Kaiser Permanente Study Shows That A Larger Abdomen In Midlife Increases Risk Of Dementia

People in their 40s with
larger stomachs have a higher risk for dementia when they reach their 70s,
according to a study published in the March 26, 2008, online issue of
Neurology(R), the medical journal of the American Academy of Neurology.


Previous studies have looked at central obesity (as determined by waist
circumference) and body mass index in the elderly and its link to dementia
risk. In addition, previous studies have shown that a large abdomen -- in
midlife -- increases the risk of diabetes, stroke, and coronary heart
disease. This is the first time researchers have demonstrated a
longitudinal association between midlife belly fat and the risk of
dementia.



Capturing abdominal obesity in midlife may be a much better indicator
of the long term metabolic dysregulation that leads to dementia risk, said
study author Rachel Whitmer, Ph.D., a research scientist at the Kaiser
Permanente Division of Research in Oakland, CA. Measuring abdomen size in
older age people may not be as good an indicator because as people age they
tend to naturally lose muscle and bone mass and gain belly size, she
explained.



"Considering that 50 percent of adults in this country have abdominal
obesity, this is a disturbing finding. It is well known that being
overweight in midlife and beyond increases risk factors for disease.
However, where one carries the weight -- especially in midlife -- appears
to be an important predictor for dementia risk," she said.



"Autopsies have shown that changes in the brain associated with
Alzheimer's disease may start in young to middle adulthood, and another
study showed that high abdominal fat in elderly adults was tied to greater
brain atrophy. These findings imply that the dangerous effects of abdominal
obesity on the brain may start long before the signs of dementia appear."
She explained that additional research needs to be completed to determine
the underlying mechanisms that link abdominal obesity in midlife to
dementia risk.



Researchers studied 6,583 people age 40 to 45 in northern California
who had their abdominal density measured. Belly fat was measured by using a
caliper to determine the distance from the back to the upper abdomen,
midway between the top of the pelvis and the bottom of the ribs. Belly
density is highly correlated with visceral fat tissue, the fat tissue that
is wrapped around the organs, according to the researchers. An average of
36 years later, 16 percent of the participants had been diagnosed with
dementia.
















The study found that those who were overweight and had a large belly
were 2.3 times more likely to develop dementia than people with a normal
weight and belly size. People who were both obese and had a large belly
were 3.6 times more likely to develop dementia than those of normal weight
and belly size. Those who were overweight or obese but did not have a large
abdomen had an 80-percent increased risk of dementia.



Having a large abdomen increased the risk of dementia regardless of
whether the participants were of normal weight overall, overweight, or
obese, and regardless of existing health conditions, including diabetes,
stroke and cardiovascular disease.



Non-whites, smokers, people with high blood pressure, high cholesterol
or diabetes, and those with less than a high school level of education were
more likely to have abdominal obesity.



As with all observational studies, it is possible that the association
of the abdominal obesity and dementia is not driven by the abdominal
obesity, but rather by a complex set of health-related behaviors, for which
abdominal obesity is but one part.



Additional authors on the study include Deborah R. Gustafson, Ph.D.,
Goteberg University, Goteberg, Sweden; Elizabeth Barrett-Connor, MD,
department of family medicine, University of California, La Jolla, Calif.;
Mary N. Haan, DrPH, department of epidemiology, University of Michigan, Ann
Arbor, Mich.; Erica P. Gunderson, Ph.D., Kaiser Permanente Division of
Research, Oakland, Calif.; and Kristine Yaffe, MD, Departments of
Psychiatry, Neurology and Epidemiology, University of California, San
Francisco. Funding for the study was provided by the National Institutes of
Health.



The American Academy of Neurology, an association of more than 21,000
neurologists and neuroscience professionals, is dedicated to improving
patient care through education and research. A neurologist is a doctor with
specialized training in diagnosing, treating and managing disorders of the
brain and nervous system such as stroke, Alzheimer's disease, epilepsy,
Parkinson's disease, and multiple sclerosis.



For more information about the American Academy of Neurology, visit
aan.



About Kaiser Permanente Research



Kaiser Permanente's eight research centers comprise one of the largest
research programs in the U.S. and engage in work designed to improve the
health of individuals everywhere. KP HealthConnect(TM), Kaiser Permanente's
electronic health record, and other resources provide population data for
research, and in turn, research findings arm KP physicians with
up-to-the-minute research and clinical data. Kaiser Permanente's research
program works with national and local health agencies and community
organizations to share and widely disseminate its research data. Kaiser
Permanente's research program is funded in part by Kaiser Permanente's
Community Benefit division, which in 2006 directed $808 million in health
services, technology, and funding toward total community health.



About Kaiser Permanente



Kaiser Permanente is America's leading integrated health plan. Founded
in 1945, it is a not-for-profit, group practice prepayment program
headquartered in Oakland, Calif. Kaiser Permanente serves the health care
needs of 8.7 million members in nine states and the District of Columbia.
Today it encompasses the not-for-profit Kaiser Foundation Health Plan,
Inc., Kaiser Foundation Hospitals and their subsidiaries, and the
for-profit Permanente Medical Groups. Nationwide, Kaiser Permanente
includes approximately 159,000 technical, administrative and clerical
employees and caregivers, and more than 13,000 physicians representing all
specialties. For more Kaiser Permanente news, visit the KP News Center at:
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