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Open Access 01-12-2021 | Obesity | Research

Investigating the relationship between BMI across adulthood and late life brain pathologies

Authors: Christopher A. Lane, Josephine Barnes, Jennifer M. Nicholas, John W. Baker, Carole H. Sudre, David M. Cash, Thomas D. Parker, Ian B. Malone, Kirsty Lu, Sarah-Naomi James, Ashvini Keshavan, Sarah Buchanan, Sarah Keuss, Heidi Murray-Smith, Andrew Wong, Elizabeth Gordon, William Coath, Marc Modat, David Thomas, Rebecca Hardy, Marcus Richards, Nick C. Fox, Jonathan M. Schott

Published in: Alzheimer's Research & Therapy | Issue 1/2021

Abstract

Background

In view of reported associations between high adiposity, particularly in midlife and late-life dementia risk, we aimed to determine associations between body mass index (BMI), and BMI changes across adulthood and brain structure and pathology at age 69–71 years.

Methods

Four hundred sixty-five dementia-free participants from Insight 46, a sub-study of the British 1946 birth cohort, who had cross-sectional T1/FLAIR volumetric MRI, and florbetapir amyloid-PET imaging at age 69–71 years, were included in analyses. We quantified white matter hyperintensity volume (WMHV) using T1 and FLAIR 3D-MRI; β-amyloid (Aβ) positivity/negativity using a SUVR approach; and whole brain (WBV) and hippocampal volumes (HV) using 3D T1-MRI. We investigated the influence of BMI, and BMI changes at and between 36, 43, 53, 60–64, 69 and 71 years, on late-life WMHV, Aβ-status, WBV and mean HV. Analyses were repeated using overweight and obese status.

Results

At no time-point was BMI, change in BMI or overweight/obese status associated with WMHV or WBV at age 69–71 years. Decreasing BMI in the 1–2 years before imaging was associated with an increased odds of being β-amyloid positive (OR 1.45, 95% confidence interval 1.09, 1.92). There were associations between being overweight and larger mean HV at ages 60–64 (β = 0.073 ml, 95% CI 0.009, 0.137), 69 (β = 0.076 ml, 95% CI 0.012, 0.140) and 71 years (β = 0.101 ml, 95% CI 0.037, 0.165). A similar, albeit weaker, trend was seen with obese status.

Conclusions

Using WMHV, β-amyloid status and brain volumes as indicators of brain health, we do not find evidence to explain reported associations between midlife obesity and late-life dementia risk. Declining BMI in later life may reflect preclinical Alzheimer’s disease.

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Title: Investigating the relationship between BMI across adulthood and late life brain pathologies
Authors: Christopher A. Lane
Josephine Barnes
Jennifer M. Nicholas
John W. Baker
Carole H. Sudre
David M. Cash
Thomas D. Parker
Ian B. Malone
Kirsty Lu
Sarah-Naomi James
Ashvini Keshavan
Sarah Buchanan
Sarah Keuss
Heidi Murray-Smith
Andrew Wong
Elizabeth Gordon
William Coath
Marc Modat
David Thomas
Rebecca Hardy
Marcus Richards
Nick C. Fox
Jonathan M. Schott
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Obesity
Obesity
Alzheimer's Disease
Dementia
Alzheimer's Disease
Pathology
Dementia
Overweight
Published in: Alzheimer's Research & Therapy / Issue 1/2021
Electronic ISSN: 1758-9193
DOI: https://doi.org/10.1186/s13195-021-00830-7

At a glance: The STEP trials

Springer Medicine

Investigating the relationship between BMI across adulthood and late life brain pathologies

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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