Longitudinal body weight dynamics in relation to cognitive decline over two decades: A prospective cohort study

Obesity (Silver Spring). 2023 Mar;31(3):852-860. doi: 10.1002/oby.23671. Epub 2023 Feb 13.


Objective: The aim of this study was to investigate the associations of body weight change (BWC) and body weight variability (BWV) with changes in cognitive function.

Methods: In 10,340 Health and Retirement Study participants (mean age: 68.0 years), body weight was reported biennially from 1993/1994 to 2016, and cognitive function was measured biennially from 1998 to 2016. We calculated BWC and BWV as the slope and root-mean-square error by regressing body weight on time for each individual. BWC was categorized by quintiles (Q): stable weight (Q2 to Q4), weight loss (Q1), and weight gain (Q5). BWV was categorized by tertiles. We used linear mixed regression models to assess associations with cognitive change.

Results: Compared with stable weight (median: 0 kg/y), weight loss (median: -1.3 kg/y) predicted faster cognitive decline as demonstrated by mean difference of -0.023 (95% CI: -0.027 to -0.019) in cognitive change z score per year, whereas weight gain (median: 1 kg/y) was related to slower cognitive decline (β = 0.006; 95% CI: 0.003 to 0.009). Larger BWV was also associated with faster cognitive decline (β comparing the top with bottom tertile = -0.003; 95% CI: -0.006 to -0.0002). Similar associations were observed for episodic and working memory.

Conclusions: Weight loss and large BWV over a long time independently predicted faster cognitive decline in middle-aged and older adults, underscoring the importance of long-term dynamic body weight monitoring.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Body Weight
  • Cognitive Dysfunction*
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Prospective Studies
  • Weight Gain
  • Weight Loss