Decreases in Body Mass Index After Cardiac Rehabilitation Predict Improved Cognitive Function in Older Adults with Heart Failure

Abstract Body composition has been proposed as an important modifiable risk factor of cognitive decline in multiple epidemiological studies. However, the relationship between body mass index (BMI) and cognitive function remains controversial and conflicting in diverse populations. This study aims to investigate the association between BMI and cognitive decline in U.S. Chinese older adults. Classifications of BMI are based on Asian criteria recommended by WHO (underweight: BMI<18.5, normal weight: 18.5≤BMI<23, overweight: 23≤bmi<27.5, obesity: bmi≥27.5). Logistic regression models were conducted. Compared with normal-weight participants, underweight participants were more likely to experience decline in episodic memory (OR=1.68, p=0.002) and work memory (OR=1.38, p=0.05). Being overweight and obesity were not associated with cognitive function decline. The findings indicate that underweight could potentially be a risk factor of cognitive function decline among U.S. Chinese older adults. Perspective studies may further investigate the association between weight loss and cognitive decline for the development of prevention strategies.

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Cardiac rehabilitation is associated with lasting improvements in cognitive function in older adults with heart failure

Acta Cardiologica ◽

10.1080/ac.69.4.3036657 ◽

2014 ◽

Vol 69 (4) ◽

pp. 407-414 ◽

Cited By ~ 20

Author(s):

Michael L. Alosco ◽

Mary Beth Spitznagel ◽

Ronald Cohen ◽

Lawrence H. Sweet ◽

Richard Josephson ◽

...

Keyword(s):

Heart Failure ◽

Older Adults ◽

Cognitive Function ◽

Cardiac Rehabilitation

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Abstract P172: Associations of Body Mass Index From Early-, Mid-, and Older- Adulthood With Incident Heart Failure and Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis

Circulation ◽

10.1161/circ.137.suppl_1.p172 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Michael J Fliotsos ◽

Di Zhao ◽

Chiadi Ndumele ◽

Eliseo Guallar ◽

Gregory L Burke ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Older Adults ◽

Body Mass Index ◽

Body Mass ◽

Clinical Encounter ◽

Cvd Risk ◽

Prognostic Information ◽

Measured Weight ◽

Increased Risk

Background: Obesity contributes significantly to increased risk of cardiovascular disease (CVD) and particularly heart failure (HF). However, an elevated body mass index (BMI) in older adults might not fully reflect the additional risk associated with excess weight at a younger age. We determined the prognostic value of self-reported weights from early- and mid-adulthood, after accounting for current weight, with incident HF and CVD. Methods: We studied 6,437 MESA participants (aged 45-84 years) with self-reported weights at ages 20 and 40 (by questionnaire) and measured weight at the baseline exam (2000-2002). BMI was calculated using measured height at baseline. Cox hazard models assessed relationships between BMI at each age with HF and CVD. Results: Participant mean age was 62±10 years and 53% were women. Over a median follow-up of 13 years, 290 HF and 828 CVD events occurred. Elevated BMI at each age point (age 20, age 40, and MESA baseline) was independently associated with HF, and to lesser extent with CVD ( Figure ). After adjustment for demographics, CVD risk factors, and baseline BMI, higher self-reported BMIs at ages 20 and 40 years were independently associated with increased risk of incident HF with hazard ratios (HR) 1.18 (95% CI 1.05-1.32) and 1.30 (1.15-1.46), respectively, per 1 SD higher BMI. Participants with self-reported obesity (BMI≥30) at age 20 [HR 3.20 (1.93-5.32)] and age 40 [HR 1.92 (1.31-2.83)] had greater HF risk, even after accounting for current BMI. For incident CVD, only higher self-reported BMI at age 20 (per 1 SD) was associated after accounting for current BMI [HR 1.09 (1.01-1.17)]. Conclusions: Assessment of self-reported lifetime weights is a simple tool utilized in any clinical encounter. Although subject to recall bias, self-reported weights provide prognostic information about future HF risk, incremental to current BMI, in a multi-ethnic cohort of middle-aged to older adults.

