Relationship between obesity-related anthropometric indicators and cognitive function in Chinese suburb-dwelling older adults

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Abstract

Background

Studies relating obesity to cognition in older people show conflicting results, which may be explained by the choice of obesity indicators.

Objectives

This study aimed to investigate the relationship between obesity-related indicators and cognitive impairment, especially between different age or gender subgroups, and explore whether obesity-related indicators were related to specific cognitive domains.

Methods

This was a cross-sectional study on 1753 participants aged ≥ 60 years (41.0% men; aged 71.36 ± 5.96 years). Obesity-related indicators included body mass index (BMI), waist circumference (WC), calf circumference (CC), waist to hip ratio (WHR), waist to calf circumstance ratio (WCR), fat to fat-free mass ratio (FM/FFM). The Mini-Mental State Examination scale (MMSE) was used to assess cognitive function. Cognitive impairment was defined as a score ≤ 17 for illiterates, ≤ 20 for participants with primary school education, and ≤ 24 for those with junior high school degrees or above. Multiple logistic regression analysis was used to estimate multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines were used to analyze and visualize the linear relationships.

Results

The prevalence of cognitive impairment was 18.77%. In the fully adjusted model, CC was negatively associated with cognitive impairment (OR = 0.94, 95% CI: 0.90−0.98). Further analysis showed that CC correlated positively with recall and place orientation. A higher FM/FFM was found to be associated with a higher prevalence of cognitive impairment (OR: 1.44, 95%CI: 0.88–2.35, P for trend = 0.029); this association was notable in women ( P for trend = 0.002) and the oldest ( P for trend = 0.009), and so did the potential effect of BMI on cognitive impairment (70–80 years: P for trend = 0.011; ≥ 80 years: P for trend = 0.013). No statistically significant association was found between cognitive impairment and WC, WHR, or WCR.

Conclusion

CC and FM/FFM were associated with cognitive impairment in older people. Future research needs to distinguish the effects of fat and muscle mass on cognitive function, with special attention to different ages and genders.

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Most cited references 42

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International physical activity questionnaire: 12-country reliability and validity.

CORA L. CRAIG, ALISON L. MARSHALL, MICHAEL SJ??STR??M … (2003)

Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.

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The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

Marilyn Albert, Steven Dekosky, Dennis D Dickson … (2011)

The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of developing criteria for the symptomatic predementia phase of Alzheimer's disease (AD), referred to in this article as mild cognitive impairment due to AD. The workgroup developed the following two sets of criteria: (1) core clinical criteria that could be used by healthcare providers without access to advanced imaging techniques or cerebrospinal fluid analysis, and (2) research criteria that could be used in clinical research settings, including clinical trials. The second set of criteria incorporate the use of biomarkers based on imaging and cerebrospinal fluid measures. The final set of criteria for mild cognitive impairment due to AD has four levels of certainty, depending on the presence and nature of the biomarker findings. Considerable work is needed to validate the criteria that use biomarkers and to standardize biomarker analysis for use in community settings. Copyright © 2011 The Alzheimer's Association. All rights reserved.

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The global prevalence of dementia: a systematic review and metaanalysis.

Martin Prince, Renata Bryce, Emiliano Albanese … (2013)

The evidence base on the prevalence of dementia is expanding rapidly, particularly in countries with low and middle incomes. A reappraisal of global prevalence and numbers is due, given the significant implications for social and public policy and planning. In this study we provide a systematic review of the global literature on the prevalence of dementia (1980-2009) and metaanalysis to estimate the prevalence and numbers of those affected, aged ≥60 years in 21 Global Burden of Disease regions. Age-standardized prevalence for those aged ≥60 years varied in a narrow band, 5%-7% in most world regions, with a higher prevalence in Latin America (8.5%), and a distinctively lower prevalence in the four sub-Saharan African regions (2%-4%). It was estimated that 35.6 million people lived with dementia worldwide in 2010, with numbers expected to almost double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. In 2010, 58% of all people with dementia lived in countries with low or middle incomes, with this proportion anticipated to rise to 63% in 2030 and 71% in 2050. The detailed estimates in this study constitute the best current basis for policymaking, planning, and allocation of health and welfare resources in dementia care. The age-specific prevalence of dementia varies little between world regions, and may converge further. Future projections of numbers of people with dementia may be modified substantially by preventive interventions (lowering incidence), improvements in treatment and care (prolonging survival), and disease-modifying interventions (preventing or slowing progression). All countries need to commission nationally representative surveys that are repeated regularly to monitor trends. Copyright © 2013 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

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Author and article information

Contributors

Weibo Ma: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SupervisionRole: VisualizationRole: Writing – original draftRole: Writing – review & editing

Hui Zhang: Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – review & editing

Ning Wu: Role: ConceptualizationRole: InvestigationRole: Methodology

Yuewen Liu: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Supervision

Peipei Han: Role: Data curationRole: Formal analysisRole: Funding acquisitionRole: ResourcesRole: Supervision

Feng Wang: Role: Investigation

Jingru Wang: Role: Investigation

Fandi Xie: Role: Funding acquisition

Shumeng Niu: Role: Resources

Hao Hu: Role: Resources

Chenyu Zhang: Role: Investigation

Nuo Chen: Role: Investigation

Yichen Zhang: Role: Investigation

Qi Guo:

ORCID: https://orcid.org/0000-0003-0439-8274

Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: ResourcesRole: Writing – review & editing

Ying Yu: Role: ConceptualizationRole: MethodologyRole: ResourcesRole: Writing – review & editing

Clemens Fürnsinn: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS One

Journal ID (publisher-id): plos

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 27 October 2021

Publication date Collection: 2021

Volume: 16

Issue: 10

Electronic Location Identifier: e0258922

Affiliations

[1 ] Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China

[2 ] Department of Economics and Management, East China Normal University, Shanghai, China

[3 ] Department of Rehabilitation Clinic, Shanghai Jiangwan Hospital, Shanghai, China

Medical University of Vienna, AUSTRIA

Author notes

Competing Interests: The authors have declared that no competing interests exist.

* E-mail: guoqijp@ 123456gmail.com (QG); yuying@ 123456sumhs.edu.cn (YY)

Author information

Qi Guo https://orcid.org/0000-0003-0439-8274

Article

Publisher ID: PONE-D-21-05438

DOI: 10.1371/journal.pone.0258922

PMC ID: 8550380

PubMed ID: 34705855

SO-VID: 94844959-df34-4d33-be4e-95d8405ec6b3

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 18 February 2021

Date accepted : 11 October 2021

Page count

Figures: 1, Tables: 5, Pages: 14

Funding

Funded by: Shanghai Sailing Program

Award ID: 20YF1418200

Award Recipient : Peipei Han

Funded by: Shanghai Education Science Committee

The study was funded by Shanghai Sailing Program (20YF1418200). The organization that funded our research was Shanghai Education Science Committee, which gave us a grant of 200,000 RMB. The cost of consumables for anthropometry comes from the funds provided by Shanghai Education Science Committee. There are not any authors who received a salary from my funder. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Data Availability All relevant data are within the manuscript and its Supporting Information files.

Relationship between obesity-related anthropometric indicators and cognitive function in Chinese suburb-dwelling older adults

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Most cited references 42

International physical activity questionnaire: 12-country reliability and validity.

The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

The global prevalence of dementia: a systematic review and metaanalysis.

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