Weight loss in a cardiovascular trial population identifies people at future risk of dementia.
van der Veere P., Hammami I., Buck G., Greenland M., Offer A., Nunn M., Whiteley W., Bulbulia R., Collins R., Armitage J., Mafham M., Parish S., Heart Protection Study Collaborative Group None.
Introduction: Populations at increased risk of dementia need to be identified for well-powered trials of preventive interventions. Weight loss, which often occurs in pre-clinical dementia, could identify a population at sufficiently high dementia risk. Methods: In 12,975 survivors in the Heart Protection Study statin trial of people with, or at high risk of, cardiovascular disease, the association of weight change over 5 years during the trial with post-trial dementia recorded in electronic hospital admission and death records (n = 784) was assessed, after adjustment for age, sex, treatment allocation, and deprivation measures. Results: Among the 60% without substantial weight gain (≤2 kg weight gain), each 1 kg weight loss was associated with a risk ratio for dementia of 1.04 (95% confidence interval, 1.02-1.07). Weight loss ≥4 kg and cognitive function below the mean identified participants aged ≥67 years with a 13% 10-year dementia risk. Discussion: The combination of weight loss and high vascular risk identified individuals at high risk of dementia who could be recruited to dementia prevention trials.