Urban–Rural Disparities in the Association Between Body Mass Index and Cognitive Impairment in Older Adults: A Cross–Sectional Study in Central China

Background: Some studies have demonstrated an association between low and high body mass index (BMI) and an increased risk of dementia. However, only a few of these studies were performed in rural areas. Objective: This cross–sectional study investigated the associations between BMI and cognitive impairment among community–dwelling older adults from rural and urban areas. Methods: 8,221 older persons enrolled in the Hubei Memory & Ageing Cohort Study (HMACS) were recruited. Sociodemographic and lifestyle data, comorbidities, physical measurements, and clinical diagnoses of cognitive impairment were analyzed. Logistic regression was performed to assess the associations of BMI categories with cognitive impairment. A series of sensitivity analyses were conducted to test whether reverse causality could influence our results. Results: Being underweight in the rural–dwelling participants increased the risk of cognitive impairment. Being overweight was a protective factor in rural–dwelling participants aged 65–69 years and 75–79 years, whereas being underweight was significantly associated with cognitive impairment (OR, 1.37; 95% CI: 1.03–1.83; p < 0.05). Sensitivity analyses support that underweight had an additive effect on the odds of cognitive impairment and was related to risk of dementia. Interaction test revealed that the differences between urban/rural in the relationship between BMI and cognitive impairment are statistically significant. Conclusion: Associations between BMI and cognitive impairment differ among urban/rural groups. Older people with low BMI living in rural China are at a higher risk for dementia than those living in urban areas.

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Body mass index, waist-to-hip ratio and cognitive function among Chinese elderly: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-022055 ◽

2018 ◽

Vol 8 (10) ◽

pp. e022055 ◽

Cited By ~ 2

Author(s):

Tao Zhang ◽

Rui Yan ◽

Qifeng Chen ◽

Xuhua Ying ◽

Yujia Zhai ◽

...

Keyword(s):

Body Mass Index ◽

Cognitive Impairment ◽

Cognitive Function ◽

Body Mass ◽

Cross Sectional Study ◽

Baseline Survey ◽

Sectional Study ◽

Cross Sectional ◽

Chinese Elderly ◽

Waist To Hip Ratio

ObjectivesTo investigate the associations between body mass index (BMI), waist-to-hip ratio (WHR) and cognitive function among Chinese elderly.DesignCross-sectional study.SettingCommunity.ParticipantsData were obtained from the baseline survey of a community-based cohort in Zhejiang Province, and 9326 persons aged 60 years and older were enrolled.Primary outcome measuresWe investigated the association between BMI and cognition, and then explored the association between WHR and cognition across different quartiles of BMI.ResultsA sample of 9087 persons was used in this study, including 4375 men and 4712 women. Higher WHR increased cognitive impairment risk in those with BMI >25.3 kg/m2(OR (per 0.1 increase) 1.39; 95% CI 1.13 to 1.70). No statistically significant association was found in other BMI categories.ConclusionsHigher WHR could increase the risk of cognitive impairment among elderly with BMI >25.3 kg/m2. Our results suggest that it could be of benefit to the elderly with high BMI to control WHR.

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Comparison of body mass index range criteria and their association with cognition, functioning and depression: a cross-sectional study in Mexican older adults

BMC Geriatrics ◽

10.1186/s12877-019-1363-0 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Damaris Francis Estrella-Castillo ◽

Lizzette Gómez-de-Regil

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Outcome Measures ◽

Body Mass ◽

Physical Functioning ◽

Cross Sectional Study ◽

Normal Weight ◽

Cognitive Status ◽

Sectional Study ◽

Cross Sectional

Abstract Background World population is living longer, demanding adjustments in public health policies. Body mass index (BMI) is widely known and used as a parameter and predictor of health status although an adapted criterion for older adults is usually overlooked. BMI has been extensively analysed in relation to mortality but fewer studies address its association with cognition, functioning and depression in older adults. The present study aimed at 1) comparing BMI distribution according to the ranges proposed by the World Health Organization (WHO) and the United States National Research Council Committee on Diet and Health (CDH), 2) analysing their association with cognitive functioning, physical functioning and depression and 3) analysing a possible, interaction of BMI criteria with sex on the outcome measures. Methods This cross-sectional study included 395 participants recruited by convenience sampling; 283 (71.6%) women and 112 (24.58%) men. Mean age was 74.68 (SD = 8.50, range: 60–98). Outcome measures included the Short Portable Mental State Questionnaire for cognitive status, the Barthel’s Index of Activities of Daily Living for physical functioning, and the Geriatric Depression Scale. Results WHO criterion classified most cases (65.3%) as overweight, followed by normal weight (32.2%) and underweight (2.5%) whereas CDH criterion considered most (48.1%) as normal weight, and followed by overweight (31.4%) and underweight (20.5%). Analysing cognitive status, independent physical functioning and depression mean scores, significant differences (p ≤ .001) were found when comparing the three weight groups (underweight, normal weight and overweight) using either the WHO- or the CDH criterion. Post-hoc tests revealed that in all comparisons the underweight group scored the lowest in all three outcome measures. According to the CDH criterion, overweight was favourable for females but unfavourable for males regarding cognitive status (interaction F(2,389) = 4.52, p ≤ .01) and independent functioning (interaction F(2,389) = 3.86, p ≤ .05). Conclusions BMI and its associations to relevant outcome measures in the older adults must rely on criteria that take into account the particular features of this population, such as the CDH criterion. Underweight was associated with decremented cognition, less independent physical functioning and more depression. Overweight seemed favourable for women but unfavourable for men.

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