Evaluation of Adiposity and Cognitive Function in Adults
Type of article: Clinical Article Summary
MedED Catalogue Reference: MG005
Compiler: Linda Ravenhill
Sources: JAMA Networks Open
Researchers Anand SS, Friedrich MG, Lee DS, et al. undertook to determine whether adiposity is linked to lower cognitive scores and vascular brain injury in the absence of cardiovascular risk.
The link between general adiposity and the increased risk of comorbidities such as cardiovascular disease (CVD), diabetes, and hypertension has been well documented. However, the link between the adiposity (amount and distribution) and cognitive decline where no cardiovascular disease was present had not, according to the researchers, been well-established.
Their cross-sectional study included participants between the ages of 30 and 75, who had participated in 2 large cohort studies – the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM) and the Polish study Prospective Urban Rural Epidemiological–Mind (PURE-MIND). Participants who had a history of stroke, coronary artery disease, heart failure, or other heart diseases were excluded from the sampling process.
The final cohort of 9189 participants had a mean age of 57.8. 56% were women, and the participants had an ethnic make-up of East and Southeast Asian (11.0%); South Asian (3.2%); White European (83.8%); and 1.9% from other ethnicities including Black, Indigenous, mixed, and those of unknown ethnicity.
The following measurements were conducted: 9166 participants had their body fat percentage measured via bioelectrical impedance analysis; 6773 had an MRI of the abdomen to determine the visceral adipose tissue (VAT); all participants underwent a brain MRI to determine vascular brain injury (silent brain infarctions and high white matter hyperintensities).
“Cardiovascular risk factors were measured using health and lifestyle questions and physical measures, and cognitive assessment was measured by the Digital Symbol Substitution Test (DSST) and the Montreal Cognitive Assessment (MoCA).” 1(p3)
The researchers found that in adults with no prior history of cardiovascular disease, the total percentage of body fat and visceral adipose tissue had significantly reduced cognitive scores. Specifically:
“For each 1-SD increase in adiposity (corresponding to 9.2% increase in BF or 36 mL of VAT), there was a reduction of 0.8 in the DSST cognitive score, which is equivalent to 1.0 years of cognitive ageing. Compared with those in the lowest quartile, those in the highest quartile of adiposity using either metric had a commensurate 3 years of cognitive aging.” 1(Pg9)
In light of the 2019 Global Burden of Disease report, which indicates global dementia is set to triple by 2050, the results of this study support the growing consensus that strategic initiatives to reduce adiposity should form part of any initiative to prevent cognitive decline
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