Aims: We examined the individual association between body mass index (BMI) and cognitive function among the very elderly. Methods: The present study analyzed data from a survey that was conducted on all residents aged 90 years or more from a district which had 2,311,709 inhabitants in 2005. The subjects were divided into 4 groups according to quartiles of BMI (<16.6, 16.6–18.9, 18.9–21.1 and >21.1), and according to classification criteria of underweight, normal weight, overweight and obesity in BMI (<18.5, 18.5–23.0, 23.0–27.5 and >27.5), respectively. Results: The subjects included in the statistical analysis were 211 men and 427 women. Those in the 3rd quartile of BMI (18.9–21.1) had higher cognitive function scores (p < 0.001) and were less likely to present possible dementia (p = 0.016) than the others. However, there was no difference in cognitive function scores (p = 0.350) or prevalence of possible dementia (p = 0.263) among obesity, overweight, normal weight and underweight groups. Conclusions: Concerning longevity in Chinese, there is an association between BMI and cognitive function. BMI of around 20 (18.9–21.1) is associated with the lowest risk of prevalence of possible dementia and the highest cognitive function scores.

Keywords:
Body mass index, Cognitive function, Nonagenarians/centenarians
1.
Gustafson D: Adiposity indices and dementia. Lancet Neurol 2006;5:713–720.
2.
Jagust W: What can imaging reveal about obesity and the brain? Curr Alzheimer Res 2007;4:135–139.
3.
Gustafson D, Lissner L, Bengtsson C, Björkelund C, Skoog I: A 24-year follow-up of body mass index and cerebral atrophy. Neurology 2004;63:1876–1881.
4.
Ward MA, Carlsson CM, Trivedi MA, Sager MA, Johnson SC: The effect of body mass index on global brain volume in middle-aged adults: a cross sectional study. BMC Neurol 2005;5:23.
5.
Jagust W, Harvey D, Mungas D, Haan M: Central obesity and the aging brain. Arch Neurol 2005;62:1545–1548.
6.
Gustafson D, Rothenberg E, Blennow K, Steen B, Skoog I: An 18-year follow-up of overweight and risk of Alzheimer disease. Arch Intern Med 2003;163:1524–1528.
7.
Kivipelto M, Ngandu T, Fratiglioni L, Viitanen M, Kåreholt I, Winblad B, Helkala EL, Tuomilehto J, Soininen H, Nissinen A: Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Arch Neurol 2005;62:1556–1560.
8.
Whitmer RA, Gunderson EP, Barrett-Connor E, Quesenberry CP Jr, Yaffe K: Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study. BMJ 2005;330:1360.
9.
Elias MF, Elias PK, Sullivan LM, Wolf PA, D’Agostino RB: Lower cognitive function in the presence of obesity and hypertension: the Framingham Heart Study. Int J Obes Relat Metab Disord 2003;27:260–268.
10.
Elias MF, Elias PK, Sullivan LM, Wolf PA, D’Agostino RB: Obesity, diabetes and cognitive deficit: the Framingham Heart Study. Neurobiol Aging 2005;26(Suppl 1):11–16.
11.
Waldstein SR, Katzel LI: Interactive relations of central versus total obesity and blood pressure to cognitive function. Int J Obes (Lond) 2006;30:201–207.
12.
Gunstad J, Paul RH, Cohen RA, Tate DF, Spitznagel MB, Gordon E: Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Compr Psychiatry 2007;48:57–61.
13.
Horber FF, Gruber B, Thomi F, Jensen EX, Jaeger P: Effect of sex and age on bone mass, body composition and fuel metabolism in humans. Nutrition 1997;13:524–534.
14.
Snijder MB, van Dam RM, Visser M, Seidell JC: What aspects of body fat are particularly hazardous and how do we measure them? Int J Epidemiol 2006;35:83–92.
15.
Wang Q, Hassager C, Ravn P, Wang S, Christiansen C: Total and regional body-composition changes in early postmenopausal women: age-related or menopause-related? Am J Clin Nutr 1994;60:843–848.
16.
Zamboni M, Armellini F, Harris T, et al: Effects of age on body fat distribution and cardiovascular risk factors in women. Am J Clin Nutr 1997;66:111–115.
17.
Ohlson LO, Larsson B, Svardsudd K, et al: The influence of body fat distribution on the incidence of diabetes mellitus. 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes 1985;34:1055–1058.
18.
Okosun IS, Cooper RS, Rotimi CN, Osotimehin B, Forrester T: Association of waist circumference with risk of hypertension and type 2 diabetes in Nigerians, Jamaicans, and African-Americans. Diabetes Care 1998;21:1836–1842.
19.
Boyko EJ, Fujimoto WY, Leonetti DL, Newell-Morris L: Visceral adiposity and risk of type 2 diabetes: a prospective study among Japanese Americans. Diabetes Care 2000;23:465–471.
