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Association between body mass index and cortical thickness: among elderly cognitively normal men and women

  • Hojeong Kim (a1), Changsoo Kim (a2), Sang Won Seo (a3), Duk L. Na (a3), Hee Jin Kim (a3), Mira Kang (a4), Hee-Young Shin (a4), Seong Kyung Cho (a4), Sang eon Park (a1), Jeongmin Lee (a1), Jung Won Hwang (a1), Seun Jeon (a5), Jong-Min Lee (a5), Geon Ha Kim (a3), Hanna Cho (a3), Byoung Seok Ye (a3), Young Noh (a6), Cindy W. Yoon (a7) and Eliseo Guallar (a8)...



There is increasing evidence of a relationship between underweight or obesity and dementia risk. Several studies have investigated the relationship between body weight and brain atrophy, a pathological change preceding dementia, but their results are inconsistent. Therefore, we aimed to evaluate the relationship between body mass index (BMI) and cortical atrophy among cognitively normal participants.


We recruited cognitively normal participants (n = 1,111) who underwent medical checkups and detailed neurologic screening, including magnetic resonance imaging (MRI) in the health screening visits between September 2008 and December 2011. The main outcome was cortical thickness measured using MRI. The number of subjects with five BMI groups in men/women was 9/9, 148/258, 185/128, 149/111, and 64/50 in underweight, normal, overweight, mild obesity, and moderate to severe obesity, respectively. Linear and non-linear relationships between BMI and cortical thickness were examined using multiple linear regression analysis and generalized additive models after adjustment for potential confounders.


Among men, underweight participants showed significant cortical thinning in the frontal and temporal regions compared to normal weight participants, while overweight and mildly obese participants had greater cortical thicknesses in the frontal region and the frontal, temporal, and occipital regions, respectively. However, cortical thickness in each brain region was not significantly different in normal weight and moderate to severe obesity groups. Among women, the association between BMI and cortical thickness was not statistically significant.


Our findings suggested that underweight might be an important risk factor for pathological changes in the brain, while overweight or mild obesity may be inversely associated with cortical atrophy in cognitively normal elderly males.


Corresponding author

Correspondence should be addressed to: Sang Won Seo, MD, PhD, Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea. Phone: +82-2-3410-1233; Fax: +82-2-3410-0052. Email:
Changsoo Kim, MD, PhD, Department of Preventive Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. Phone: +82-2-2228-1860; Fax: +82-2-392-8133. Email:


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International Psychogeriatrics
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