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Table of Contents
Vol. 34, No. 4, 2010
Issue release date: May 2010
Section title: Original Paper
Free Access
Neuroepidemiology 2010;34:222–229
(DOI:10.1159/000297742)

Longitudinal Examination of Obesity and Cognitive Function: Results from the Baltimore Longitudinal Study of Aging

Gunstad J.a, b · Lhotsky A.c · Wendell C.R.c · Ferrucci L.d · Zonderman A.B.c
aDepartment of Psychology, Kent State University, Kent, Ohio, bDepartment of Psychiatry, Summa Health System, Akron, Ohio, cLaboratory of Personality and Cognition and dClinical Research Branch, National Institute on Aging, National Institutes of Health, Bethesda, Md., USA
email Corresponding Author

Abstract

Background: Obesity indices (i.e. BMI, waist-to-hip ratio) show differential relationships to other health outcomes, though their association to neurocognitive outcome is unclear. Methods: We examined whether central obesity would be more closely associated with cognitive function in 1,703 participants from the Baltimore Longitudinal Study of Aging. Results: Longitudinal mixed-effects regression models showed multiple obesity indices were associated with poorer performance in a variety of cognitive domains, including global screening measures, memory, and verbal fluency tasks. Obesity was associated with better performance on tests of attention and visuospatial ability. An obesity index by age interaction emerged in multiple domains, including memory and attention/executive function. Conclusion: Obesity indices showed similar associations to cognitive function, and further work is needed to clarify the physiological mechanisms that link obesity to poor neurocognitive outcome.

© 2010 S. Karger AG, Basel


  

Key Words

  • Obesity
  • Cognition
  • Aged
  • Longitudinal
  • Age-associated cognitive change

References

  1. Mokdad AH, Marks JS, Stroup DF, Gerberding JL: Actual causes of death in the United States, 2000. JAMA 2004;291:1238–1245.
  2. Flegal KM, Graubard BI, Williamson DF, Gail MH: Excess deaths associated with underweight, overweight, and obesity. JAMA 2005;293:1861–1867.
  3. Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, et al: A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005;352:1138–1145.
  4. Bray GA: Medical consequences of obesity. J Clin Endocrinol Metab 2004;89:2583–2589.
  5. Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC: Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care 1994;17:961–969.
  6. Colditz GA, Willett WC, Stampfer MJ, Manson JE, Hennekens CH, Arky RA, et al: Weight as a risk factor for clinical diabetes in women. Am J Epidemiol 1990;132:501–513.
  7. Harris MM, Stevens J, Thomas N, Schreiner P, Folsom AR: Associations of fat distribution and obesity with hypertension in a bi-ethnic population: the ARIC study. Atherosclerosis Risk in Communities Study. Obes Res 2000;8:516–524.
  8. Rosenberg L, Palmer JR, Campbell LL, Rao RS: Obesity and hypertension among college-educated black women in the United States. J Hum Hypertens 1999;13:237–241.
  9. Gustafson D, Lissner L, Bengtsson C, Bjorkelund C, Skoog I: A 24-year follow-up of body mass index and cerebral atrophy. Neurology 2004;63:1876–1881.
  10. Gustafson D, Rothenberg E, Blennow K, Steen B, Skoog I: An 18-year follow-up of overweight and risk of Alzheimer disease. Arch Intern Med 2003;163:1524–1528.
  11. Gustafson DR, Steen B, Skoog I: Body mass index and white matter lesions in elderly women: an 18-year longitudinal study. Int Psychogeriatr 2004;16:327–336.
  12. Ward MA, Carlsson CM, Trivedi MA, Sager MA, Johnson SC: The effect of body mass index on global brain volume in middle-aged adults: a cross sectional study. BMC Neurol 2005;5:23.
  13. Kivipelto M, Ngandu T, Fratiglioni L, Viitanen M, Kareholt I, Winblad B, et al: Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Arch Neurol 2005;62:1556–1560.
  14. Jagust W, Harvey D, Mungas D, Haan M: Central obesity and the aging brain. Arch Neurol 2005;62:1545–1548.
  15. Gunstad J, Paul RH, Cohen RA, Tate DF, Spitznagel MB, Gordon E: Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Compr Psychiatry 2007;48:57–61.
  16. Gunstad J, Paul RH, Cohen RA, Tate DF, Gordon E: Obesity is associated with memory deficits in young and middle-aged adults. Eat Weight Disord 2006;11:e15–e19.
  17. Jeong SK, Nam HS, Son MH, Son EJ, Cho KH: Interactive effect of obesity indexes on cognition. Dement Geriatr Cogn Disord 2005;19:91–96.
  18. Kuo HK, Jones RN, Milberg WP, Tennstedt S, Talbot L, Morris JN, et al: Cognitive function in normal-weight, overweight, and obese older adults: an analysis of the Advanced Cognitive Training for Independent and Vital Elderly cohort. J Am Geriatr Soc 2006;54:97–103.
  19. Waldstein SR, Katzel LI: Interactive relations of central versus total obesity and blood pressure to cognitive function. Int J Obes 2006;30:201–207.
  20. Cournot M, Marquie JC, Ansiau D, Martinaud C, Fonds H, Ferrieres J, et al: Relation between body mass index and cognitive function in healthy middle-aged men and women. Neurol 2006;67:1208–1214.
  21. Elias MF, Elias PK, Sullivan LM, Wolf PA, D’Agostino RB: Lower cognitive function in the presence of obesity and hypertension: the Framingham Heart Study. Int J Obes Relat Metab Disord 2003;27:260–268.
  22. Elias MF, Elias PK, Sullivan LM, Wolf PA, D’Agostino RB: Obesity, diabetes and cognitive deficit: The Framingham Heart Study. Neurobiol Aging 2005;(suppl 1):11–16.

