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An 18-year follow-up of overweight and risk of Alzheimer disease
Gustafson D, Rothenberg E, Blennow K, Steen B, Skoog I.. Archives of internal medicine, 2003-07-01
Topic: Amyloid, tau and blood-test diagnosis
Background Overweight and obesity are epidemic in Western societies and constitute a major public health problem because of adverse effects on vascular health. Vascular factors may play a role in the development of a rapidly growing disease of late life, Alzheimer disease (AD). Using body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters), we examined whether overweight is a risk factor for dementia and AD. Methods The relationship between BMI and dementia risk was investigated in a representative cohort of 392 nondemented Swedish adults who were followed up from age 70 to 88 years, with the use of neuropsychiatric, anthropometric, and other measurements. Multivariate Cox proportional hazards regression analyses included BMI, blood pressure, cardiovascular disease, cigarette smoking, socioeconomic status, and treatment for hypertension. Results During the 18-year follow-up (4184.8 risk-years), 93 participants were diagnosed as having dementia. Women who developed dementia between ages 79 and 88 years were overweight, with a higher average BMI at age 70 years (27.7 vs 25.7; P =.007), 75 years (27.9 vs 25.0; P Conclusions Overweight is epidemic in Western societies. Our data suggest that overweight at high ages is a risk factor for dementia, particularly AD, in women. This may have profound implications for dementia prevention.
Key findings
- Results During the 18-year follow-up (4184.8 risk-years), 93 participants were diagnosed as having dementia.
- Our data suggest that overweight at high ages is a risk factor for dementia, particularly AD, in women.
Why it matters
Among 392 Swedish adults without dementia at age 70 and followed to age 88, 93 developed dementia. Women who developed dementia between 79 and 88 had a higher average BMI at age 70 (27.7 vs 25.7) and at 75 (27.9 vs 25.0). The record reports no comparable result for men. The authors conclude that overweight "at high ages is a risk factor for dementia, particularly AD, in women"; this is an observed association, not evidence that weight loss in old age prevents dementia.
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Study details
- Participants93
- Evidence strengthModerate
How this study scored 56/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of internal medicine) |
| Journal's citation record | 3 / 4 | Archives of Internal Medicine: journal h-index 462 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 1 / 4 | 93 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 813 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 32.5 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 5 / 6 | Cited 21.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 42 other studies in this library |
| Still being cited | 3 / 4 | Cited 60 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Ingmar Gr. Skoog: h-index 105 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Utah State University: institution h-index 527 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12860573) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 56 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Gustafson, D., Rothenberg, E., Blennow, K., Steen, B., & Skoog, I. (2003). An 18-year follow-up of overweight and risk of Alzheimer disease. Archives of internal medicine. https://doi.org/10.1001/archinte.163.13.1524
Vancouver
Gustafson D, Rothenberg E, Blennow K, Steen B, Skoog I. An 18-year follow-up of overweight and risk of Alzheimer disease. Archives of internal medicine. 2003. doi:10.1001/archinte.163.13.1524. PMID: 12860573.
BibTeX
@article{gustafson2003-12860573,
author = {Gustafson, D. and Rothenberg, E. and Blennow, K. and Steen, B. and Skoog, I.},
title = {{An 18-year follow-up of overweight and risk of Alzheimer disease}},
journal = {Archives of internal medicine},
year = {2003},
doi = {10.1001/archinte.163.13.1524},
pmid = {12860573},
url = {https://doi.org/10.1001/archinte.163.13.1524}
}
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