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A recent study published in JAMA Network Open on Feb. 7 suggests that lower body mass index (BMI), decreased waist circumference, and elevated high-density lipoprotein (HDL) cholesterol levels are observed in the decade preceding a dementia diagnosis.
Study Overview
Led by Zimu Wu, Ph.D., from Monash University in Melbourne, Australia, the research team conducted a case-control study using data from community-dwelling participants in the Aspirin in Reducing Events in the Elderly (ASPREE) study. Dementia cases were matched with dementia-free controls based on sociodemographic characteristics and time of diagnosis.
The analysis included 1,078 individuals diagnosed with dementia and 4,312 control participants without dementia. The researchers found that compared to controls, individuals who developed dementia exhibited lower BMI levels from seven years before diagnosis and a consistent decline in waist circumference from ten years prior to diagnosis. Additionally, the rate of decline in these measures was more pronounced in dementia cases than in the control group.
Key Findings
- BMI & Waist Circumference: Dementia cases showed consistently lower BMI and waist circumference compared to controls, with a more rapid decline over the years.
- Cholesterol Levels: Higher HDL cholesterol levels were observed in dementia cases, particularly between five to three years before diagnosis, followed by a decline closer to diagnosis.
- Blood Pressure & Lipid Profile: Dementia cases exhibited lower systolic blood pressure and triglycerides in the decade before diagnosis. However, higher low-density lipoprotein (LDL) and total cholesterol levels were noted, though these levels did not significantly differ from those of the control group.
Implications
According to the researchers, these findings highlight the potential role of cardiometabolic changes as early indicators of cognitive decline. “These findings indicate that certain cardiometabolic factors may deviate from their usual levels before dementia,” the authors wrote. They emphasize the importance of continuous monitoring of these markers to better understand their potential as predictive factors or risk indicators for cognitive impairment.
Conflicts of Interest
It is noteworthy that two authors of the study disclosed ties to the pharmaceutical industry.
Disclaimer
This article is for informational purposes only and does not constitute medical advice. Individuals concerned about dementia risk factors should consult healthcare professionals for personalized guidance.
More information: Zimu Wu et al, Cardiometabolic Trajectories Preceding Dementia in Community-Dwelling Older Individuals, JAMA Network Open (2025). DOI: 10.1001/jamanetworkopen.2024.58591
