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

Authors

Kylie R. Kadey, Wayne State University
John L. Woodard, Wayne State University
Allison C. Moll, Wayne State University
Kristy A. Nielson, Marquette UniversityFollow
J. Carson Smith, University of Maryland at College Park
Sally Durgerian, BrainDataDriven LLCFollow
Stephen M. Rao, Schey Center for Cognitive NeuroimagingFollow

Document Type

Article

Publication Date

5-2021

Publisher

IOS Press

Source Publication

Journal of Alzheimer's Disease

Source ISSN

1387-2877

Abstract

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.

Comments

Accepted version. Journal of Alzheimer’s Disease, Vol. 81, No. 1 (May 2021): 189-199. DOI. © 2021 IOS Press. Used with permission.

Recommended Citation

Kadey, Kylie R.; Woodard, John L.; Moll, Allison C.; Nielson, Kristy A.; Smith, J. Carson; Durgerian, Sally; and Rao, Stephen M., "Five-Year Change in Body Mass Index Predicts Conversion to Mild Cognitive Impairment or Dementia Only in APOE ɛ4 Allele Carriers" (2021). Psychology Faculty Research and Publications. 500.
https://epublications.marquette.edu/psych_fac/500