“Ongezonde” veertigers hebben veel grotere kans op dementie als ze zeventig zijn*
Uit eerdere studies is al gebleken dat ouderen met veel buikvet (de appelvorm) meer kans hebben op diabetes en hart- en vaatziektes. In deze studie blijkt nu dat de kans op dementie aanzienlijk toeneemt met de hoeveelheid buikvet op veertigjarige leeftijd. Bij ruim 6.500 veertigers werd het buikvet gemeten en 36 jaar later werd gekeken wat de kans was op ontwikkeling van dementie. Na die 36 jaar bleek 16% van de deelnemers dementie ontwikkeld te hebben. Zij met het meeste buikvet en het meeste overgewicht als veertiger hadden wel 360% meer kans op dementie, minder overgewicht betekende altijd nog 230% meer kans. Zij met veel of weinig overgewicht doch weinig buikvet hadden daarentegen maar 80% meer kans op dementie. Dat er een rechtstreeks verband is tussen buikvet en dementie blijkt niet uit deze studie en vermoedelijk is buikvet het gevolge van verschillende factoren van een ongezonde levensstijl en zijn het die factoren die leiden tot dementie.
Large Bellies Indicate Double Or Triple The Risk Of Dementia
People in their 40s with larger stomachs have a higher risk for dementia when they reach their 70s, according to a study published in an, online issue of Neurology®, the medical journal of the American Academy of Neurology.
Previous studies have looked at central obesity (as determined by waist circumference) and body mass index in the elderly and its link to dementia risk. In addition, previous studies have shown that a large abdomen -- in midlife -- increases the risk of diabetes, stroke, and coronary heart disease. This is the first time researchers have demonstrated a longitudinal association between midlife belly fat and the risk of dementia.
Capturing abdominal obesity in midlife may be a much better indicator of the long term metabolic dysregulation that leads to dementia risk, said study author Rachel Whitmer, PhD, a research scientist at the Kaiser Permanente Division of Research in Oakland, CA. Measuring abdomen size in older age people may not be as good an indicator because as people age they tend to naturally lose muscle and bone mass and gain belly size, she explained.
"Considering that 50 percent of adults in this country have abdominal obesity, this is a disturbing finding. It is well known that being overweight in midlife and beyond increases risk factors for disease. However, where one carries the weight - especially in midlife - appears to be an important predictor for dementia risk," she
said.
"Autopsies have shown that changes in the brain associated with Alzheimer's disease may start in young to middle adulthood, and another study showed that high abdominal fat in elderly adults was tied to greater brain atrophy. These findings imply that the dangerous effects of abdominal obesity on the brain may start long before the signs of dementia appear." She explained that additional research needs to be completed to determine the underlying mechanisms that link abdominal obesity in midlife to dementia risk.
Researchers studied 6,583 people age 40 to 45 in northern California who had their abdominal density measured. Belly fat was measured by using a caliper to determine the distance from the back to the upper abdomen, midway between the top of the pelvis and the bottom of the ribs. Belly density is highly correlated with visceral fat tissue, the fat tissue that is wrapped around the organs, according to the researchers. An average of 36 years later, 16 percent of the participants had been diagnosed with dementia.
The study found that those who were overweight and had a large belly were 2.3 times more likely to develop dementia than people with a normal weight and belly size. People who were both obese and had a large belly were 3.6 times more likely to develop dementia than those of normal weight and belly size. Those who were overweight or obese but did not have a large abdomen had an 80-percent increased risk of dementia.
Having a large abdomen increased the risk of dementia regardless of whether the participants were of normal weight overall, overweight, or obese, and regardless of existing health conditions, including diabetes, stroke and cardiovascular disease.
Non-whites, smokers, people with high blood pressure, high cholesterol or diabetes, and those with less than a high school level of education were more likely to have abdominal
obesity.
As with all observational studies, it is possible that the association of the abdominal obesity and dementia is not driven by the abdominal obesity, but rather by a complex set of health-related behaviors, for which abdominal obesity is but one part.
Additional authors on the study include Deborah R. Gustafson, Ph.D., Goteberg University, Goteberg, Sweden; Elizabeth Barrett-Connor, MD, department of family medicine, University of California, La Jolla, Calif.; Mary N. Haan, DrPH, department of epidemiology, University of Michigan, Ann Arbor, Mich.; Erica P. Gunderson, Ph.D., Kaiser Permanente Division of Research, Oakland, Calif.; and Kristine Yaffe, MD, Departments of Psychiatry, Neurology and Epidemiology, University of California, San Francisco. Funding for the study was provided by the National Institutes of
Health.
The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit http://www.aan.com/.
About Kaiser Permanente Research
Kaiser Permanente's eight research centers comprise one of the largest research programs in the U.S. and engage in work designed to improve the health of individuals everywhere. KP HealthConnect™ , Kaiser Permanente's electronic health record, and other resources provide population data for research, and in turn, research findings arm KP physicians with up-to-the-minute research and clinical data. Kaiser Permanente's research program works with national and local health agencies and community organizations to share and widely disseminate its research data. Kaiser Permanente's research program is funded in part by Kaiser Permanente's Community Benefit division, which in 2006 directed $808 million in health services, technology, and funding toward total community health.
About Kaiser Permanente
Kaiser Permanente is America's leading integrated health plan. Founded in 1945, it is a not-for-profit; group practice prepayment program headquartered in Oakland, Calif. Kaiser Permanente serves the health care needs of 8.7 million members in nine states and the District of Columbia. Today it encompasses the not-for-profit Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the for-profit Permanente Medical Groups. Nationwide, Kaiser Permanente includes approximately 159,000 technical, administrative and clerical employees and caregivers, and more than 13, 000 physicians representing all
specialties. http://www.kaiserpermanente.org/ (Mei
2008)
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