Increased adiposity linked to reduced cognitive function in adults
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Increases in generalized and visceral adipose tissue were linked to reduction of cognitive function in adults, when adjusted for other health factors, per a Canadian cross-sectional cohort study published in JAMA Network Open.
“The surrogate measures of (visceral adipose tissue) commonly used in epidemiologic studies, including the waist circumference or waist-to-hip ratio, have been examined in association with cognitive function,” Sonia S. Anand, MD, PhD, of the Population Health Research Institute at McMaster University, and colleagues wrote. “In general, cross-sectional evaluations have suggested that increased central adiposity is associated with reduced cognitive scores.”
Researchers sought to expand on previous data by analyzing whether the amount and distribution of adipose tissue affects cognitive function, allowing adjustments for cardiovascular risk factors and vascular brain injury .
They included data from 9,189 participants, aged 30 to 75 years, from the Canadian Alliance for Healthy Hearts and Minds (CAHHM) and Prospective Urban Rural Epidemiological-Mind (PURE-MIND) cohort studies. Those from the CAHHM study were from Canada and recruited from Jan. 1, 2014, and Dec. 31, 2018, while those from the PURE-MIND study were from Canada or Poland and recruited from Jan. 1, 2010, to Dec. 31, 2018.
Anand and colleagues used bioelectrical impedance analysis to evaluate body fat percentage in 9,166 participants from the original cohort and MRI to measure visceral adipose tissue in 6,773 participants; all participants underwent MRI to assess vascular brain injury. Researchers gauged cognitive function with the Digital Symbol Substitution Test (DSST; scores range from 0-133 with lower numbers correlating to reduced function), and the Montreal Cognitive Assessment (MCA; scores range from 0-30 with ≥ 26 indicating normal cognitive function). Reduced cognition was defined as a DSST score less than 1 SD below the mean. They assessed cardiovascular risk via the INTERHEART Risk Score (IHRS; scores range from 0-48, with ≥ 17 denoting increased risk). Percentages of body fat and visceral adipose tissue were broken down in to four, sex-specific quartiles.
Results showed that higher body fat percentage and visceral adipose tissue were closely linked to increased cardiovascular risk factors, vascular brain injuries, and, subsequently, lower cognitive scores for both men and women; for every 1-SD increase in adiposity, researchers noted a reduction of 0.8 in DSST score (95% CI, 0.4-1.1).
Further, researchers noted a population attributable risk for reduced DSST score for higher body fat percentage of 20.5% (95% CI, 7.0%-33.2%) and for visceral adipose tissue of 19.6% (95% CI, 2%-36%). Higher body fat percentage and visceral adipose tissue did not correlate with MCA scores.
“Future evaluations of excess adiposity with additional tests of cognitive function inclusive of verbal and performance IQ are needed to further understand the role of adiposity on cognitive function,” Anand and colleagues wrote. “Strategies to prevent or reduce adiposity may preserve cognitive function among adults.”