Dement Neurocogn Disord.  2022 Jan;21(1):30-41. 10.12779/dnd.2022.21.1.30.

Association Between Body Mass Index and Cognitive Function in Mild Cognitive Impairment Regardless of APOE ε4 Status

  • 1Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
  • 2Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
  • 3Division of Psychiatry, Division of Mental Health Care of Older People, University College London, London, UK
  • 4Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 5Clinical Trial Center, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
  • 6Department of Neurology, Eulji University School of Medicine, Daejeon, Korea
  • 7Department of Neurology, Dong-A University College of Medicine, Busan, Korea
  • 8Department of Neurology, Pusan National University School of Medicine, Busan, Korea
  • 9Department of Neurology, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, Korea
  • 10Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
  • 11Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 12Department of Neurology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea


Background and Purpose
In this study we aimed to find the association between neuropsychological performance and body mass index (BMI) in patients with mild cognitive impairment (MCI). In addition, we investigated the effects of the apolipoprotein E (APOE) genotype in the relationship between the BMI and cognition in MCI.
We enrolled a cohort of 3,038 subjects with MCI aged 65–90 from the Clinical Research Center for Dementia of South Korea and a dementia cohort of the Ewha Womans University Mokdong Hospital. MCI patients were classified into three subgroups according to the Asian standard of BMI. We compared cognitive performances between groups by one-way analysis of variance. To investigate the effects of the APOE genotype, we used multivariate linear regression models after adjusting for possible confounders.
Even though normal BMI groups were younger, had more females, and had less comorbidities, the higher BMI groups had better cognitive functions. Among subjects with APOE ε4 carriers, there was a positive relationship between the BMI and the memory task alone.
Our findings suggested that higher BMI in patients with MCI were associated with better cognitive performance. The effects of the APOE ε4 genotype in the associations between BMI and cognition were distinguishing. Therefore, according to physical status, APOE ε4 genotype-specific strategies in the assessments and treatments may be necessary in elderly patients with MCI.


Body Mass Index; Apolipoprotein E; Cognitive Function; Mild Cognitive Impairment
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