Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Interactive relations of central versus total obesity and blood pressure to cognitive function

International Journal of Obesity volume 30, pages 201–207 (2006)Cite this article

Abstract

Objective:

To examine the potential interactive relations of central versus total obesity and blood pressure (BP) to cognitive function.

Method:

In all, 90 healthy, stroke, and dementia-free middle-aged and older adults (ages 54–81 years; 63% male; 93% White) underwent biomedical and neuropsychological assessment. Relations of central obesity (assessed by waist circumference (WC)) and systolic or diastolic BP to cognitive function were examined in multiple regression models. Next, body mass index (BMI) was substituted for WC in the models.

Results:

After statistical adjustment for age, education, gender, and other potential confounders including components of the metabolic syndrome (depending on the model), significant interactions of WC and systolic (or diastolic) BP were noted for the Grooved Pegboard – Dominant Hand and Stroop Interference scores, with marginally significant results for Grooved Pegboard – Nondominant Hand. In general, individuals with greater WC and higher BP performed most poorly on these measures. Similar results were obtained for BMI.

Conclusion:

Independent of other confounders including facets of the metabolic syndrome, the combination of greater WC (or BMI) and higher (systolic or diastolic) BP was associated with diminished performance on tests of motor speed and manual dexterity, and executive function (i.e. response inhibition) accounting for 3–13% of the variance in these measures. In healthy older adults, there are similar, negative relations of central and total obesity to cognitive function that are potentiated by higher BP levels.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Kurth T, Gaziano JM, Berger K, Kase CS, Rexrode KM, Cook NR et al. Body mass index and the risk of stroke in men. Arch Intern Med 2002; 162: 2557–2562.

    Article  Google Scholar 

  2. Rosengren A, Wilhelmsen L, Lappas G, Johansson S . Body mass index, coronary heart disease and stroke in Swedish women. A prospective 19-year follow-up in the BEDA study. J Cardiovasc Risk 2003; 10: 443–450.

    Article  Google Scholar 

  3. Song YM, Sung J, Davey Smith G, Ebrahim S . Body mass index and ischemic and hemorrhagic stroke: a prospective study in Korean men. Stroke 2004; 35: 831–836.

    Article  Google Scholar 

  4. Gustafson D, Rothenberg E, Blennow K, Steen B, Skoog I . An 18-year follow-up of overweight and risk of Alzheimer disease. Arch Intern Med 2003; 163: 1524–1528.

    Article  Google Scholar 

  5. Haan MN, Wallace R . Can dementia be prevented? Brain aging in a population-based context. Annu Rev Public Health 2004; 25: 1–24.

    Article  Google Scholar 

  6. Kilander L, Nyman H, Boberg M, Lithell H . Cognitive function, vascular risk factors and education: a cross-sectional study based on a cohort of 70-year-old men. J Intern Med 1997; 242: 313–321.

    Article  CAS  Google Scholar 

  7. Sorensen TI, Sonne-Holm S, Christensen U, Kreiner S . Reduced intellectual performance in extreme overweight. Hum Biol 1982; 54: 765–775.

    CAS  PubMed  Google Scholar 

  8. Elias MF, Elias PK, Sullivan LM, Wolf PA, D'Agostino RB . Lower cognitive function in the presence of obesity and hypertension: the Framingham heart study. Int J Obesity Relat Metab Disord 2003; 27: 260–268.

    Article  CAS  Google Scholar 

  9. Droyvold WB, Midthjell K, Nilsen TI, Holmen J . Change in body mass index and its impact on blood pressure: a prospective population study. Int J Obes Relat Metab Disord 2005; 29: 650–655.

    Article  CAS  Google Scholar 

  10. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–1913.

    Article  Google Scholar 

  11. Meyer JS, Rauch GM, Rauch RA, Anwarul H, Crawford K . Cardiovascular and other risk factors for Alzheimer's disease and vascular dementia. Ann NY Acad Sci 2000; 903: 411–423.

    Article  CAS  Google Scholar 

  12. Waldstein SR, Manuck SB, Ryan CM, Muldoon MF . Neuropsychological correlates of hypertension: review and methodologic considerations. Psychol Bull 1991; 110: 451–468.

    Article  CAS  Google Scholar 

  13. Waldstein SR, Katzel LI . Hypertension and cognitive function. In: Waldstein SR, Elias MF (eds). Neuropsychology of Cardiovascular Disease. Lawrence Erlbaum Associates: Mahwah, NJ, 2001. pp. 15–36.

    Chapter  Google Scholar 

  14. Elias MF, Wolf PA, D'Agostino RB, Cobb J, White LR . Untreated blood pressure level is inversely related to cognitive functioning: the Framingham Study. Am J Epidemiol 1993; 138: 353–364.

    Article  CAS  Google Scholar 

  15. Shen BJ, Todaro JF, Niaura R, McCaffery JM, Zhang J, Spiro III A et al. Are metabolic risk factors one unified syndrome? Modeling the structure of the metabolic syndrome X. Am J Epidemiol 2003; 157: 701–711.

    Article  Google Scholar 

  16. Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Am J Clin Nutr 1998; 68: 899–917.

