http://www.frontiersin.org/neuroscience/agingneuroscience/paper/10.3389/fnagi.2010.00024/

Vollständiger Abstract

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<h4>Background</h4>Obesity is a modifiable risk factor for cognitive impairment; however, body mass index fails to capture fat distribution. Waist-to-hip ratio (WHR), reflecting central adiposity, may better characterize obesity-related differences in cognitive impairment. Nevertheless, whether the association between WHR and cognitive impairment varies by sex and age remains unclear.<h4>Methods</h4>This cross-sectional study included 1,792 adults aged ≥40 years from rural China. Cognitive impairment was defined using education-adjusted cutoffs on the Chinese Mini-Mental Status. WHR and clinical characteristics were collected by trained investigators. Multivariable logistic regression, restricted cubic splines, stratified analyses, and interaction analyses were performed.<h4>Results</h4>In the total population, WHR was positively associated with the odds of cognitive impairment (OR = 1.245 per SD, 95% CI: 1.022-1.517, <i>P</i> = 0.029), with borderline evidence of nonlinearity (<i>P</i> <i>overall</i> = 0.019, <i>P</i> <i>nonlinear</i> = 0.090). In sex-stratified analyses, the association in females showed evidence of nonlinearity, with the estimated odds remaining relatively stable below a WHR of 0.88 and increasing at higher levels (<i>P</i> <i>overall</i> = 0.014, <i>P</i> <i>nonlinear</i> = 0.049), whereas no significant association was observed in males. Age-stratified analyses demonstrated a significant association in the middle-aged group (40-59 years, <i>P</i> <i>overall</i> = 0.016, <i>P</i> <i>nonlinear</i> = 0.143) but not in those ≥60 years. Further interaction analyses showed that age appeared to modify the association between WHR and cognitive impairment in males (OR = 0.462 per SD, 95% CI: 0.258-0.828, <i>P</i> <i>interaction</i> = 0.010), but not in females. Specifically, the positive association between WHR and cognitive impairment was observed only in middle-aged males (OR = 1.652 per SD, 95% CI: 1.052-2.595, <i>P</i> = 0.029), but not in older males (OR = 0.804 per SD, 95% CI: 0.492-1.314, <i>P</i> = 0.384).<h4>Conclusion</h4>Our findings show that WHR is associated with screening-defined cognitive impairment, with patterns that may differ by sex and age. Females exhibited a possible nonlinear association, whereas in males the association was mainly observed in midlife. These findings highlight central adiposity as an important correlate of cognitive impairment. Given the rural single-region sample, larger longitudinal studies with clinically adjudicated outcomes are warranted to assess generalizability and clarify temporal associations.

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