Obesity’s Impact on Alzheimer’s Risk in African Americans

Published on September 4, 2023

Just like a heavy load weighing down a backpacker and making it difficult to navigate through dense forests, obesity can have a detrimental effect on the brain of older African Americans with the APOE-ε4 Alzheimer’s disease risk allele. This study explored the relationship between body mass index (BMI) and cognitive function in this population group. Surprisingly, overweight individuals showed better cognitive function in the hippocampus, a brain region critical for learning and memory, compared to those with a normal BMI. However, for individuals in the obese categories, the presence of the APOE-ε4 allele was a determining factor. Non-carriers had larger volumes in a specific region of the hippocampus, while carriers had smaller volumes. These findings highlight the complex interplay between obesity and genetics in relation to Alzheimer’s risk. If you want to learn more about how obesity impacts brain health among older African Americans at risk for Alzheimer’s disease, check out the full article!

IntroductionExcess body weight and Alzheimer’s disease (AD) disproportionately affect older African Americans. While mid-life obesity increases risk for AD, few data exist on the relationship between late-life obesity and AD, or how obesity-based and genetic risk for AD interact. Although the APOE-ε4 allele confers a strong genetic risk for AD, it is unclear if late-life obesity poses a greater risk for APOE-ε4 carriers compared to non-carriers. Here we assessed: (1) the influence of body mass index (BMI) (normal; overweight; class 1 obese; ≥ class 2 obese) on cognitive and structural MRI measures of AD risk; and (2) the interaction between BMI and APOE-ε4 in older African Americans.MethodsSeventy cognitively normal older African American participants (Mage = 69.50 years; MBMI = 31.01 kg/m2; 39% APOE-ε4 allele carriers; 86% female) completed anthropometric measurements, physical assessments, saliva collection for APOE-ε4 genotyping, cognitive testing, health and lifestyle questionnaires, and structural neuroimaging [volume/surface area (SA) for medial temporal lobe subregions and hippocampal subfields]. Covariates included age, sex, education, literacy, depressive symptomology, and estimated aerobic fitness.ResultsUsing ANCOVAs, we observed that individuals who were overweight demonstrated better hippocampal cognitive function (generalization of learning: a sensitive marker of preclinical AD) than individuals with normal BMI, p = 0.016, ηp2 = 0.18. However, individuals in the obese categories who were APOE-ε4 non-carriers had larger hippocampal subfield cornu Ammonis region 1 (CA1) volumes, while those who were APOE-ε4 carriers had smaller CA1 volumes, p = 0.003, ηp2 = 0.23.DiscussionThus, being overweight by BMI standards may preserve hippocampal function, but obesity reduces hippocampal structure and function in older African Americans with the APOE-ε4 Alzheimer’s disease risk allele.

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