Increased Adiposity Associated With Decreased Cognitive Scores Among Adults

Midlife diabetes, HTN linked to cognitive decline
Midlife diabetes, HTN linked to cognitive decline
Excess adipose tissue increases the risk of vascular brain injury. Researchers studied if adipose tissue was associated with lower cognitive scores.

A cross-sectional study found that reduced cognitive scores were associated with higher body fat percentage and visceral and generalized adiposity. These findings were published in JAMA Network Open.

The Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM) and Prospective Urban Rural Epidemiological-Mind (PURE-MIND) studies were conducted between 2010 and 2018 in Canada and Poland. Study participants (N=9189) were evaluated for cardiovascular risk factors, total body adiposity and cognitive function.  Bioelectrical impedance analysis to assess body fat (BF) was performed on 9166 participants, and abdominal resonance imaging (MRI) was performed on 6773 participants to measure vascular brain injury and visceral adipose tissue (VAT) mass.

The study comprised individuals aged mean 57.8 (standard deviation [SD], 8.8) years, 56.4% were women, 83.8% were White, BMI was 26.9 (SD, 5.9) kg/m2, and 73.0% attended college or university.

Stratified by gender, women had higher BF percentage than men (8.1% vs 6.8%), lower mean visceral adipose tissue (VAT; mean, 61.4 vs 83.6 mL), and fewer women had central obesity on the basis of waist-to-hip ratio (36.9% vs 66.8%).

In general, there was a positive trend between increasing total percentage of BF and VAT with cardiovascular risk factors such as hypertension, diabetes, and apolipoprotein levels, as well as other related risk factors. A similar pattern was observed between increasing percentage of BF (P <.007) and VAT (P =.05) with MRI-detected vascular brain injury.

For cognitive measurements, women scored higher on the Digital Symbol Substitution Test (DSST; mean, 75.7 vs 68.6) and Montreal Cognitive Assessment (MoCA; mean, 27.1 vs 26.7).

Increasing percentage of BF was associated with lower DSST scores (P <.001) and MoCA (P =.003) scores. Higher VAT was associated with lower DSST scores (P <.001) but not MoCA (P =.19) scores.

Total percentage of BF was an independent predictor of decreased cognitive scores in a multivariate model. After adjusting for age, gender, educational level, ethnicity, cardiovascular risk factors, and MRI-detected vascular brain injury, every 9.2% increase in BF or 36 mL of VAT associated with a 0.8-point decrease in DSST scores, equivalent to 1.0 year of cognitive aging.

Researchers acknowledged they were unable to test for causation between cognitive function and adiposity.

“Generalized and visceral adiposity were associated with reduced cognitive scores, after adjustment for cardiovascular risk factors, educational levels, and vascular brain injury,” the researchers concluded. “These results suggest that strategies to prevent or reduce adiposity may preserve cognitive function.”

Disclosure: Some study authors declared affiliations with pharmaceutical companies. Please see the original reference for a full list of disclosures.


Anand SS, Friedrich MG, Lee DS, et al. Evaluation of Adiposity and Cognitive Function in Adults. JAMA Netw Open. 2022;5(2):e2146324. doi:10.1001/jamanetworkopen.2021.46324