The impact of slope-adjusted visit-to-visit body mass index variability on early dementia risk prediction
Authors' conclusion
Slope-adjusted visit-to-visit BMI variability is independently associated with dementia risk, particularly among females, while BMI decline patterns are strong risk factors of dementia. Incorporating longitudinal monitoring of visit-to-visit BMI variability into routine dementia screening may be beneficial.
Study context
- Population
- Individuals aged 50–74 years with five annual health checkups, Japanese national health insurance data (2015–2023); mean age 66.6 years, men 38.6%
- Participants
- 303,042 individuals
- Exposure
- Highest vs lowest tertile of slope-adjusted visit-to-visit BMI-SD
- Outcome
- Dementia (proxy: antidementia drug initiation), with death as a competing risk
- Follow-up
- Mean 2.17 ± 1.19 years
Methodological detailsFine-Gray competing risk models
- Fine-Gray competing risk models
Main finding
As reported in the abstract
Dementia risk (antidementia drug initiation)
- Highest tertile of slope-adjusted BMI-SD significantly associated with increased dementia risk vs lowest tertile, after adjusting for covariates incl. baseline body mass index (BMI) and annual BMI change
- Fine-Gray competing risk models; death as competing risk
Observational data: associations, not effects.
Further findings
Annual BMI change: first tertile (BMI decline ≤−0.31%)
| HR (95% CI) | ||
|---|---|---|
| BMI decline ≤−0.31%U-shaped association of annual BMI change with dementia risk | 1.60 (1.32–1.93) | |
| 0.512Hazard ratio (log scale) |
| Outcome | P value |
|---|---|
| Highest slope-adjusted BMI-SD tertile and dementia risk, by sexFemales vs Males · association stronger in females | P for interaction = 0.0039 |
Events during follow-up
- Antidementia drugs initiated
- 665
- Died
- 2394
- Donepezil share of antidementia drugs
- 67.4%
C-statistic improvement over basic model
- Adding BMI at baseline
- +0.0147
- Adding slope-adjusted BMI-SD
- +0.0146
- No significant difference between these; greatest improvement when BMI decline ≤−0.31% added
Original publication
The impact of slope-adjusted visit-to-visit body mass index variability on early dementia risk prediction. Int J Obes (Lond). Published 13 March 2026. doi:10.
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