted across subgroups and sensitivity analyses
Original publication
Challenging the obesity paradox in cognitive function: Weight‐adjusted waist index as an obesity indicator in older adults. Diabetes Obes Metab. Published 5 December 2025. doi:10.
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