Evidence mapPaperPMID 41555838Full record

ArticleDiabetes, obesity & metabolism2026

Association of metabolic obesity phenotypes with cognitive decline in the ELSA-Brasil study.

Paulo Henrique Lazzaris Coelho, Natalia Gomes Gonçalves, Itamar S Santos, Alessandra C Goulart, Sandhi Maria Barreto, Luana Giatti, Paulo Caramelli, Paulo Andrade Lotufo, Isabela Martins Bensenor, Claudia Kimie Suemoto

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Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Paulo Henrique Lazzaris CoelhoDivision of Geriatrics, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0009-0001-6518-9620
Natalia Gomes GonçalvesDivision of Geriatrics, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
Itamar S SantosCenter for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, São Paulo, Brazil.
Alessandra C GoulartCenter for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, São Paulo, Brazil.
Sandhi Maria BarretoDepartment of Preventive and Social Medicine & Clinical Hospital/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Luana GiattiDepartment of Preventive and Social Medicine & Clinical Hospital/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Paulo CaramelliBehavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Paulo Andrade LotufoCenter for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, São Paulo, Brazil.
Isabela Martins BensenorCenter for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, São Paulo, Brazil.
Claudia Kimie SuemotoDivision of Geriatrics, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo investigate the association between metabolic obesity phenotypes and cognitive decline and evaluate the potential mediating role of C-reactive protein (CRP).

methodsLongitudinal cohort study using three waves (2008-2019) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Data were analysed from December 2024 to May 2025. Baseline sample consisted of 15 105 participants aged 35-74 years. Six phenotypes were defined by body mass index (BMI) category (normal weight, overweight, obesity) and metabolic health. Metabolic health was defined using traditional metabolic syndrome criteria and more stringent criteria: low waist-to-hip ratio (WHR), no diabetes or hypertension. Global cognition Z-scores were derived from tests of memory (immediate, delayed recall, and recognition of a word list), verbal fluency (phonemic and semantic), and Trail-Making tests (TMT-B). Mediation analysis evaluated CRP as a potential mediator.

resultsAmong 12 795 participants (mean age 51.1 years; 55% women; 53% White) followed for a median of 8 years, metabolically unhealthy phenotypes-across all BMI categories-were associated with faster cognitive decline (β estimates ranged from -0.037 to -0.053; all p < 0.001), whereas metabolically healthy overweight (β = 0.016; 95% CI = -0.002, 0.034; p = 0.081) and metabolically healthy obesity (β = 0.000; 95% CI = -0.027, 0.026; p = 0.981) were not. No evidence of CRP mediation was identified. BMI was not associated with cognitive decline (β = -0.001; 95% CI = -0.002, 0.000; p = 0.170), whereas WHR was (β = -0.020, 95% CI = -0.026, -0.014, p < 0.001).

conclusionsMetabolic dysfunction may be a stronger predictor of subsequent cognitive decline than excess body weight. Dementia prevention strategies may benefit from early identification and management of metabolic dysfunction across all weight categories.

Indexed as

Cognitive DysfunctionMetabolic SyndromeObesityAdultAgedBody Mass IndexBrazilC-Reactive ProteinFemaleHumansLongitudinal StudiesMaleMiddle AgedPhenotypeC-Reactive Proteincohort studyelderlymacrovascular diseaseobesity careobservational studyweight management

Identifiers

PMID41555838
PMCPMC12992203

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.