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The cerebral metabolic rate of oxygen (CMRO\u2082) reflects hemodynamic and oxidative stress and precedes structural atrophy, but its role in adiposity-related brain change remains unclear. We examined whether current and life-course adiposity relate to CMRO\u2082 and to structural change. A total of 303 community-dwelling adults aged 50\u00a0years and older were included. Body shape was assessed using Body Mass Index (BMI) and Body Roundness Index (BRI). Global CMRO\u2082 was derived from TRUST and phase-contrast MRI. T1-weighted MPRAGE provided volumetry, and medial temporal atrophy (MTA) grading. General linear models estimated associations of BMI and BRI with CMRO\u2082, including age interactions. Age-stratified mediation tested CMRO\u2082 as a mediator of adiposity to MTA associations. Body-shape trajectories at ages 25, 40, 60, and current age were modeled and related to CMRO\u2082 and metabolism-related regions. Adiposity was associated with lower CMRO\u2082: with overweight (\u03b2\u2009=\u2009-1.12\u00a0\u03bcmol\/100\u00a0g\/min, 95%CI\u2009=\u2009(-1.96, -0.28)) and higher BRI (\u03b2\u2009=\u2009-1.31, 95%CI\u2009=\u2009(-2.36, -0.27)) showing stronger effects with advancing age. Among participants aged 70\u00a0years, CMRO\u2082 mediated the association between BMI and MTA (indirect \u03b2\u2009=\u20090.06, 95%CI\u2009=\u2009(0.01, 0.14)). Three adulthood body-shape patterns emerged, and CMRO\u2082 was lower in moderate increasing (\u03b2\u2009=\u2009-11.40; 95%CI\u2009=\u2009(-20.90, -1.90)) and high-rising (\u03b2\u2009=\u2009\u2009\u2212\u200912.23; 95%CI\u2009=\u2009(-23.56, -0.90)) groups. Metabolism-related regions were larger in higher-risk patterns, particularly the left hypothalamus. Greater and prolonged adiposity is linked to reduced CMRO\u2082 and related structural differences in older adults.<\/jats:p>","DOI":"10.1007\/s11357-025-02082-x","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T11:38:25Z","timestamp":1768217905000},"page":"183-196","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Life-course body shape trajectories and cerebral oxygen metabolism in community-dwelling older adults"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8863-2699","authenticated-orcid":false,"given":"Yifan","family":"Yan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuhao","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renwei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shenghao","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingkai","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuyan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9462-7768","authenticated-orcid":false,"given":"Zixuan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4639-6480","authenticated-orcid":false,"given":"Xin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"2082_CR1","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1038\/s44220-025-00501-8","volume":"3","author":"D Zhang","year":"2025","unstructured":"Zhang D, Fu Y, Shen C, Liu C, Chen N, Cao H, et al. 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