ABSTRACT OBJECTIVE: To examine the potential interactive relations of central versus total obesity and blood pressure (BP) to cognitive function. METHOD: In all, 90 healthy, stroke, and

dementia-free middle-aged and older adults (ages 54–81 years; 63% male; 93% White) underwent biomedical and neuropsychological assessment. Relations of central obesity (assessed by waist

circumference (WC)) and systolic or diastolic BP to cognitive function were examined in multiple regression models. Next, body mass index (BMI) was substituted for WC in the models. RESULTS:

After statistical adjustment for age, education, gender, and other potential confounders including components of the metabolic syndrome (depending on the model), significant interactions of

including facets of the metabolic syndrome, the combination of greater WC (or BMI) and higher (systolic or diastolic) BP was associated with diminished performance on tests of motor speed

and manual dexterity, and executive function (i.e. response inhibition) accounting for 3–13% of the variance in these measures. In healthy older adults, there are similar, negative relations

of central and total obesity to cognitive function that are potentiated by higher BP levels. Access through your institution Buy or subscribe This is a preview of subscription content,

access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online access $259.00 per year only $21.58 per issue Learn

more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS

OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS ASSOCIATION OF ADIPOSITY EVALUATED BY

ANTHROPOMETRIC AND BIOELECTRICAL IMPEDANCE ANALYSIS MEASURES WITH COGNITIVE PERFORMANCE IN THE ELSA-BRASIL STUDY Article 13 April 2025 IMPACT OF BLOOD GLUCOSE ON COGNITIVE FUNCTION IN

INSULIN RESISTANCE: NOVEL INSIGHTS FROM AMBULATORY ASSESSMENT Article Open access 11 September 2024 DISTINCT COMPONENTS OF CARDIOVASCULAR HEALTH ARE LINKED WITH AGE-RELATED DIFFERENCES IN

COGNITIVE ABILITIES Article Open access 18 January 2023 REFERENCES * Kurth T, Gaziano JM, Berger K, Kase CS, Rexrode KM, Cook NR et al. Body mass index and the risk of stroke in men. _Arch

Intern Med_ 2002; 162: 2557–2562. Article  Google Scholar  * Rosengren A, Wilhelmsen L, Lappas G, Johansson S . Body mass index, coronary heart disease and stroke in Swedish women. A

prospective 19-year follow-up in the BEDA study. _J Cardiovasc Risk_ 2003; 10: 443–450. Article  Google Scholar  * Song YM, Sung J, Davey Smith G, Ebrahim S . Body mass index and ischemic

and hemorrhagic stroke: a prospective study in Korean men. _Stroke_ 2004; 35: 831–836. Article  Google Scholar  * Gustafson D, Rothenberg E, Blennow K, Steen B, Skoog I . An 18-year

follow-up of overweight and risk of Alzheimer disease. _Arch Intern Med_ 2003; 163: 1524–1528. Article  Google Scholar  * Haan MN, Wallace R . Can dementia be prevented? Brain aging in a

population-based context. _Annu Rev Public Health_ 2004; 25: 1–24. Article  Google Scholar  * Kilander L, Nyman H, Boberg M, Lithell H . Cognitive function, vascular risk factors and

education: a cross-sectional study based on a cohort of 70-year-old men. _J Intern Med_ 1997; 242: 313–321. Article  CAS  Google Scholar  * Sorensen TI, Sonne-Holm S, Christensen U, Kreiner

S . Reduced intellectual performance in extreme overweight. _Hum Biol_ 1982; 54: 765–775. CAS  PubMed  Google Scholar  * Elias MF, Elias PK, Sullivan LM, Wolf PA, D'Agostino RB . Lower

cognitive function in the presence of obesity and hypertension: the Framingham heart study. _Int J Obesity Relat Metab Disord_ 2003; 27: 260–268. Article  CAS  Google Scholar  * Droyvold WB,

Midthjell K, Nilsen TI, Holmen J . Change in body mass index and its impact on blood pressure: a prospective population study. _Int J Obes Relat Metab Disord_ 2005; 29: 650–655. Article 

CAS  Google Scholar  * Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a

meta-analysis of individual data for one million adults in 61 prospective studies. _Lancet_ 2002; 360: 1903–1913. Article  Google Scholar  * Meyer JS, Rauch GM, Rauch RA, Anwarul H, Crawford

K . Cardiovascular and other risk factors for Alzheimer's disease and vascular dementia. _Ann NY Acad Sci_ 2000; 903: 411–423. Article  CAS  Google Scholar  * Waldstein SR, Manuck SB,

Ryan CM, Muldoon MF . Neuropsychological correlates of hypertension: review and methodologic considerations. _Psychol Bull_ 1991; 110: 451–468. Article  CAS  Google Scholar  * Waldstein SR,

Katzel LI . Hypertension and cognitive function. In: Waldstein SR, Elias MF (eds). _Neuropsychology of Cardiovascular Disease_. Lawrence Erlbaum Associates: Mahwah, NJ, 2001. pp. 15–36.