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RACIAL/ETHNIC VARIATIONS IN THE RELATION BETWEEN BODY MASS INDEX AND COGNITIVE FUNCTION AMONG OLDER ADULTS

The Gerontologist ◽

10.1093/geront/gnv184.12 ◽

2015 ◽

Vol 55 (Suppl_2) ◽

pp. 416-416

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Cognitive Function ◽

Body Mass ◽

Ethnic Variations ◽

Racial Ethnic

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THE ASSOCIATION BETWEEN BODY MASS INDEX AND COGNITIVE FUNCTION IN U.S. CHINESE OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igy023.426 ◽

2018 ◽

Vol 2 (suppl_1) ◽

pp. 115-115

Author(s):

Y HUA ◽

X Dong

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Cognitive Function ◽

Body Mass ◽

Chinese Older Adults

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Enhanced task-related brain activation and resting perfusion in healthy older adults after chronic blueberry supplementation

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2016-0550 ◽

2017 ◽

Vol 42 (7) ◽

pp. 773-779 ◽

Cited By ~ 58

Author(s):

Joanna L. Bowtell ◽

Zainie Aboo-Bakkar ◽

Myra E. Conway ◽

Anna-Lynne R. Adlam ◽

Jonathan Fulford

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Cognitive Function ◽

Magnetic Resonance ◽

Body Mass ◽

Brain Perfusion ◽

Magnetic Resonance Images ◽

Healthy Older Adults ◽

Male Age ◽

Blueberry Supplementation

Blueberries are rich in flavonoids, which possess antioxidant and anti-inflammatory properties. High flavonoid intakes attenuate age-related cognitive decline, but data from human intervention studies are sparse. We investigated whether 12 weeks of blueberry concentrate supplementation improved brain perfusion, task-related activation, and cognitive function in healthy older adults. Participants were randomised to consume either 30 mL blueberry concentrate providing 387 mg anthocyanidins (5 female, 7 male; age 67.5 ± 3.0 y; body mass index, 25.9 ± 3.3 kg·m−2) or isoenergetic placebo (8 female, 6 male; age 69.0 ± 3.3 y; body mass index, 27.1 ± 4.0 kg·m−2). Pre- and postsupplementation, participants undertook a battery of cognitive function tests and a numerical Stroop test within a 1.5T magnetic resonance imaging scanner while functional magnetic resonance images were continuously acquired. Quantitative resting brain perfusion was determined using an arterial spin labelling technique, and blood biomarkers of inflammation and oxidative stress were measured. Significant increases in brain activity were observed in response to blueberry supplementation relative to the placebo group within Brodmann areas 4/6/10/21/40/44/45, precuneus, anterior cingulate, and insula/thalamus (p < 0.001) as well as significant improvements in grey matter perfusion in the parietal (5.0 ± 1.8 vs –2.9 ± 2.4%, p = 0.013) and occipital (8.0 ± 2.6 vs –0.7 ± 3.2%, p = 0.031) lobes. There was also evidence suggesting improvement in working memory (2-back test) after blueberry versus placebo supplementation (p = 0.05). Supplementation with an anthocyanin-rich blueberry concentrate improved brain perfusion and activation in brain areas associated with cognitive function in healthy older adults.

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Impact of body mass index on the clinical outcomes in heart failure patients undergoing cardiac rehabilitation

European Heart Journal ◽

10.1093/ehjci/ehaa946.3116 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Kunimoto ◽

K Shimada ◽

M Yokoyama ◽

K Fujiwara ◽

A Honzawa ◽

...

