Objectives Theoretical perspectives suggest that adiposity and cognitive function may be bidirectionally associated, but this has not been examined in a large-scale dataset. The current investigation aims to fill this gap using a large, representative sample of middle-aged and older adults. Methods Using data from the Canadian Longitudinal Study on Aging (CLSA; n = 25,854), the bidirectional hypothesis was examined with three indicators of cognitive function (i.e., executive function, processing speed and verbal fluency) and adiposity (i.e., waist circumference [WC], body mass index [BMI] and total fat mass). We used multivariate multivariable regression and structural equation modeling to assess the prospective associations between adiposity and cognitive indicators. Results Analyses revealed that higher baseline WC was associated with higher Stroop interference at follow-up for both middle-aged (standardized estimate, β = 0.08, 95% CI 0.06, 0.10) and older adults (β = 0.07, 95% CI 0.04, 0.09). Similarly, higher baseline Stroop interference was also associated with higher follow-up WC in middle-aged (β = 0.08, 95% CI 0.06, 0.10) and older adults (β = 0.03, 95% CI 0.01, 0.06). Effects involving semantic fluency and processing speed were less consistent. The above effects were similar to those observed using other adiposity indicators (e.g., BMI, total fat mass) and were robust to adjustment for demographics and other cofounders, and when using latent variable modeling of the adiposity variable. Conclusion Evidence for a bidirectional relationship between adiposity and cognitive function exists, though the associations are most reliable for executive function and primarily evident at mid-life.

中文翻译：

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肥胖与认知功能之间的双向关联：加拿大老龄化纵向研究 (CLSA) 的前瞻性分析


目标 理论观点表明，肥胖和认知功能可能是双向相关的，但这尚未在大规模数据集中得到检验。目前的调查旨在利用大量具有代表性的中老年人样本来填补这一空白。方法 使用加拿大老龄化纵向研究（CLSA；n = 25,854）的数据，通过认知功能（即执行功能、处理速度和语言流畅性）和肥胖（即腰围 [WC] 的三个指标）检验双向假设。 ]、体重指数 [BMI] 和总脂肪量）。我们使用多元多元回归和结构方程模型来评估肥胖和认知指标之间的前瞻性关联。结果分析显示，对于中年人（标准化估计，β = 0.08，95% CI 0.06，0.10）和老年人（β = 0.07，95% CI 0.04， 0.09）。同样，较高的基线 Stroop 干扰也与中年人（β = 0.08，95% CI 0.06，0.10）和老年人（β = 0.03，95% CI 0.01，0.06）较高的随访 WC 相关。涉及语义流畅性和处理速度的效果不太一致。上述效果与使用其他肥胖指标（例如体重指数、总脂肪量）观察到的效果相似，并且在对人口统计数据和其他共同创始人进行调整以及使用肥胖变量的潜在变量建模时具有稳健性。结论 肥胖与认知功能之间存在双向关系的证据是存在的，尽管这种关联对于执行功能而言最为可靠，并且主要在中年时明显。