    External Resources

  23. Lindqvist P, Andersson K, Sundh V, Lissner L, Bjorkelund C, Bengtsson C: Concurrent and separate effects of body mass index and waist-to-hip ratio on 24-year mortality in the Population Study of Women in Gothenburg: evidence of age-dependency. Eur J Epidemiol 2006;21:789–794.
  24. Dagenais GR, Yi Q, Mann JF, Bosch J, Pogue J, Yusuf S: Prognostic impact of body weight and abdominal obesity in women and men with cardiovascular disease. Am Heart J 2005;149:54–60.
  25. Barrett-Connor E, Edelstein S, Corey-Bloom J, Wiederholt W: Weight loss precedes dementia in community-dwelling older adults. J Nutr Health Aging 1998;2:113–114.
  26. Stewart R, Masaki K, Xue QL, Peila R, Petrovitch H, White LR, et al: A 32-year prospective study of change in body weight and incident dementia: the Honolulu-Asia Aging Study. Arch Neurol 2005;62:55–60.
  27. Tanji J, Hoshi E: Role of the lateral prefrontal cortex in executive behavioral control. Physiol Rev 2008;88:37–57.
  28. Skoog I, Gustafson D: Update on hypertension and Alzheimer’s disease. Neurol Res 2006;28:605–611.
  29. Hayden KM, Zandi PP, Lyketsos CG, Khachaturian AS, Bastian LA, Charoonruk G, et al: Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study. Alzheimer Dis Assoc Disord 2006;20:93–100.
  30. Halling A, Berglund J: Association of diagnosis of ischaemic heart disease, diabetes mellitus and heart failure with cognitive function in the elderly population. Eur J Gen Pract 2006;12:114–119.
  31. Ylikoski R, Ylikoski A, Raininko R, Keskivaara P, Sulkava R, Tilvis R, et al: Cardiovascular diseases, health status, brain imaging findings and neuropsychological functioning in neurologically healthy elderly individuals. Arch Gerontol Geriatr 2000;30:115–130.
  32. Rahmouni K, Correia ML, Haynes WG, Mark AL: Obesity-associated hypertension: new insights into mechanisms. Hypertension 2005;45:9–14.
  33. Convit A, Wolf OT, Tarshish C, de Leon MJ: Reduced glucose tolerance is associated with poor memory performance and hippocampal atrophy among normal elderly. Proc Natl Acad Sci USA 2003;100:2019–2022.
  34. Teunissen CE, van Boxtel MP, Bosma H, Bosmans E, Delanghe J, De BC, et al: Inflammation markers in relation to cognition in a healthy aging population. J Neuroimmunol 2003;134:142–150.
  35. Colcombe S, Kramer AF: Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci 2003;14:125–130.
  36. Bjorntorp P, Rosmond R: Neuroendocrine abnormalities in visceral obesity. Int J Obes Relat Metab Disord 2000;(suppl 2):S80–S85.
  37. Sapolsky RM: Glucocorticoids, stress, and their adverse neurological effects: relevance to aging. Exp Gerontol 1999;34:721–732.
  38. Balakrishnan K, Verdile G, Mehta PD, Beilby J, Nolan D, Galvao DA, et al: Plasma Abeta42 correlates positively with increased body fat in healthy individuals. J Alzheimers Dis 2005;8:269–282.
  39. Razay G, Vreugdenhil A, Wilcock G: Obesity, abdominal obesity and Alzheimer disease. Dement Geriatr Cogn Disord 2006;22:173–176.
  40. Leahey T, Myers T, Gunstad J, Glickman E, Spitznagel M, et al: Abeta40 is associated with cognitive function, body fat, and physical fitness in healthy older adults. Nutr Neurosci 2007;10:205–209.
  41. Nieoullon A, Coquerel A: Dopamine: a key regulator to adapt action, emotion, motivation and cognition. Curr Opin Neurol 2003; (suppl 2):S3–S9.

