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

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

Research output: Contribution to journalArticle

Abstract

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 followup of 65 months (interquartile range 51 to 74months). TheMHO group showed the lowest incidence of overall dementia [hazard ratio (HR) 0.85; 95%CI, 0.84 to 0.86] andAD(HR0.87; 95%CI, 0.86 to 0.88), but not VaD, comparedwith themetabolically healthy nonobese group. All components ofmetabolic syndrome except obesity significantly elevated the risk of dementia, and these associationsweremore pronounced in VaD. In particular, being underweight dramatically increased the risk of dementia.

Original languageEnglish
Article numberjcem_201801491
Pages (from-to)2942-2952
Number of pages11
JournalJournal of Clinical Endocrinology and Metabolism
Volume104
Issue number7
DOIs
Publication statusPublished - 2019 Mar 21

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Health Status
Dementia
Cohort Studies
Obesity
Health
Population
Vascular Dementia
Health insurance
Hazards
Alzheimer Disease
Republic of Korea
Metabolome
Thinness
National Health Programs
Retrospective Studies
Outcome Assessment (Health Care)
Incidence

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Lee, Ji Yeon ; Han, Kyungdo ; Han, Eugene ; Kim, Gyuri ; Cho, Hanna ; Kim, Kwang Joon ; Lee, Byung Wan ; Kang, Eun Seok ; Cha, Bong Soo ; Brayne, Carol ; Lee, Yong Ho. / Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life : A Population-Based Cohort Study. In: Journal of Clinical Endocrinology and Metabolism. 2019 ; Vol. 104, No. 7. pp. 2942-2952.
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Lee, JY, Han, K, Han, E, Kim, G, Cho, H, Kim, KJ, Lee, BW, Kang, ES, Cha, BS, Brayne, C & Lee, YH 2019, 'Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study', Journal of Clinical Endocrinology and Metabolism, vol. 104, no. 7, jcem_201801491, pp. 2942-2952. https://doi.org/10.1210/jc.2018-01491

Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life : A Population-Based Cohort Study. / Lee, Ji Yeon; Han, Kyungdo; Han, Eugene; Kim, Gyuri; Cho, Hanna; Kim, Kwang Joon; Lee, Byung Wan; Kang, Eun Seok; Cha, Bong Soo; Brayne, Carol; Lee, Yong Ho.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 104, No. 7, jcem_201801491, 21.03.2019, p. 2942-2952.

Research output: Contribution to journalArticle

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AU - Lee, Ji Yeon

AU - Han, Kyungdo

AU - Han, Eugene

AU - Kim, Gyuri

AU - Cho, Hanna

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AU - Lee, Byung Wan

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AU - Lee, Yong Ho

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N2 - 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 followup of 65 months (interquartile range 51 to 74months). TheMHO group showed the lowest incidence of overall dementia [hazard ratio (HR) 0.85; 95%CI, 0.84 to 0.86] andAD(HR0.87; 95%CI, 0.86 to 0.88), but not VaD, comparedwith themetabolically healthy nonobese group. All components ofmetabolic syndrome except obesity significantly elevated the risk of dementia, and these associationsweremore pronounced in VaD. In particular, being underweight dramatically increased the risk of dementia.

AB - 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 followup of 65 months (interquartile range 51 to 74months). TheMHO group showed the lowest incidence of overall dementia [hazard ratio (HR) 0.85; 95%CI, 0.84 to 0.86] andAD(HR0.87; 95%CI, 0.86 to 0.88), but not VaD, comparedwith themetabolically healthy nonobese group. All components ofmetabolic syndrome except obesity significantly elevated the risk of dementia, and these associationsweremore pronounced in VaD. In particular, being underweight dramatically increased the risk of dementia.

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