JAMDA xxx (2014) e1ee7
JAMDA journal homepage: www.jamda.com
Original Study
Body-Mass Index and Mortality in Incident Dementia: A Cohort Study on 11,398 Patients From SveDem, the Swedish Dementia Registry Sara García-Ptacek MD a, b, *, Ingemar Kåreholt PhD c, d, Bahman Farahmand PhD a, Maria Luz Cuadrado PhD b, e, Dorota Religa PhD f, g, Maria Eriksdotter PhD a, f a
Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Medicine, Universidad Complutense, Madrid, Spain Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden d Institute for Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden e Neurology Department, Hospital Clínico San Carlos, Madrid, Spain f Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden g Alzheimer’s Disease Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden b c
a b s t r a c t Keywords: Dementia mortality epidemiology Alzheimer disease
Background: Body mass index (BMI) is used worldwide as an indirect measure of nutritional status and has been shown to be associated with mortality. Controversy exists over the cut points associated with lowest mortality, particularly in older populations. In patients suffering from dementia, information on BMI and mortality could improve decisions about patient care. Objectives: The objective was to explore the association between BMI and mortality risk in an incident dementia cohort. Design: Cohort study based on SveDem, the Swedish Quality Dementia Registry; 2008e2011. Setting: Specialist memory clinics, Sweden. Participants: A total of 11,398 patients with incident dementia with data on BMI (28,190 person-years at risk for death). Main outcome measures: Hazard ratios and 95% confidence intervals for mortality associated with BMI were calculated, controlling for age, sex, dementia type, results from Mini-Mental State Examination, and number of medications. BMI categories and linear splines were used. Results: Higher BMI was associated with decreased mortality risk, with all higher BMI categories showing reduced risk relative to patients with BMI of 18.5 to 22.9 kg/m2, whereas underweight patients (BMI
JAMDA journal homepage: www.jamda.com
Original Study
Body-Mass Index and Mortality in Incident Dementia: A Cohort Study on 11,398 Patients From SveDem, the Swedish Dementia Registry Sara García-Ptacek MD a, b, *, Ingemar Kåreholt PhD c, d, Bahman Farahmand PhD a, Maria Luz Cuadrado PhD b, e, Dorota Religa PhD f, g, Maria Eriksdotter PhD a, f a
Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Medicine, Universidad Complutense, Madrid, Spain Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden d Institute for Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden e Neurology Department, Hospital Clínico San Carlos, Madrid, Spain f Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden g Alzheimer’s Disease Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden b c
a b s t r a c t Keywords: Dementia mortality epidemiology Alzheimer disease
Background: Body mass index (BMI) is used worldwide as an indirect measure of nutritional status and has been shown to be associated with mortality. Controversy exists over the cut points associated with lowest mortality, particularly in older populations. In patients suffering from dementia, information on BMI and mortality could improve decisions about patient care. Objectives: The objective was to explore the association between BMI and mortality risk in an incident dementia cohort. Design: Cohort study based on SveDem, the Swedish Quality Dementia Registry; 2008e2011. Setting: Specialist memory clinics, Sweden. Participants: A total of 11,398 patients with incident dementia with data on BMI (28,190 person-years at risk for death). Main outcome measures: Hazard ratios and 95% confidence intervals for mortality associated with BMI were calculated, controlling for age, sex, dementia type, results from Mini-Mental State Examination, and number of medications. BMI categories and linear splines were used. Results: Higher BMI was associated with decreased mortality risk, with all higher BMI categories showing reduced risk relative to patients with BMI of 18.5 to 22.9 kg/m2, whereas underweight patients (BMI
