scholarly journals Body Mass Index and Mild Cognitive Impairment Among Middle-Aged and Older Adults from Low- and Middle-Income Countries

2021 ◽  
pp. 1-11
Author(s):  
Lee Smith ◽  
Jae Il Shin ◽  
Hans Oh ◽  
Christina Carmichael ◽  
Louis Jacob ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Body Mass ◽  
Multivariable Logistic Regression Analysis ◽  
Middle Aged ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Background: The effect of weight modification on future dementia risk is currently a subject of debate and may be modified by age. Objective: The aim of the present study was to investigate the association between body mass index (BMI) status with mild cognitive impairment (MCI) (a preclinical stage of dementia) in middle-aged and older adults residing in six low- and middle-income countries using nationally representative data. Methods: Cross-sectional data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. MCI was defined using the National Institute on Aging-Alzheimer’s Association criteria. BMI (kg/m2) was based on measured weight and height and categorized as: underweight (<18.5), normal (18.5–24.9), overweight (25.0–29.9), and obese (≥30.0). Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. Results: Data on 32,715 individuals aged ≥50 years with preservation in functional abilities were analyzed [mean (SD) age 62.1 (15.6) years; 51.7% females]. Among those aged 50–64 years, compared to normal weight, underweight (OR = 1.44; 95% CI = 1.14–1.81), overweight (OR = 1.17; 95% CI = 1.002–1.37), and obesity (OR = 1.46; 95% CI = 1.09–1.94) were all significantly associated with higher odds for MCI. In those aged ≥65 years, underweight (OR = 0.71; 95% CI = 0.54–0.95) and overweight (OR = 0.72; 95% CI = 0.55–0.94) were associated with significantly lower odds for MCI, while obesity was not significantly associated with MCI. Conclusion: The results of the study suggest that the association between BMI and MCI is likely moderated by age. Future longitudinal studies are required to confirm or refute the present findings before recommendations for policy and practice can be made.

scholarly journals Sarcopenia and Mild Cognitive Impairment in Older Adults from Six Low- and Middle-Income Countries

2021 ◽  
pp. 1-10
Author(s):  
Louis Jacob ◽  
Karel Kostev ◽  
Lee Smith ◽  
Hans Oh ◽  
Guillermo F. López-Sánchez ◽  
...  
Keyword(s):  
South Africa ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Positive Association ◽  
Community Dwelling ◽  
Middle Income ◽  
Middle Income Countries ◽  
Skeletal Mass ◽  
Low And Middle Income

Background: Little is known about the relationship between sarcopenia and mild cognitive impairment (MCI) in low- and middle-income countries (LMICs). Objective: This study aimed to investigate this association among community-dwelling adults aged≥65 years from six LMICs. Methods: Cross-sectional, nationally representative data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. These data were obtained in China, Ghana, India, Mexico, Russia, and South Africa in 2007–2010. Participants were considered to have sarcopenia if they had low skeletal muscle mass (i.e., lower skeletal mass index) and a weak handgrip strength. MCI was defined using the National Institute on Aging-Alzheimer’s Association criteria. Multivariable logistic regression analysis was conducted to assess associations. Results: The final analytical sample consisted of 12,912 individuals aged≥65 years with preservation in functional abilities without stroke (mean [standard deviation] age 72.2 [10.8] years; 45.2% males). The overall prevalence of sarcopenia and MCI were 11.3% and 18.1%, respectively. After adjusting for potential confounders, there was a positive association between sarcopenia and MCI in all countries (i.e., odds ratio [OR] >  1) with the exception of South Africa, and the overall estimate was OR = 1.60 (95% confidence interval [CI] = 1.32–1.93) with a low level of between-country heterogeneity (I2 = 0.0%). Conclusion: There was a positive association between sarcopenia and MCI in this sample of older adults living in LMICs. Causality should be assessed in future longitudinal research, while the utility of sarcopenia as a marker of MCI should also be investigated.

scholarly journals Active Travel and Mild Cognitive Impairment among Older Adults from Low- and Middle-Income Countries

2021 ◽  
Vol 10 (6) ◽  
pp. 1243
Author(s):  
Lee Smith ◽  
Nicola Veronese ◽  
Guillermo F. López-Sánchez ◽  
Lin Yang ◽  
Damiano Pizzol ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Active Travel ◽  
World Health ◽  
Multivariable Logistic Regression Analysis ◽  
Adult Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Active travel may be an easily achievable form of physical activity for older people especially in low- and middle-income countries (LMICs), but there are currently no studies on how this form of physical activity is associated with a preclinical state of dementia known as mild cognitive impairment (MCI). Therefore, we aimed to investigate the association between active travel and MCI among adults aged ≥50 years from six LMICs. Cross-sectional, community-based data from the World Health Organization’s Study on Global Ageing and Adult Health were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer’s Association criteria. Active travel (minutes/week) was assessed with questions of the Global Physical Activity Questionnaire (GPAQ) and presented in tertiles. Multivariable logistic regression analysis was conducted to assess the association between active travel and MCI. Data on 32715 people aged ≥ 50 years (mean age 62.4 years; 52.1% females) were analyzed. Compared to the highest tertile of active travel, the lowest tertile was associated with 1.33 (95%CI = 1.14–1.54) times higher odds for MCI overall. This association was particularly pronounced among those aged ≥65 years (OR = 1.70; 95%CI = 1.32–2.19) but active travel was not associated with MCI among those aged 50–64 years. In conclusion, low levels of active travel were associated with a significantly higher odds of MCI in adults aged ≥65 years in LMICs. Promoting active travel among people of this age group in LMICs via tailored interventions and/or country-wide infrastructure investment to provide a safe environment for active travel may lead to a reduction in MCI and subsequent dementia.

