Having a large gut in midlife increases the chance of dementia in old age, according to research published Wednesday [03/26/2008] that suggests that abdominal fat is a bigger risk factor than family history.The study of 6,583 adults found that people with the highest amount of abdominal fat between the ages of 40 and 45 were about three times more likely to develop dementia than those with the lowest amount of abdominal fat.
By contrast, people who have parents or a sibling with Alzheimer's disease face twice the risk of developing the disease.
The report in the journal Neurology was the latest to show that belly fat can pose serious health risks, even for those who are not obese. Previous research has shown that people with large abdomens face a greater chance of diabetes, stroke and heart disease.
"This ought to be a wake-up call to baby boomers in terms of diet and exercise," said Dr. Sam Gandy, a spokesman for the Alzheimer's Association who was not involved in the study. "If they are not frightened enough about heart disease, maybe they will worry about losing their mental function."
Dementia is an age-related condition that involves the loss of memory and other cognitive functions. It affects 5.7 million Americans, or about one in 10 people older than 65. Alzheimer's disease is the most common form of dementia, accounting for 60 to 80 percent of cases.
Being overweight has also become a significant health problem in the nation. About 50 percent of U.S. adults have an unhealthy amount of belly fat, the latest report found.
Participants in the study were members of Kaiser Permanente of northern California, who had their belly fat measured between 1964 and 1973.
Clinicians measured belly fat by placing one end of a tong-like instrument on the back of each subject, and the other end of the tong on the subject's abdomen. A person had high belly fat if the distance between the two ends -- the subject's diameter -- was more than 25 centimeters, or 9.8 inches.
An average of 36 years later, 16 percent of all subjects had been found to have dementia.
The researchers categorized subjects as overweight if they had a body mass index of 25 to 29.9. The index, also known as BMI, is a ratio of height and weight. For example, a 6-foot-tall person who weighs 184 pounds is overweight.
People who were obese -- with a BMI of greater than 30 -- and had a large belly in middle age were 3.6 times more likely to develop dementia later in life than those whose weight and belly size had been in the healthy range. Increases in thigh fat did not add to the risk of dementia, according to the report.
Lead author Rachel A. Whitmer, a Kaiser Permanente researcher, said scientists did not know how abdominal fat might contribute to the risk of dementia. One theory is that hormones and proteins released by abdominal fat spur the buildup of amyloid plaques in the brain, which are associated with Alzheimer's. Abdominal fat is more biologically active than fat located in other areas of the body, she noted.
Another possibility, said Whitmer, is that dementia is not directly related to abdominal fat, but is linked to obesity-related diseases such as stroke, diabetes or cardiovascular disease.
Although losing weight can be a challenge, she said, abdominal fat is easier to lose than other kinds of fat. "The good news is, it goes away with diet and exercise," said Whitmer.
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