Higher BMI is associated with smaller regional brain volume in older adults with type 2 diabetes

Rebecca K. West*, Abigail Livny, Ramit Ravona-Springer, Barbara B. Bendlin, Anthony Heymann, Derek Leroith, Xiaoyu Liu, Hung Mo Lin, Hagit Hochner, Yechiel Friedlander, Ithamar Ganmore, Amir Tirosh, Michal Schnaider Beeri

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Aims/hypothesis: There are established relationships between adiposity (obesity) and higher dementia risk, faster cognitive decline and associated neural injury. Type 2 diabetes is strongly linked to greater adiposity and has been consistently associated with neural injury and poor cognitive outcomes. However, although obesity is a major cause of type 2 diabetes, there is limited evidence on the association of adiposity with brain atrophy among individuals with type 2 diabetes. Methods: We examined the association of BMI (a measure of adiposity), and of long-term trajectories of BMI (three empirically identified groups of trajectories—‘normal’, ‘overweight’ and ‘obese’—using SAS macro PROC TRAJ), with regional brain volume, in a sample of older individuals (aged 64–84) with type 2 diabetes participating in the Israel Diabetes and Cognitive Decline Study (n = 198). Results: Using linear regression, we found that greater BMI was associated with smaller volumes of the inferior frontal gyrus (IFG) (r = −0.25, p = 0.001) and the middle temporal gyrus (r = −0.19; p = 0.010) after adjusting for sociodemographic covariates and total intracranial volume. In addition, there were significant differences between BMI trajectory groups in IFG volume (F = 4.34, p = 0.014), such that a long-term trajectory of obesity was associated with a smaller volume. Additional adjustment for cardiovascular and diabetes-related potential confounders did not substantively alter the results. There were no associations of adiposity with superior frontal gyrus, middle frontal gyrus or total grey matter volumes. Conclusions/interpretation: In older adults with type 2 diabetes, long-term adiposity may have a detrimental impact on volume of brain regions relevant to cognitive functioning. Further studies to identify the underlying mechanisms are warranted. [Figure not available: see fulltext.].

Original languageAmerican English
Pages (from-to)2446-2451
Number of pages6
Issue number11
StatePublished - 1 Nov 2020

Bibliographical note

Funding Information:
Study funded by NIH (AG02219, AG034087, AG051545, AG053446, AG061093). We thank the LeRoy Schecter Foundation and Dr. Marina Nissim for their kind gifts which supported this study. Acknowledgements Authors’ relationships and activities

Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.


  • Adiposity
  • BMI
  • Brain volume
  • Cognitive functioning
  • Inferior frontal gyrus
  • Middle temporal gyrus
  • Type 2 diabetes


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