    External Resources

  42. Noble EP: D2 dopamine receptor gene in psychiatric and neurologic disorders and its phenotypes. Am J Med Genet B Neuropsychiatr Genet 2003;116:103–125.

    External Resources

  43. Gunstad J, Benitez A, Smith J, Glickman E, Spitznagel MB, et al: Serum brain-derived neurotrophic factor is associated with cognitive function in healthy older adults. J Geriatr Psychiatry Neurol 2008;21:166–170.
  44. Gunstad J, Spitznagel MB, Keary TA, Glickman E, Alexander T, et al: Serum leptin levels are associated with cognitive function in older adults. Brain Res 2008;1230:233–236.
  45. Pasinetti GM, Zhao Z, Qin W, Ho L, Shrishailam Y, Macgrogan D, et al: Caloric intake and Alzheimer’s disease: experimental approaches and therapeutic implications. Interdiscip Top Gerontol 2007;35:159–175.
  46. Mattson MP: Will caloric restriction and folate protect against AD and PD? Neurol 2003;60:690–695.
  47. Bryan J, Tiggemann M: The effect of weight-loss dieting on cognitive performance and psychological well-being in overweight women. Appetite 2001;36:147–156.
  48. Pollitt E, Leibel RL, Greenfield D: Brief fasting, stress, and cognition in children. Am J Clin Nutr 1981;34:1526–1533.
  49. Pollitt E, Lewis NL, Garza C, Shulman RJ: Fasting and cognitive function. J Psychiatr Res 1982;17:169–174.
  50. Green MW, Rogers PJ, Elliman NA, Gatenby SJ: Impairment of cognitive performance associated with dieting and high levels of dietary restraint. Physiol Behav 1994;55:447–452.
  51. Gunstad J, Spitznagel MB, Paul RH, Cohen RA, Kohn M, et al: Body mass index and neuropsychological function in healthy children and adolescents. Appetite 2008;50:246–251.
  52. Li Y, Dai Q, Jackson JC, Zhang J: Overweight is associated with decreased cognitive functioning among school-age children and adolescents. Obesity 2008;16:1809–1815.

    External Resources

  53. Lokken KL, Boeka AG, Austin HM, Gunstad J, Harmon CM: Evidence of executive dysfunction in extremely obese adolescents: a pilot study. Surg Obes Relat Dis 2009;5:547–552.
  54. Stern Y: Cognitive reserve and Alzheimer disease. Alzheimer Dis Assoc Disord 2006;20:112–117.
  55. Corral M, Rodriguez M, Amenedo E, Sanchez JL, Diaz F: Cognitive reserve, age, and neuropsychological performance in healthy participants. Dev Neuropsychol 2006;29:479–491.

