- Most adiposity measures were significantly correlated, except for BMI and ABSI.
- Associations with cognitive screening were small and inconsistent; BMI showed linear relations, WC and WHtR showed nonlinear relations.
- MRI-derived brain age gap related to BMI, WC, WHtR, showing nonlinear increases and higher predicted brain age at elevated adiposity; combined measures added little.
Exp Gerontol. 2026 Nov 5:113380. doi: 10.1016/j.exger.2026.113380. Online ahead of print.
ABSTRACT
BACKGROUND: Adiposity has pernicious health implications, notably contributing to cognitive decline and neuroanatomical alterations. Research regarding which measures of adiposity are most related to cognition and the brain is inconsistent. This study explores the relationships between 1) multiple adiposity measures, 2) adiposity measures and cognitive screening performance, and 3) adiposity measures and a machine-learning predicted brain age gap (BAG).
METHODS: Cross-sectional data were combined from two multi-site studies, including 641 non-Hispanic black and non-Hispanic white adults (45-85 years old). Adiposity measures included Body Mass Index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR), and A Body Shape Index (ABSI) z-score. Cognition was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). MoCA scores were converted to equivalent MMSE scores. The predicted BAG was obtained using DeepBrainNet (n = 204) from T1-weighted brain MRI.
RESULTS: Adiposity measures were significantly correlated, except for BMI and ABSI. After covariate adjustment, cognitive screening associations were small and inconsistent, with a linear association for BMI and nonlinear associations for WC and WHtR. BAG associations depended on model form, with nonlinear patterns for BMI, WC, and WHtR and higher predicted BAG at higher versus intermediate adiposity levels. Combining adiposity measures showed little additional predictive value.
CONCLUSIONS: Anthropometric adiposity measures, particularly BMI, WC, and WHtR, were more consistently related to MRI-derived brain age gap than to brief cognitive screening performance in a cohort of middle-aged and older adults. These findings describe cross-sectional associations with older predicted brain age, especially at higher adiposity levels.
PMID:42988018 | DOI:10.1016/j.exger.2026.113380
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