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February 06, 2020
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Target belly fat to preserve cognitive function in older adults with type 2 diabetes

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Older adults with type 2 diabetes and normal BMI may be at greater risk for cognitive decline if they have elevated visceral fat area, according to findings published in Clinical Obesity.

“Visceral fat area emerged as a significant associate of overall cognitive performance, outperforming other surrogate measures of regional obesity,” Su Chi Lim, PhD, FRCP, FAMS, MRCP, MBBS, research associate professor at the Saw Swee Hock School of Public Health of the National University Hospital and the clinical research unit at Khoo Teck Puat Hospital in Singapore, and colleagues wrote. “The findings suggest that abdominal visceral adiposity may contribute to the pathogenesis of cognitive dysfunction.”

Lim and colleagues assessed the cognitive function of 677 Asian adults aged 60 years or older with type 2 diabetes and without dementia (mean age, 67 years; 48.3% women) via the Repeatable Battery for the Assessment of Neuropsychological Status, with higher scores indicating greater cognitive function. The researchers used the tetrapolar multifrequency bioelectrical impedance method to determine visceral fat area, hip circumference and waist circumference, and calculated BMI, waist-hip ration, waist-height ratio, abdominal volume index, body roundness index, and conicity index.

The researchers defined BMI-based obesity as a BMI of at least 23 kg/m2 and visceral fat area-based obesity as a visceral fat area of at least 100 cm2.

doctor measuring stomach of obese/overweight man 
Older adults with type 2 diabetes and normal BMI may be at greater risk for cognitive decline if they have elevated visceral fat area.
Source: Shutterstock

There was a negative association between visceral fat area and the overall score of the cognitive assessment in fully adjusted models (P = .005). In these same models, there were negative associations between visceral fat area and delayed memory (P = .008) as well as between the language portion of the assessment and visceral fat area (P = .006), waist-to-height ratio (P = .016) and body roundness index (P = .011). The researchers also observed a negative association between having visceral adipose tissue-based obesity and the total cognitive score on the assessment (P = .025) as well as immediate memory (P = .031), delayed memory (P = .003) and the language portion of the assessment (P = .033). In addition, there was a negative association between having both forms of obesity and delayed memory (P = .005).

“Our findings revealed that visceral fat area outperformed other surrogate indices of central obesity as an independent associate of reduced cognitive performance in older multiethnic Asians with type 2 diabetes, thus highlighting the adverse effect of visceral obesity on cognition,” the researchers wrote. “Assessment of visceral adiposity and interventions that target visceral adiposity may help to prevent cognitive decline in older patients with diabetes and reduce the global burden of dementia in ageing populations.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.