  

Author Contacts

John Gunstad, PhD
221 Kent Hall
Kent State University
Kent, OH 44242 (USA)
Tel. +1 330 672 2589, Fax +1 330 672 3786, E-Mail jgunstad@kent.edu

  

Article Information

Received: May 17, 2009
Accepted: January 8, 2010
Published online: March 18, 2010
Number of Print Pages : 8
Number of Figures : 1, Number of Tables : 5, Number of References : 55

  

Publication Details

Neuroepidemiology

Vol. 34, No. 4, Year 2010 (Cover Date: May 2010)

Journal Editor: Feigin V.L. (Auckland)
ISSN: 0251-5350 (Print), eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

Background: Obesity indices (i.e. BMI, waist-to-hip ratio) show differential relationships to other health outcomes, though their association to neurocognitive outcome is unclear. Methods: We examined whether central obesity would be more closely associated with cognitive function in 1,703 participants from the Baltimore Longitudinal Study of Aging. Results: Longitudinal mixed-effects regression models showed multiple obesity indices were associated with poorer performance in a variety of cognitive domains, including global screening measures, memory, and verbal fluency tasks. Obesity was associated with better performance on tests of attention and visuospatial ability. An obesity index by age interaction emerged in multiple domains, including memory and attention/executive function. Conclusion: Obesity indices showed similar associations to cognitive function, and further work is needed to clarify the physiological mechanisms that link obesity to poor neurocognitive outcome.

© 2010 S. Karger AG, Basel


  

Author Contacts

John Gunstad, PhD
221 Kent Hall
Kent State University
Kent, OH 44242 (USA)
Tel. +1 330 672 2589, Fax +1 330 672 3786, E-Mail jgunstad@kent.edu

  

Article Information

Received: May 17, 2009
Accepted: January 8, 2010
Published online: March 18, 2010
Number of Print Pages : 8
Number of Figures : 1, Number of Tables : 5, Number of References : 55

  

Publication Details

Neuroepidemiology

Vol. 34, No. 4, Year 2010 (Cover Date: May 2010)

Journal Editor: Feigin V.L. (Auckland)
ISSN: 0251-5350 (Print), eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 5/17/2009
Accepted: 1/8/2010
Published online: 3/18/2010
Issue release date: May 2010

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 5

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Mokdad AH, Marks JS, Stroup DF, Gerberding JL: Actual causes of death in the United States, 2000. JAMA 2004;291:1238–1245.
  2. Flegal KM, Graubard BI, Williamson DF, Gail MH: Excess deaths associated with underweight, overweight, and obesity. JAMA 2005;293:1861–1867.
  3. Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, et al: A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005;352:1138–1145.
  4. Bray GA: Medical consequences of obesity. J Clin Endocrinol Metab 2004;89:2583–2589.
  5. Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC: Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care 1994;17:961–969.
  6. Colditz GA, Willett WC, Stampfer MJ, Manson JE, Hennekens CH, Arky RA, et al: Weight as a risk factor for clinical diabetes in women. Am J Epidemiol 1990;132:501–513.
  7. Harris MM, Stevens J, Thomas N, Schreiner P, Folsom AR: Associations of fat distribution and obesity with hypertension in a bi-ethnic population: the ARIC study. Atherosclerosis Risk in Communities Study. Obes Res 2000;8:516–524.
  8. Rosenberg L, Palmer JR, Campbell LL, Rao RS: Obesity and hypertension among college-educated black women in the United States. J Hum Hypertens 1999;13:237–241.
  9. Gustafson D, Lissner L, Bengtsson C, Bjorkelund C, Skoog I: A 24-year follow-up of body mass index and cerebral atrophy. Neurology 2004;63:1876–1881.
  10. Gustafson D, Rothenberg E, Blennow K, Steen B, Skoog I: An 18-year follow-up of overweight and risk of Alzheimer disease. Arch Intern Med 2003;163:1524–1528.
  11. Gustafson DR, Steen B, Skoog I: Body mass index and white matter lesions in elderly women: an 18-year longitudinal study. Int Psychogeriatr 2004;16:327–336.
  12. Ward MA, Carlsson CM, Trivedi MA, Sager MA, Johnson SC: The effect of body mass index on global brain volume in middle-aged adults: a cross sectional study. BMC Neurol 2005;5:23.
  13. Kivipelto M, Ngandu T, Fratiglioni L, Viitanen M, Kareholt I, Winblad B, et al: Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Arch Neurol 2005;62:1556–1560.
  14. Jagust W, Harvey D, Mungas D, Haan M: Central obesity and the aging brain. Arch Neurol 2005;62:1545–1548.
  15. Gunstad J, Paul RH, Cohen RA, Tate DF, Spitznagel MB, Gordon E: Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Compr Psychiatry 2007;48:57–61.
  16. Gunstad J, Paul RH, Cohen RA, Tate DF, Gordon E: Obesity is associated with memory deficits in young and middle-aged adults. Eat Weight Disord 2006;11:e15–e19.
  17. Jeong SK, Nam HS, Son MH, Son EJ, Cho KH: Interactive effect of obesity indexes on cognition. Dement Geriatr Cogn Disord 2005;19:91–96.
  18. Kuo HK, Jones RN, Milberg WP, Tennstedt S, Talbot L, Morris JN, et al: Cognitive function in normal-weight, overweight, and obese older adults: an analysis of the Advanced Cognitive Training for Independent and Vital Elderly cohort. J Am Geriatr Soc 2006;54:97–103.
  19. Waldstein SR, Katzel LI: Interactive relations of central versus total obesity and blood pressure to cognitive function. Int J Obes 2006;30:201–207.
  20. Cournot M, Marquie JC, Ansiau D, Martinaud C, Fonds H, Ferrieres J, et al: Relation between body mass index and cognitive function in healthy middle-aged men and women. Neurol 2006;67:1208–1214.
  21. Elias MF, Elias PK, Sullivan LM, Wolf PA, D’Agostino RB: Lower cognitive function in the presence of obesity and hypertension: the Framingham Heart Study. Int J Obes Relat Metab Disord 2003;27:260–268.
  22. Elias MF, Elias PK, Sullivan LM, Wolf PA, D’Agostino RB: Obesity, diabetes and cognitive deficit: The Framingham Heart Study. Neurobiol Aging 2005;(suppl 1):11–16.

