A recent study published in JAMA Network Open has uncovered significant links between weight loss and the risk of developing dementia in older adults. The research, which tracked nearly 5,400 participants over a span of 11 years, suggests that changes in body mass index (BMI) and waist circumference may serve as early markers for cognitive decline.
The study involved participants aged 65 years and older from the United States and Australia, who were free from major cognitive deficits, physical disabilities, or cardiovascular diseases. Researchers monitored various aspects of their cardiometabolic health from 2010 to 2022. Notably, the findings revealed that seniors diagnosed with dementia exhibited a lower baseline BMI and experienced a more pronounced decline in BMI beginning at least 11 years prior to their diagnosis.
The researchers noted that people with dementia had a faster decline in both BMI and waist circumference compared to those with normal cognitive function. This suggests that noticeable weight loss could be an early warning sign of impending cognitive issues.
The analysis included data from the Aspirin in Reducing Events in the Elderly (ASPREE) trial along with an observational follow-up study, ASPREE Extension. The study's lead author, Dr. Zhiruo Wu, emphasized the potential for these findings to aid in early identification of individuals at risk for dementia.
“Dementia develops over many years before symptoms become noticeable,” Dr. Wu stated. This prolonged period before clinical symptoms manifest underscores the importance of monitoring changes in physical health as potential indicators of cognitive decline.
In addition to weight changes, the study also highlighted that individuals who went on to be diagnosed with dementia showed greater increases in high-density lipoprotein (HDL) cholesterol levels. Specifically, these increases were most notable between 11 and four years prior to diagnosis. Five years before their diagnosis, individuals with dementia exhibited higher HDL levels than their cognitively healthy counterparts.
The implications of these findings are significant. They suggest that both weight loss and increasing HDL cholesterol levels may be early symptoms of dementia. However, it remains unclear whether these factors are direct risk indicators for the condition or simply associated changes resulting from the disease process itself.
“Weight loss may be an early sign of dementia-related brain changes that affect appetite, metabolism, and daily function,” Dr. Wu added. This connection between metabolic changes and cognitive health reinforces the need for further exploration into how these factors interact over time.
In observing the decline in waist circumference, researchers found that those who would eventually develop dementia had significantly lower measurements ten years prior to their diagnosis compared to those who maintained normal cognitive function. Willa Brenowitz, PhD, MPH, noted, “Weight loss is associated with dementia because dementia is causing the weight loss,” emphasizing the biological mechanisms at play in this relationship.
The study’s findings align with previous research indicating connections between declining BMI and various cardiometabolic changes associated with dementia. Brenowitz pointed out the importance of considering other potential causes when assessing cognitive health.
“Cognitive health is likely best checked if there are other potential reasons for concerns such as someone noticing they or a family member is having more memory issues than before, or other cognitive changes,” she advised.
Despite these promising insights, Dr. Wu acknowledged limitations within the study. “While this pattern was observed, how to differentiate these changes from normal aging in practical settings is beyond the scope of this study.” This indicates a need for further research to better understand how these observations can be applied in real-world scenarios.
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