Role of obesity-related anthropometric indicators on cognitive function in obese older adults: A systematic review and meta-analysis

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2025-02-13 DOI:10.1016/j.puhe.2025.01.040

Kochaphan Phirom , Sothida Nantakool , Busaba Chuatrakoon , Kitttipan Rerkasem

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引用次数: 0

Abstract

Objectives

The association between obesity and cognitive function in older adults remains inconsistent due to the use of various anthropometric indicators, such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR). More conclusive evidence is warranted. The aim of this study was to systematically summarize and synthesize the association between specific obesity-related anthropometric indicators (BMI, WC, and WHR) and cognitive function in obese older adults. Higher BMI, WC, or WHR is linked to cognitive decline in this population.

Study design

Systematic review and meta-analysis.

Methods

A comprehensive literature search was carried out using PubMed, CINAHL, Scopus, Embase, and the Cochrane Library (from their inception to October 2023). Studies investigating the association between obesity indicators, including BMI, WC, WHR, and cognitive performance in older adults were included. The weighted mean difference (WMD), Odds Ratio, and 95 % confidence interval (CI) were used to estimate the pooled effect size. A random-effects model was employed as the main method. Subgroup analyses and the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach were assessed (registered number: CRD42023461770).

Results

Thirty-three eligible studies, involving 83,251 participants, were included. Obese older adults, as assessed by WC, had lower Mini-Mental State Examination (MMSE) scores than non-obese counterparts (WMD −0.84, 95 % CI −1.64 to −0.05, very low certainty). Those measured by WHR had a 31 % higher risk of cognitive impairment (OR 1.31, 95 % CI 1.12 to 1.53, moderate certainty). Subgroup analysis revealed a lower Montreal Cognitive Assessment (MoCA) score in obese group classified by WHO criteria compared to controls (WMD -1.67, 95 % CI -2.94 to −0.39).

Conclusion

This review suggests an association between obesity, as measured by WHR and WC, and poorer cognitive performance in older adults. WHR is moderately recommended for identifying cognitive impairment-related obesity, while WC recommendations are limited by very low evidence certainty.

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肥胖相关人体测量指标对肥胖老年人认知功能的作用：系统回顾和荟萃分析

由于使用了各种人体测量指标，如体重指数（BMI）、腰围（WC）和腰臀比（WHR），老年人肥胖与认知功能之间的关系仍然不一致。更确凿的证据是有根据的。本研究的目的是系统总结和综合肥胖老年人特定肥胖相关人体测量指标（BMI、WC和WHR）与认知功能之间的关系。较高的体重指数、腰围或腰臀比与这一人群的认知能力下降有关。研究设计：系统回顾和荟萃分析。方法采用PubMed、CINAHL、Scopus、Embase和Cochrane Library（自建库至2023年10月）进行综合文献检索。研究调查肥胖指标之间的关系，包括BMI、腰围、腰宽比和老年人的认知表现。加权平均差（WMD）、优势比和95%置信区间（CI）用于估计合并效应大小。采用随机效应模型作为主要方法。采用建议分级评估、发展和评价（GRADE）方法评估亚组分析和证据的确定性（注册号：CRD42023461770）。结果纳入33项符合条件的研究，涉及83,251名受试者。根据WC评估，肥胖老年人的最小精神状态检查（MMSE）得分低于非肥胖老年人（WMD - 0.84, 95% CI - 1.64至- 0.05，非常低的确定性）。WHR测量的患者发生认知障碍的风险高出31% （OR 1.31, 95% CI 1.12至1.53，中等确定性）。亚组分析显示，与对照组相比，WHO标准肥胖组蒙特利尔认知评估（MoCA）评分较低（WMD -1.67, 95% CI -2.94至- 0.39）。结论：本综述表明，以腰宽比和腰围衡量的肥胖与老年人较差的认知能力之间存在关联。WHR被适度推荐用于识别认知障碍相关的肥胖，而WC的推荐受到证据确定性非常低的限制。

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.