20.
Holm B, Söderhamn O: Factors associated with nutritional status in a group of people in an early stage of dementia. Clin Nutr 2003;22:385–389.
21.
Keller HH, Gibbs AJ, Boudreau LD, Goy RE, Pattillo MS, Brown HM: Prevention of weight loss in dementia with comprehensive nutritional treatment. J Am Geriatr Soc 2003;51:945–952.
22.
Mazzali G, Bissoli L, Gambina S, Residori L, Pagliari P, Guariento S, Sun M, Broggio E, Bosello O, Zamboni M: Energy balance in Alzheimer’s disease. Nutr Health Aging 2002;6:247–253.
23.
Huang CQ, Dong BR, Zhang YL, Wu HM, Liu QX, Flaherty JH: Moderate or severe dementia and hypertension among Chinese nonagenarians and centenarians. Hypertens Res 2009;32:554–558.
24.
Huang CQ, Dong BR, Wu HM, Zhang YL, Wu JH, Lu ZC, Flaherty JH: Association of moderate or severe dementia with serum lipid/lipoprotein among Chinese nonagenarians and centenarians. Dement Geriatr Cogn Disord 2009;27:111–116.
25.
Holtsberg PA, Poon LW, Noble CA, Martin P: Mini-Mental State Exam status of community-dwelling cognitively intact centenarians. Int Psychogeriatr 1995;7:417–427.
26.
Reischies FM, Geiselmann B: Age-related cognitive decline and vision impairment affecting the detection of dementia syndrome in old age. Br J Psychiatry 1997;171:449–451.
27.
WHO Expert Consultation: Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157–163.
28.
Drøyvold WB, Nilsen TI, Krüger O, Holmen TL, Krokstad S, Midthjell K, Holmen J: Change in height, weight and body mass index: longitudinal data from the HUNT Study in Norway. Int J Obes (Lond) 2006;30:935–939.
29.
Scholtens S, Brunekreef B, Visscher TL, Smit HA, Kerkhof M, de Jongste JC, Gerritsen J, Wijga AH: Reported versus measured body weight and height of 4-year-old children and the prevalence of overweight. Eur J Public Health 2007;17:369–374.
30.
Lau EM, Lynn HS, Woo JW, Kwok TC, Melton LJ 3rd: Prevalence of and risk factors for sarcopenia in elderly Chinese men and women. J Gerontol A Biol Sci Med Sci 2005;60:213–216.
31.
Chan KM, Pang WS, Ee CH, Ding YY, Choo P: Self-perception of health among elderly community dwellers in Singapore. Ann Acad Med Singapore 1998;27:461–467.
32.
Kuo HK, Jones RN, Milberg WP: Cognitive function in normal-weight, overweight, and obese older adults: an analysis of the Advanced Cognitive Training for Independent and Vital Elderly cohort. J Am Geriatr Soc 2006;54:97–103.
33.
Nourhashemi F, Deschamps V, Larrieu S: The PAQUID Study. Body mass index and incidence of dementia. Neurology 2003;60:117–119.
34.
Barrett-Connor E, Edelstein SL, Corey-Bloom J: Weight loss precedes dementia in community-dwelling older adults. J Am Geriatr Soc 1996;44:1147–1152.
35.
Stewart R, Masaki K, Xue QL: A 32-year prospective study of change in body weight and incident dementia: the Honolulu-Asia Aging Study. Arch Neurol 2005;62:55–60.
36.
Buchman AS, Wilson RS, Bienias JL: Change in body mass index and risk of incident Alzheimer disease. Neurology 2005;65:892–897.
37.
Tombaugh TN, McIntyre NJ: The Mini-Mental State Examination: A comprehensive review. J Am Geriatr Soc 1992;40:922–935.
38.
Uhlmann RF, Larson EB: Effect of education on the mini-mental state examination as a screening test for dementia. J Am Geriatr Soc 1991;39:876–880.
39.
van den Berg E, Biessels GJ, de Craen AJ, Gussekloo J, Westendorp RG: The metabolic syndrome is associated with decelerated cognitive decline in the oldest old. Neurology 2007;69:979–985.
40.
Huang CQ, Dong BR, Zhang YL, Wu HM, Liu QX: Association of moderate or severe dementia with smoking, alcohol consumption, tea consumption, and exercise among Chinese nonagenarians/centenarians. Cogn Behav Neurol 2009;22:190–196.
41.
Feng L, Gwee X, Kua EH, Ng TP: Cognitive function and tea consumption in community dwelling older Chinese in Singapore. J Nutr Health Aging 2010;14:433–438.
42.
Osher E, Stern N: Obesity in elderly subjects: in sheep’s clothing perhaps, but still a wolf! Diabetes Care 2009;32(Suppl 2):S398–S402.
© 2011 S. Karger AG, Basel
2011
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.