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Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study

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Author(s)
Ji-Yeon LeeKyungdo HanEugene HanGyuri KimHanna ChoKwang Joon KimByung Wan LeeEun Seok KangBong-Soo ChaCarol BrayneYong-ho Lee
Keimyung Author(s)
Han, Eu Gene
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of clinical endocrinology and metabolism
Issued Date
2019
Volume
104
Issue
7
Abstract
Context:
The risk for dementia among subjects who are obese with normal metabolic profiles, or called metabolically healthy obese (MHO), remains uninvestigated.

Objective:
To determine the association between late-life metabolic health and obesity status and risk of incident dementia.

Design:
Retrospective cohort study.

Setting:
The National Health Insurance System, Republic of Korea.

Patients:
A total of 12,296,863 adults >50 years old who underwent health examinations from 2009 to 2012 without baseline history of dementia.

Main Outcome Measure:
Incident overall dementia, Alzheimer’s disease (AD), and vascular dementia (VaD).

Results:
Among subjects ≥60 years old, 363,932 (6.4%) developed dementia during a median follow-up of 65 months (interquartile range 51 to 74 months). The MHO group showed the lowest incidence of overall dementia [hazard ratio (HR) 0.85; 95% CI, 0.84 to 0.86] and AD (HR 0.87; 95% CI, 0.86 to 0.88), but not VaD, compared with the metabolically healthy nonobese group. All components of metabolic syndrome except obesity significantly elevated the risk of dementia, and these associations were more pronounced in VaD. In particular, being underweight dramatically increased the risk of dementia.

Conclusions:
The MHO phenotype in late life demonstrated lower risk of overall dementia and AD but not VaD. Additional studies in other populations are warranted to elucidate current results and may predict individuals most at risk for developing dementia.
Keimyung Author(s)(Kor)
한유진
Publisher
School of Medicine (의과대학)
Citation
Ji-Yeon Lee et al. (2019). Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study. Journal of clinical endocrinology and metabolism, 104(7), 2942–2952. doi: 10.1210/jc.2018-01491
Type
Article
ISSN
1945-7197
Source
https://academic.oup.com/jcem/article/104/7/2942/5364430
DOI
10.1210/jc.2018-01491
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42356
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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