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Cardiac Rehabilitation ◽

Body Mass ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Favorable Effect ◽

Kaplan Meier ◽

All Cause Mortality

Abstract Background Increased body mass index (BMI) has recently shown to have a favorable effect on the prognosis in heart failure (HF) patients. However, the impact of BMI on clinical events and mortality in HF patients who underwent cardiac rehabilitation (CR) remains unclear. Purpose This study aimed to investigate whether the obesity paradox is present in HF patients who have undergone CR. Methods This study enrolled 238 consecutive HF patients who had undergone CR at our university hospital between November 2015 and October 2017. The clinical characteristics and anthropometric data of these patients, including BMI, were collected at the beginning of the CR. The major adverse cardiovascular event (MACE) was defined as a composite of all-cause mortality and unplanned hospitalization for HF. Follow-up data regarding the primary endpoints were collected until November 2018. Results Patients (mean age 68.7 years, male 61%) were divided into four groups as per BMI quartiles. More patients in the highest BMI group were women, were significantly younger, and had a higher prevalence of hypertension, dyslipidemia, and diabetes mellitus; however, no significant differences were observed in the prevalence of chronic kidney disease, left ventricular ejection fraction, and brain natriuretic peptide levels of the four groups. During a median follow-up duration of 583 days, 28 patients experienced all-cause mortality, and 42 were hospitalized for HF. Kaplan–Meier analysis showed that patients in the highest BMI quartiles had lower rates of MACE (Log-rank P<0.05) (Figure 1). After adjusting for confounding factors, Cox regression multivariate analysis revealed that BMI was negatively and independently associated with the incidence of MACE (hazard ratio: 0.89, 95% confidence interval: 0.83–0.96, P<0.05). Conclusion Increased BMI was associated with better clinical prognosis even in HF patients who have undergone CR Therefore, BMI assessment may be useful for risk stratification in HF patients who have undergone CR. Figure 1. Kaplan-Meier survival curve Funding Acknowledgement Type of funding source: None

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Synergistic Impact of Body Mass Index and Cognitive Function on All-Cause Mortality in Older Adults: A Nationwide Longitudinal Study

Frontiers in Endocrinology ◽

10.3389/fendo.2021.620261 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ke Han ◽

Wangping Jia ◽

Shengshu Wang ◽

Wenzhe Cao ◽

Yang Song ◽

...

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Cognitive Impairment ◽

Cognitive Function ◽

Body Mass ◽

Cognitively Impaired ◽

Chinese Older Adults ◽

All Cause Mortality ◽

Low Bmi ◽

Normal Cognition

BackgroundBody mass index (BMI) and cognitive function are independent predictors of mortality risk. However, little is known about the combined impact of BMI and cognitive function on the risk of all-cause mortality in older adults. In this study, we aimed to examine the associations between BMI, cognitive function, and all-cause mortality, including between-factor interactions, in the general population of older adults in China.MethodsWe used the data between 2011 and 2018 from the Chinese Longitudinal Healthy Longevity Survey that included adults aged ≥65 years residing in the 23 provinces of China. The association between BMI and cognitive function on all-cause mortality was examined with the Cox proportional hazards regression model.ResultsThe study included 8,293 Chinese older adults. Low BMI (underweight) and cognitive impairment were associated with the highest risk of death after adjustments [hazard ratio (HR) = 2.18; 95% confidence interval (CI), 1.96–2.41]; this combined effect was more prominent among adults aged <100 years and women. In addition, there was an interaction effect of BMI and cognitive impairment on all-cause mortality (P <0.001). Concurrently, among older adults with normal cognition, the risk of mortality related to underweight was higher than among their cognitively impaired counterparts [55% (normal cognition) vs. 38% (cognitive impairment)].ConclusionsLow BMI (underweight) and cognitive impairment were independently and jointly associated with increased risk of all-cause mortality among Chinese older adults, and females showed a stronger effect in this association. The association between BMI and mortality was more pronounced in the participants with normal cognition than in their cognitively impaired counterparts.

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