Risk of Dementia Associated with Body Mass Index, Changes in Body Weight and Waist Circumference in Older People with Type 2 Diabetes: the Edinburgh Type 2 Diabetes Study.

Aims/HypothesisTo determine the relationship of dementia with preceding body mass index (BMI), changes in body weight and waist circumference in older people with type 2 diabetes. MethodsIn the Edinburgh Type 2 Diabetes Study (1064 men and women with type 2 diabetes, aged 60-75), body weight, waist circumference and BMI were measured at baseline and after 4 years in a subgroup (n = 821). Percentage body weight and waist circumference change over 4 years were calculated. Data on incident dementia was recorded during a median follow-up time of 10.84 years. Survival models considering a range of co-variables and/or death as a competing risk were used to estimate the risks of dementia associated with each weight-related variable. ResultsA total of 105 incident dementia events were recorded. When compared with people in the lowest BMI group (<25 kg/m(2)), risk of dementia was lower in intermediate BMI groups (25-29.9 kg/m(2), HR 0.44, p = 0.002; 30-34.9 kg/m(2), HR 0.41, p = 0.001) and the highest BMI group (>= 35 kg/m(2), HR 0.35, p = 0.001). In the weight change subgroup, 78 incident dementia events were recorded between years 4 and 10. Body weight loss over 5% (compared with <= 5%) was associated with higher incidence of dementia (HR 2.06, p = 0.010). The association between waist circumference change and dementia was not significant. Conclusions/InterpretationsBoth a lower BMI and weight loss over a period of years are indicative of increased dementia risk for older people with type 2 diabetes, while waist circumference changes may be less informative.