{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T08:07:05Z","timestamp":1790928425912,"version":"4.1.0"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Poor cardiometabolic health is a risk factor associated with cognitive impairment in later life, but it remains unclear whether cardiometabolic trajectories can serve as early markers associated with dementia.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare cardiometabolic trajectories that precede dementia diagnosis with those among individuals without dementia.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This case-control study analyzed a sample drawn from community-dwelling participants in the Aspirin in Reducing Events in the Elderly (ASPREE) study. Recruitment through primary care physicians occurred between March 2010 and December 2014, with participants followed up for a maximum of 11 years. Dementia cases were matched on sociodemographic characteristics and time of diagnosis to dementia-free controls. Data analysis was performed between February and June 2024.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Body mass index (BMI), waist circumference, systolic and diastolic blood pressure, glucose levels, high- and low-density lipoprotein (HDL and LDL) and total cholesterol levels, and triglyceride levels were measured repeatedly between 2010 and 2022.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n Dementia (\n Diagnostic and Statistical Manual of Mental Disorders<\/jats:italic>\n [\n Fourth Edition<\/jats:italic>\n ] criteria) was adjudicated by an international expert panel.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 5390 participants (mean [SD] age, 76.9 [4.8] years; 2915 women [54.1%]), there were 2655 individuals (49.3%) with less than 12 years of education. The study included 1078 dementia cases and 4312 controls. Up to a decade before diagnosis, dementia cases compared with controls had lower BMI for all years from \u22127 years (marginal estimate, 27.52 [95% CI, 27.24 to 27.79] vs 28.00 [95% CI, 27.86 to 28.14]; contrast\n P<\/jats:italic>\n \u2009=\u2009002) to 0 years (marginal estimate, 26.09 [95% CI, 25.81 to 26.36] vs 27.22 [95% CI, 27.09 to 27.36]; contrast\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and lower waist circumference for all years from \u221210 years (marginal estimate, 95.45 cm [95% CI, 94.33 to 96.57 cm] vs 97.35 cm [95% CI, 96.79 to 97.92 cm]; contrast\n P<\/jats:italic>\n \u2009=\u2009.003) to 0 years (marginal estimate, 93.90 [95% CI, 93.15 cm to 94.64 cm] vs 96.67 cm [95% CI, 96.30 to 97.05 cm]; contrast\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001); cases also had a faster decline in BMI (linear change \u03b2, \u22120.13 [95% CI, \u22120.19 to \u22120.08]) and waist circumference (linear change \u03b2, \u22120.30 cm [95% CI, \u22120.51 to \u22120.08 cm]). Compared with controls, cases generally had higher HDL levels, in particular from 5 years (marginal estimate, 62.57 mg\/dL [95% CI, 61.59 to 63.56 mg\/dL] vs 60.84 mg\/dL [95% CI, 60.35 to 61.34 mg\/dL]; contrast\n P<\/jats:italic>\n \u2009=\u2009.002) to 3 years (marginal estimate, 62.78 mg\/dL [95% CI, 61.82 to 63.74 mg\/dL] vs 61.08 mg\/dL [95% CI, 60.60 to 61.56 mg\/dL]; contrast\n P<\/jats:italic>\n \u2009=\u2009.002) before dementia but with a decline in levels just before diagnosis (linear change \u03b2, \u22120.47 mg\/dL [95% CI, \u22120.86 to \u22120.07 mg\/dL]). Dementia cases had lower systolic blood pressure and triglyceride levels in the decade before diagnosis and higher LDL and total cholesterol levels, but these were not significantly different from controls.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study of older individuals, decline in BMI, waist circumference, and HDL occurred up to a decade before dementia diagnosis. These findings provide insights into cardiometabolic changes preceding dementia and the potential for early monitoring and intervention.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.58591","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T11:32:23Z","timestamp":1738927943000},"page":"e2458591","source":"Crossref","is-referenced-by-count":22,"title":["Cardiometabolic Trajectories Preceding Dementia in Community-Dwelling Older Individuals"],"prefix":"10.1001","volume":"8","author":[{"given":"Zimu","family":"Wu","sequence":"first","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lachlan","family":"Cribb","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 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