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Weight Loss and the Risk of Dementia: A Meta-analysis of Cohort Studies.

BACKGROUND
Weight loss is a common phenomenon among the elderly and is identified as an important indicator of health status. Many epidemiology studies have investigated the association between weight loss and dementia, but the results were inconsistent.


OBJECTIVE
To examine and determine the association between weight loss and the risk of dementia.


METHODS
Eligible cohort studies involving weight loss and dementia were searched from PubMed, Embase, and Ovid databases through October 2018. Pooled relative risks (RRs) with its 95% confi- dence intervals (CIs) were used to estimate the effects of weight loss on the risk of dementia. Sub- group and sensitivity analyses were performed to explore the potential sources of heterogeneity. The Begg's test and Egger's test were used to assess the publication bias.


RESULTS
A total of 20 cohort studies with 38,141 participants were included in this meta-analysis. Weight loss was significantly associated with the risk of dementia (RR=1.26, 95% CI=1.15-1.38). BMI decline ≥0.8 units (RR=1.31, 95% CI=1.10-1.56) and ≥4% (RR=1.19, 95% CI=1.03-1.38) could increase the risk of dementia. The risk of all-cause dementia for people with weight loss in- creased by 31% (RR=1.31, 95% CI=1.15-1.49), and 25% higher for incident Alzheimer's disease (RR=1.25, 95% CI=1.07-1.46). Weight loss in participants with normal weight had a similar de- mentia risk (RR=1.21, 95% CI=1.06-1.38) with the overweight individuals (RR=1.22, 95%CI=1.11-1.34).


CONCLUSION
Weight loss may be associated with an increased risk of dementia, especially for AD. Maintaining weight stability may help prevent dementia.