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Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study

Authors
 Ji-Yeon Lee  ;  Kyungdo Han  ;  Eugene Han  ;  Gyuri Kim  ;  Hanna Cho  ;  Kwang Joon Kim Byung Wan Lee  ;  Eun Seok Kang  ;  Bong-Soo Cha  ;  Carol Brayne  ;  Yong-ho Lee 
Citation
 JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, Vol.104(7) : 2942-2952, 2019 
Journal Title
 JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 
ISSN
 0021-972X 
Issue Date
2019
Abstract
CONTEXT: The risk for dementia among subjects who are obese with normal metabolic profiles, or called metabolically healthy obese (MHO), remains uninvestigated. OBJECTIVE: To determine the association between late-life metabolic health and obesity status and risk of incident dementia. DESIGN: Retrospective cohort study. SETTING: The National Health Insurance System, Republic of Korea. PATIENTS: A total of 12,296,863 adults >50 years old who underwent health examinations from 2009 to 2012 without baseline history of dementia. MAIN OUTCOME MEASURE: Incident overall dementia, Alzheimer's disease (AD), and vascular dementia (VaD). RESULTS: Among subjects ≥60 years old, 363,932 (6.4%) developed dementia during a median follow-up of 65 months (interquartile range 51 to 74 months). The MHO group showed the lowest incidence of overall dementia [hazard ratio (HR) 0.85; 95% CI, 0.84 to 0.86] and AD (HR 0.87; 95% CI, 0.86 to 0.88), but not VaD, compared with the metabolically healthy nonobese group. All components of metabolic syndrome except obesity significantly elevated the risk of dementia, and these associations were more pronounced in VaD. In particular, being underweight dramatically increased the risk of dementia. CONCLUSIONS: The MHO phenotype in late life demonstrated lower risk of overall dementia and AD but not VaD. Additional studies in other populations are warranted to elucidate current results and may predict individuals most at risk for developing dementia.
Full Text
https://academic.oup.com/jcem/article/104/7/2942/5364430
DOI
10.1210/jc.2018-01491
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Kwang Joon(김광준) ORCID logo https://orcid.org/0000-0002-5554-8255
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Lee, Ji Yeon(이지연)
Cho, Hanna(조한나) ORCID logo https://orcid.org/0000-0001-5936-1546
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170280
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