Obesity and Physical Functioning: Associations with Cognition in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Cohort
Kueider, Alexandra Marie
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The current study reviewed mechanisms through which obesity influences cognitive performance as well as explored the dynamic relationship between body weight, physical performance, and cognition in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial over a 10-year period. Findings from the study highlight the complex relationship between physical health and cognitive performance in older adults and suggest that higher body mass index (BMI) at baseline was associated with both cognitive and functional performance. Results from Aim 1 suggest that better performance on multiple cognitive domains was associated with attenuated declines in BMI over 10 years. Furthermore, attenuated cognitive declines were associated with a greater increase in BMI. Analyses from Aim 2 explored the mediated effect of grip-strength on weight-related changes in BMI. Findings revealed that a higher BMI at baseline was associated with better grip strength at baseline and accelerated declines in grip strength over time; whereas higher grip strength at baseline was associated with slower declines in cognition over time. Slower declines in grip strength were associated with slower declines in memory and reasoning. There was an indirect effect of BMI on cognition through changes in grip strength in the memory and reasoning outcomes, such that, a higher BMI was associated with accelerated declines in grip strength, which in turn were associated with accelerated declines in cognition. These findings are provocative given the large body of research in older adults suggesting that excess weight is protective against cognitive declines.