Body Mass Index and Mild Cognitive Impairment Among Middle-Aged and Older Adults from Low- and Middle-Income Countries

Lee Smith, Jae Il Shin, Hans Oh, Christina Carmichael, Louis Jacob, Sinisa Stefanac, Rosie K Lindsay, Pinar Soysal, Nicola Veronese, Mark A Tully, Laurie Butler, Yvonne Barnett, Ai Koyanagi

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Background: The effect of weight modification on future dementia risk is currently a subject of debate and may be modified by age. Objective: The aim of the present study was to investigate the association between body mass index (BMI) status with mild cognitive impairment (MCI) (a preclinical stage of dementia) in middle-aged and older adults residing in six low- and middle-income countries using nationally representative data. Methods: Cross-sectional data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. BMI (kg/m2) was based on measured weight and height and categorized as: underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. Results: Data on 32,715 individuals aged ≥50 years with preservation in functional abilities were analyzed [mean (SD) age 62.1 (15.6) years; 51.7% females]. Among those aged 50-64 years, compared to normal weight, underweight (OR = 1.44; 95% CI = 1.14-1.81), overweight (OR = 1.17; 95% CI = 1.002-1.37), and obesity (OR = 1.46; 95% CI = 1.09-1.94) were all significantly associated with higher odds for MCI. In those aged ≥65 years, underweight (OR = 0.71; 95% CI = 0.54-0.95) and overweight (OR = 0.72; 95% CI = 0.55-0.94) were associated with significantly lower odds for MCI, while obesity was not significantly associated with MCI. Conclusion: The results of the study suggest that the association between BMI and MCI is likely moderated by age. Future longitudinal studies are required to confirm or refute the present findings before recommendations for policy and practice can be made.

Original languageEnglish
Pages (from-to)1095-1105
Number of pages11
JournalJournal of Alzheimer's Disease
Issue number3
Early online date10 Dec 2021
Publication statusPublished (in print/issue) - 1 Feb 2022

Bibliographical note

Funding Information:
In this large sample of middle-aged and older adults from six LMICs, it was found that underweight, overweight, and obesity are significantly This paper uses data from WHO’s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263.

Publisher Copyright:
© 2022 - IOS Press. All rights reserved.


  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Clinical Psychology
  • General Medicine
  • General Neuroscience
  • body mass index
  • cognitive dysfunction
  • obesity
  • Aged


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