Body mass index in midlife and dementia:  Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies

Emiliano Albanese; Lenore J. Launer; Matthias Egger; Martin J. Prince; Panteleimon Giannakopoulos; Frank J. Wolters; Kieren Egan

doi:10.1016/j.dadm.2017.05.007

Body mass index in midlife and dementia: Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies

Emiliano Albanese, Lenore J. Launer, Matthias Egger, Martin J. Prince, Panteleimon Giannakopoulos, Frank J. Wolters, Kieren Egan

Research output: Contribution to journal › Article › peer-review

212 Citations (Scopus)

236 Downloads (Pure)

Abstract

Introduction
We conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia.
Methods

We searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity. Results We included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95% confidence interval [CI], 1.08–1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95% CI, 0.96–1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95% CI, 1.13–1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007).

Discussion

Obesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.

Original language	English
Pages (from-to)	165-178
Journal	Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume	8
DOIs	https://doi.org/10.1016/j.dadm.2017.05.007
Publication status	E-pub ahead of print - 20 Jun 2017

Keywords

Dementia
Body mass index
BMI
Obesity
Meta-analysis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

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Cite this

Albanese, E., Launer, L. J., Egger, M., Prince, M. J., Giannakopoulos, P., Wolters, F. J., & Egan, K. (2017). Body mass index in midlife and dementia: Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, 8, 165-178. Advance online publication. https://doi.org/10.1016/j.dadm.2017.05.007

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abstract = "IntroductionWe conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia.MethodsWe searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity. Results We included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95% confidence interval [CI], 1.08–1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95% CI, 0.96–1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95% CI, 1.13–1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007). DiscussionObesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.",

keywords = "Dementia, Body mass index, BMI, Obesity, Meta-analysis",

author = "Emiliano Albanese and Launer, {Lenore J.} and Matthias Egger and Prince, {Martin J.} and Panteleimon Giannakopoulos and Wolters, {Frank J.} and Kieren Egan",

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Albanese, E, Launer, LJ, Egger, M, Prince, MJ, Giannakopoulos, P, Wolters, FJ & Egan, K 2017, 'Body mass index in midlife and dementia: Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies', Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, vol. 8, pp. 165-178. https://doi.org/10.1016/j.dadm.2017.05.007

Body mass index in midlife and dementia: Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies. / Albanese, Emiliano; Launer, Lenore J.; Egger, Matthias et al.
In: Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, Vol. 8, 20.06.2017, p. 165-178.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Body mass index in midlife and dementia

T2 - Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies

AU - Albanese, Emiliano

AU - Launer, Lenore J.

AU - Egger, Matthias

AU - Prince, Martin J.

AU - Giannakopoulos, Panteleimon

AU - Wolters, Frank J.

AU - Egan, Kieren

PY - 2017/6/20

Y1 - 2017/6/20

N2 - IntroductionWe conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia.MethodsWe searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity. Results We included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95% confidence interval [CI], 1.08–1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95% CI, 0.96–1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95% CI, 1.13–1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007). DiscussionObesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.

AB - IntroductionWe conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia.MethodsWe searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity. Results We included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95% confidence interval [CI], 1.08–1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95% CI, 0.96–1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95% CI, 1.13–1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007). DiscussionObesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.

KW - Dementia

KW - Body mass index

KW - BMI

KW - Obesity

KW - Meta-analysis

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DO - 10.1016/j.dadm.2017.05.007

M3 - Article

SN - 2352-8729

VL - 8

SP - 165

EP - 178

JO - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring

JF - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring

ER -

Albanese E, Launer LJ, Egger M, Prince MJ, Giannakopoulos P, Wolters FJ et al. Body mass index in midlife and dementia: Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring. 2017 Jun 20;8:165-178. Epub 2017 Jun 20. doi: 10.1016/j.dadm.2017.05.007