ADA 2019—Lower BMI is tied to increased dementia risk after T2D diagnosis


  • Emily Willingham, PhD
  • Conference Reports
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Takeaway

  • Lower BMI is linked to increased risk for all-cause dementia and Alzheimer dementia (AD) in patients just diagnosed with type 2 diabetes (T2D). 
  • Weight change is also tied to increased all-cause dementia risk after a new diabetes diagnosis. 

Why this matters

  • Gaps persist regarding the association among new diabetes diagnosis, dementia, and BMI. 

Key results

  • During 3.5-year average follow-up, 2563 events were detected (1846 AD; 381 vascular dementia).
  • Vs BMI 18.5-23, all-cause dementia risk (all HRs; 95% CIs) decreased with BMI:
    • 23-25: 0.80 (0.69-0.91);
    • 25-30: 0.77 (0.68-0.88); and
    • ≥30: 0.79 (0.63-0.99).
  • All-cause dementia risk increased with decreasing BMI: P trend <.001.>
  • AD risk was: 
    • Higher with underweight BMI: 1.59 (1.04-2.43).
    • Decreased with BMI: 
      • 23-25: 0.79 (0.67-0.93); and
      • 25-30: 0.76 (0.65-0.88); P trend <.001.>
  • Baseline BMI, vascular dementia not associated.
  • Vs  
    • 1.34 (1.11-1.63) and 1.38 (1.08-1.76), respectively.
  • AD risk also increased with ≥10% weight loss within 2 years: 1.26 (1.01-1.59).

Study design

  • South Korean National Health Insurance Service-National Health Screening Cohort data for 167,876 people aged ≥40 years diagnosed with new-onset T2D, 2007-2012. 

Limitations

  • Dementia severity unknown.
  • Reverse causality not ruled out.