    External Resources

  23. Lindqvist P, Andersson K, Sundh V, Lissner L, Bjorkelund C, Bengtsson C: Concurrent and separate effects of body mass index and waist-to-hip ratio on 24-year mortality in the Population Study of Women in Gothenburg: evidence of age-dependency. Eur J Epidemiol 2006;21:789–794.
  24. Dagenais GR, Yi Q, Mann JF, Bosch J, Pogue J, Yusuf S: Prognostic impact of body weight and abdominal obesity in women and men with cardiovascular disease. Am Heart J 2005;149:54–60.
  25. Barrett-Connor E, Edelstein S, Corey-Bloom J, Wiederholt W: Weight loss precedes dementia in community-dwelling older adults. J Nutr Health Aging 1998;2:113–114.
  26. Stewart R, Masaki K, Xue QL, Peila R, Petrovitch H, White LR, et al: A 32-year prospective study of change in body weight and incident dementia: the Honolulu-Asia Aging Study. Arch Neurol 2005;62:55–60.
  27. Tanji J, Hoshi E: Role of the lateral prefrontal cortex in executive behavioral control. Physiol Rev 2008;88:37–57.
  28. Skoog I, Gustafson D: Update on hypertension and Alzheimer’s disease. Neurol Res 2006;28:605–611.
  29. Hayden KM, Zandi PP, Lyketsos CG, Khachaturian AS, Bastian LA, Charoonruk G, et al: Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study. Alzheimer Dis Assoc Disord 2006;20:93–100.
  30. Halling A, Berglund J: Association of diagnosis of ischaemic heart disease, diabetes mellitus and heart failure with cognitive function in the elderly population. Eur J Gen Pract 2006;12:114–119.
  31. Ylikoski R, Ylikoski A, Raininko R, Keskivaara P, Sulkava R, Tilvis R, et al: Cardiovascular diseases, health status, brain imaging findings and neuropsychological functioning in neurologically healthy elderly individuals. Arch Gerontol Geriatr 2000;30:115–130.
  32. Rahmouni K, Correia ML, Haynes WG, Mark AL: Obesity-associated hypertension: new insights into mechanisms. Hypertension 2005;45:9–14.
  33. Convit A, Wolf OT, Tarshish C, de Leon MJ: Reduced glucose tolerance is associated with poor memory performance and hippocampal atrophy among normal elderly. Proc Natl Acad Sci USA 2003;100:2019–2022.
  34. Teunissen CE, van Boxtel MP, Bosma H, Bosmans E, Delanghe J, De BC, et al: Inflammation markers in relation to cognition in a healthy aging population. J Neuroimmunol 2003;134:142–150.
  35. Colcombe S, Kramer AF: Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci 2003;14:125–130.
  36. Bjorntorp P, Rosmond R: Neuroendocrine abnormalities in visceral obesity. Int J Obes Relat Metab Disord 2000;(suppl 2):S80–S85.
  37. Sapolsky RM: Glucocorticoids, stress, and their adverse neurological effects: relevance to aging. Exp Gerontol 1999;34:721–732.
  38. Balakrishnan K, Verdile G, Mehta PD, Beilby J, Nolan D, Galvao DA, et al: Plasma Abeta42 correlates positively with increased body fat in healthy individuals. J Alzheimers Dis 2005;8:269–282.
  39. Razay G, Vreugdenhil A, Wilcock G: Obesity, abdominal obesity and Alzheimer disease. Dement Geriatr Cogn Disord 2006;22:173–176.
  40. Leahey T, Myers T, Gunstad J, Glickman E, Spitznagel M, et al: Abeta40 is associated with cognitive function, body fat, and physical fitness in healthy older adults. Nutr Neurosci 2007;10:205–209.
  41. Nieoullon A, Coquerel A: Dopamine: a key regulator to adapt action, emotion, motivation and cognition. Curr Opin Neurol 2003; (suppl 2):S3–S9.