  17. Suk SH, Sacco RL, Boden-Albala B, Cheun JF, Pittman JG, Elking MS et al. Northeren Manhattan Stroke Study. Abdominal obesity and risk of ischemic stroke: the Northern Manhattan Stroke Study. Stroke 2003; 34: 1586–1592.

    Article  Google Scholar 

  18. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683–689.

    Article  CAS  Google Scholar 

  19. Kip KE, Marroquin OC, Kelley DE, Johnson BD, Kelsey SF, Shaw LJ et al. Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women: a report from the Women's Ischemia Syndrome Evaluation (WISE) study. Circulation 2004; 109: 706–713.

    Article  Google Scholar 

  20. Ribeiro-Filho FF, Faria AN, Axjen S, Zanella M-T, Ferreira SRG . Method of estimation of visceral fat: advantages of ultrasonography. Obes Res 2003; 11: 1488–1494.

    Article  Google Scholar 

  21. Lezak MD . Neuropsychological Assessment, 3rd edn. Oxford University Press: New York, 1995.

    Google Scholar 

  22. Beck AT . Beck Depression Inventory: Manual. Psychological Corporation: San Antonio, TX, 1987.

    Google Scholar 

  23. Spielberger CD . Preliminary Manual for the State-Trait Personality Inventory. University of South Florida: Tampa, FL, 1979.

    Google Scholar 

  24. Chelune G, Ortega D, Linton J, Boustany M . Personality and cognitive findings among patients electing gastroplasty for morbid obesity. Int J Eating Disord 1986; 5: 701–712.

    Article  Google Scholar 

  25. Bjorntorp P, Rosmond R . Neuroendocrine abnormalities in visceral obesity. Int J Obes Relat Metab Disord 2000; 24 (Suppl): S80–S85.

    Article  CAS  Google Scholar 

  26. Sapolsky RM . Glucocorticoids, stress, and their adverse neurological effects: relevance to aging. Exp Gerontol 1999; 34: 721–732.

    Article  CAS  Google Scholar 

  27. Ren J . Leptin and hyperleptinemia – from friend to foe for cardiovascular function. J Endocrinol 2004; 18: 1–10.

    Article  Google Scholar 

  28. Li XL, Aou S, Oomura Y, Hori N, Fukunaga K, Hori T . Impairment of long-term potentiation and spatial memory in leptin receptor-deficient rodents. Neuroscience 2002; 113: 607–615.

    Article  CAS  Google Scholar 

  29. Everson SA, Lynch JW, Kaplan GA, Lakka TA, Sivenius J, Salonen J . Stress-induced blood pressure reactivity and incident stroke in middle-aged men. Stroke 2001; 32: 1263–1270.

    Article  CAS  Google Scholar 

  30. Waldstein SR, Siegel EL, Lefkowitz D, Maier KJ, Pelletier Brown JR, Obuchowski AM et al. Stress-induced blood pressure reactivity and silent cerebrovascular disease. Stroke 2004; 35: 1294–1298.

    Article  Google Scholar 

  31. Toni R, Malaguti A, Castorina S, Roti E, Lechan RM . New paradigms in neuroendocrinology: relationships between obesity, systemic inflammation and the neuroendocrine system. J Endocrinol Invest 2004; 27: 182–186.

    Article  CAS  Google Scholar 

  32. Das UN . Metabolic syndrome X: an inflammatory condition. Curr Hypertens Rep 2004; 6: 66–73.

    Article  Google Scholar 

  33. Yaffe K, Lindquist K, Penninx B, Simonsick E, Pahor M, Kritchevsky S et al. Inflammatory markers and cognition in well-functioning African-American and white elders. Neurology 2003; 61: 76–80.

    Article  CAS  Google Scholar 

  34. Wilson CJ, Finch CE, Cohen HJ . Cytokines and cognition – the case for a head-to-toe inflammatory paradigm. JAGS 2002; 50: 2041–2056.

    Article  Google Scholar 

  35. Gunning-Dixon FM, Raz N . The cognitive correlates of white matter abnormalities in normal aging: a quantitative review. Neuropsychology 2000; 14: 224–232.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by National Institutes of Health (NIH) Grants R29 AG15112, RO1 AG15112, and NIH K24 AG00930; a VA Merit Grant, Bristol Myers Squibb Medical Imaging Inc., the Department of Veterans Affairs Baltimore Geriatric Research Education and Clinical Center, and the Geriatrics and Gerontology Education and Research Program of the University of Maryland, Baltimore, MD, USA.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, USA

    S R Waldstein

  2. Department of Medicine, Division of Gerontology, University of Maryland School of Medicine, Baltimore, MD, USA

    S R Waldstein & L I Katzel

  3. Geriatric Research Education and Clinical Center, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA

    S R Waldstein & L I Katzel

Authors
  1. S R Waldstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L I Katzel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S R Waldstein.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Waldstein, S., Katzel, L. Interactive relations of central versus total obesity and blood pressure to cognitive function. Int J Obes 30, 201–207 (2006). https://doi.org/10.1038/sj.ijo.0803114

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0803114

Keywords

This article is cited by

Search

Advanced search

Quick links