Obesity as a risk factor for Alzheimer's disease: weighing the evidence

Obes Rev. 2018 Feb;19(2):269-280. doi: 10.1111/obr.12629. Epub 2017 Oct 10.

Abstract

Alzheimer's disease (AD) is the sixth leading cause of death in the USA today; therefore, it is imperative that public health initiatives and clinical strategies are developed to prevent and effectively treat AD. Despite the enormous impact that AD has on individuals, families, society, and the health care system, there are no biomarkers to clearly identify those at risk for AD, public health prevention strategies in place, or treatments to address the underlying pathology or stop the progression of AD. There is ample scientific as well as empirical evidence that obesity and its metabolic and vascular comorbidities are related to AD and likely in the causative pathway. Obesity prevention and treatment could prove to be an efficacious and safe approach to preventing AD, a serious and daunting epidemic disease. In this review, we present the current pathophysiological and clinical evidence linking obesity and obesity-related comorbidities (eg, insulin resistance, hyperglycaemia, and type 2 diabetes) with AD. Additionally, we discuss which population to target and when to consider treatment for AD. Finally, we summarize the current evidence regarding the efficacy of anti-obesity and anti-diabetic pharmacotherapeutic agents for the treatment of AD.

Keywords: Alzheimer's disease; metabolic; obesity; pathology.

Publication types

  • Systematic Review

MeSH terms

  • Alzheimer Disease / etiology*
  • Alzheimer Disease / metabolism
  • Alzheimer Disease / physiopathology*
  • Anti-Obesity Agents / adverse effects
  • Anti-Obesity Agents / therapeutic use
  • Biomarkers / metabolism
  • Comorbidity
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Disease Progression
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Insulin Resistance
  • Obesity / complications*
  • Obesity / metabolism
  • Obesity / physiopathology*
  • Risk Factors

Substances

  • Anti-Obesity Agents
  • Biomarkers
  • Hypoglycemic Agents