    External Resources

  42. Noble EP: D2 dopamine receptor gene in psychiatric and neurologic disorders and its phenotypes. Am J Med Genet B Neuropsychiatr Genet 2003;116:103–125.

    External Resources

  43. Gunstad J, Benitez A, Smith J, Glickman E, Spitznagel MB, et al: Serum brain-derived neurotrophic factor is associated with cognitive function in healthy older adults. J Geriatr Psychiatry Neurol 2008;21:166–170.
  44. Gunstad J, Spitznagel MB, Keary TA, Glickman E, Alexander T, et al: Serum leptin levels are associated with cognitive function in older adults. Brain Res 2008;1230:233–236.
  45. Pasinetti GM, Zhao Z, Qin W, Ho L, Shrishailam Y, Macgrogan D, et al: Caloric intake and Alzheimer’s disease: experimental approaches and therapeutic implications. Interdiscip Top Gerontol 2007;35:159–175.
  46. Mattson MP: Will caloric restriction and folate protect against AD and PD? Neurol 2003;60:690–695.
  47. Bryan J, Tiggemann M: The effect of weight-loss dieting on cognitive performance and psychological well-being in overweight women. Appetite 2001;36:147–156.
  48. Pollitt E, Leibel RL, Greenfield D: Brief fasting, stress, and cognition in children. Am J Clin Nutr 1981;34:1526–1533.
  49. Pollitt E, Lewis NL, Garza C, Shulman RJ: Fasting and cognitive function. J Psychiatr Res 1982;17:169–174.
  50. Green MW, Rogers PJ, Elliman NA, Gatenby SJ: Impairment of cognitive performance associated with dieting and high levels of dietary restraint. Physiol Behav 1994;55:447–452.
  51. Gunstad J, Spitznagel MB, Paul RH, Cohen RA, Kohn M, et al: Body mass index and neuropsychological function in healthy children and adolescents. Appetite 2008;50:246–251.
  52. Li Y, Dai Q, Jackson JC, Zhang J: Overweight is associated with decreased cognitive functioning among school-age children and adolescents. Obesity 2008;16:1809–1815.

    External Resources

  53. Lokken KL, Boeka AG, Austin HM, Gunstad J, Harmon CM: Evidence of executive dysfunction in extremely obese adolescents: a pilot study. Surg Obes Relat Dis 2009;5:547–552.
  54. Stern Y: Cognitive reserve and Alzheimer disease. Alzheimer Dis Assoc Disord 2006;20:112–117.
  55. Corral M, Rodriguez M, Amenedo E, Sanchez JL, Diaz F: Cognitive reserve, age, and neuropsychological performance in healthy participants. Dev Neuropsychol 2006;29:479–491.