scholarly journals Five-Year Change in Body Mass Index Predicts Conversion to Mild Cognitive Impairment or Dementia Only in APOE ɛ4 Allele Carriers

2021 ◽  
pp. 1-11
Author(s):  
Kylie R. Kadey ◽  
John L. Woodard ◽  
Allison C. Moll ◽  
Kristy A. Nielson ◽  
J. Carson Smith ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Body Mass ◽  
Carrier Status ◽  
Healthy Older Adults ◽  
E4 Allele ◽  
Lifestyle Risk

Background: Body mass index (BMI) has been identified as an important modifiable lifestyle risk factor for dementia, but less is known about how BMI might interact with Apolipoprotein E ɛ4 (APOE ɛ4) carrier status to predict conversion to mild cognitive impairment (MCI) and dementia. Objective: The aim of this study was to investigate the interaction between APOE ɛ4 status and baseline (bBMI) and five-year BMI change (ΔBMI) on conversion to MCI or dementia in initially cognitively healthy older adults. Methods: The associations between bBMI, ΔBMI, APOE ɛ4 status, and conversion to MCI or dementia were investigated among 1,289 cognitively healthy elders from the National Alzheimer’s Coordinating Center (NACC) database. Results: After five years, significantly more carriers (30.6%) converted to MCI or dementia than noncarriers (17.6%), p <  0.001, OR = 2.06. Neither bBMI (OR = 0.99, 95%CI = 0.96–1.02) nor the bBMI by APOE interaction (OR = 1.02, 95%CI = 0.96–1.08) predicted conversion. Although ΔBMI also did not significantly predict conversion (OR = 0.90, 95%CI = 0.78–1.04), the interaction between ΔBMI and carrier status was significant (OR = 0.72, 95%CI = 0.53–0.98). For carriers only, each one-unit decline in BMI over five years was associated with a 27%increase in the odds of conversion (OR = 0.73, 95%CI = 0.57–0.94). Conclusion: A decline in BMI over five years, but not bBMI, was strongly associated with conversion to MCI or dementia only for APOE ɛ4 carriers. Interventions and behaviors aimed at maintaining body mass may be important for long term cognitive health in older adults at genetic risk for AD.

scholarly journals Prevalence and Risk of Mild Cognitive Impairment in Low and Middle-Income Countries: A Systematic Review

2020 ◽  
pp. 1-20
Author(s):  
Andrea M. McGrattan ◽  
Yueping Zhu ◽  
Connor D. Richardson ◽  
Devi Mohan ◽  
Yee Chang Soh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Resource Planning ◽  
Cognitive State ◽  
Middle Income ◽  
Total N ◽  
Middle Income Countries ◽  
Increased Risk ◽  
Low And Middle Income

Background: Mild cognitive impairment (MCI) is a cognitive state associated with increased risk of dementia. Little research on MCI exists from low-and middle-income countries (LMICs), despite high prevalence of dementia in these settings. Objective: This systematic review aimed to review epidemiological reports to determine the prevalence of MCI and its associated risk factors in LMICs. Methods: Medline, Embase, and PsycINFO were searched from inception until November 2019. Eligible articles reported on MCI in population or community-based studies from LMICs. No restrictions on the definition of MCI used as long as it was clearly defined. Results: 4,621 articles were screened, and 78 retained. In total, n = 23 different LMICs were represented; mostly from China (n = 55 studies). Few studies from countries defined as lower-middle income (n = 14), low income (n = 4), or from population representative samples (n = 4). There was large heterogeneity in how MCI was diagnosed; with Petersen criteria the most commonly applied (n = 26). Prevalence of aMCI (Petersen criteria) ranged from 0.6%to 22.3%. Similar variability existed across studies using the International Working Group Criteria for aMCI (range 4.5%to 18.3%) and all-MCI (range 6.1%to 30.4%). Risk of MCI was associated with demographic (e.g., age), health (e.g., cardio-metabolic disease), and lifestyle (e.g., social isolation, smoking, diet and physical activity) factors. Conclusion: Outside of China, few MCI studies have been conducted in LMIC settings. There is an urgent need for population representative epidemiological studies to determine MCI prevalence in LMICs. MCI diagnostic methodology also needs to be standardized. This will allow for cross-study comparison and future resource planning.

Patterning of individual heterogeneity in body mass index: evidence from 57 low- and middle-income countries

2018 ◽  
Vol 33 (8) ◽  
pp. 741-750 ◽  
Author(s):  
Rockli Kim ◽  
Ichiro Kawachi ◽  
Brent Andrew Coull ◽  
Sankaran Venkata Subramanian
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Individual Heterogeneity ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income
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