Associations Between Cognitive Impairment with Body Mass Index, Race/Ethnicity, Educational Attainment, and Gender in Older U.S.


Christianna Dix

Faculty Mentor(s)

David Gee (Food Science and Nutrition), Nicole Stendell-Hollis (Nutrition), Amie Wojtyna (Public Health)


Body Mass Index (BMI) is a quick, inexpensive nutritional assessment which may assist RD’s in efficiently applying optimal care techniques to enable the best achievable quality of life for adults as they age. Utilizing data of older US adults (≥60 y) from 2011-2014 NHANES (National Health and Nutrition Examination Survey), this study proposes to evaluate potential associations between BMI, sex, race/ethnicity, and educational attainment with cognitive impairment. Differences in prevalence were assessed through traditionally used cut-off percentiles for each cognitive assessment: Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning and Delayed Recall, Animal Fluency (AF), and the Digit Symbol Substitution Test (DSST).
Of participants who completed at least one cognitive test (n=3123), 44% had an impaired score for at least one test and were considered cognitively impaired (48.8% males, 40.2% females; p=0.0002). Within each BMI category, 58.6% of underweight participants were cognitively impaired, compared to 43.4% normal, 45.4% overweight, 41.7% obese (p=0.09).
Among race/ethnicity, only 38.7% of the Non-Hispanic White sample showed cognitive impairment, compared to 60-66.5% of other self-identified ethnicities (p<0.0001), suggesting possible cultural biases of the assessment tools. When compared to other educational levels, higher attainment (college graduate or higher: 29% impaired) was associated with lower prevalence of impaired cognitive ability (Less than high school (77%), high school graduate or equivalent/GED (50%), some college (37%); p<0.0001). In conclusion, while differences in sex, race/ethnicity, and educational attainment were associated with differences in prevalence of impaired cognitive ability, there was no significant effect of BMI category. Keywords: BMI Body Mass Index, cognitive impairment, older US adults,


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