Chapter  Google Scholar  * Elias MF, Wolf PA, D'Agostino RB, Cobb J, White LR . Untreated blood pressure level is inversely related to cognitive functioning: the Framingham Study. _Am J

Epidemiol_ 1993; 138: 353–364. Article  CAS  Google Scholar  * Shen BJ, Todaro JF, Niaura R, McCaffery JM, Zhang J, Spiro III A et al. Are metabolic risk factors one unified syndrome?

Modeling the structure of the metabolic syndrome X. _Am J Epidemiol_ 2003; 157: 701–711. Article  Google Scholar  * Expert Panel on the Identification, Evaluation, and Treatment of

Overweight in Adults. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. _Am J Clin Nutr_ 1998; 68: 899–917. * Suk

SH, Sacco RL, Boden-Albala B, Cheun JF, Pittman JG, Elking MS et al. Northeren Manhattan Stroke Study. Abdominal obesity and risk of ischemic stroke: the Northern Manhattan Stroke Study.

_Stroke_ 2003; 34: 1586–1592. Article  Google Scholar  * Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M et al. Cardiovascular morbidity and mortality associated with the metabolic

syndrome. _Diabetes Care_ 2001; 24: 683–689. Article  CAS  Google Scholar  * Kip KE, Marroquin OC, Kelley DE, Johnson BD, Kelsey SF, Shaw LJ et al. Clinical importance of obesity versus the

metabolic syndrome in cardiovascular risk in women: a report from the Women's Ischemia Syndrome Evaluation (WISE) study. _Circulation_ 2004; 109: 706–713. Article  Google Scholar  *

Ribeiro-Filho FF, Faria AN, Axjen S, Zanella M-T, Ferreira SRG . Method of estimation of visceral fat: advantages of ultrasonography. _Obes Res_ 2003; 11: 1488–1494. Article  Google Scholar

  * Lezak MD . _Neuropsychological Assessment_, 3rd edn. Oxford University Press: New York, 1995. Google Scholar  * Beck AT . _Beck Depression Inventory: Manual_. Psychological Corporation:

San Antonio, TX, 1987. Google Scholar  * Spielberger CD . _Preliminary Manual for the State-Trait Personality Inventory_. University of South Florida: Tampa, FL, 1979. Google Scholar  *

Chelune G, Ortega D, Linton J, Boustany M . Personality and cognitive findings among patients electing gastroplasty for morbid obesity. _Int J Eating Disord_ 1986; 5: 701–712. Article 

Google Scholar  * Bjorntorp P, Rosmond R . Neuroendocrine abnormalities in visceral obesity. _Int J Obes Relat Metab Disord_ 2000; 24 (Suppl): S80–S85. Article  CAS  Google Scholar  *

Sapolsky RM . Glucocorticoids, stress, and their adverse neurological effects: relevance to aging. _Exp Gerontol_ 1999; 34: 721–732. Article  CAS  Google Scholar  * Ren J . Leptin and

hyperleptinemia – from friend to foe for cardiovascular function. _J Endocrinol_ 2004; 18: 1–10. Article  Google Scholar  * Li XL, Aou S, Oomura Y, Hori N, Fukunaga K, Hori T . Impairment of

long-term potentiation and spatial memory in leptin receptor-deficient rodents. _Neuroscience_ 2002; 113: 607–615. Article  CAS  Google Scholar  * Everson SA, Lynch JW, Kaplan GA, Lakka TA,

Sivenius J, Salonen J . Stress-induced blood pressure reactivity and incident stroke in middle-aged men. _Stroke_ 2001; 32: 1263–1270. Article  CAS  Google Scholar  * Waldstein SR, Siegel

EL, Lefkowitz D, Maier KJ, Pelletier Brown JR, Obuchowski AM et al. Stress-induced blood pressure reactivity and silent cerebrovascular disease. _Stroke_ 2004; 35: 1294–1298. Article  Google

Scholar  * Toni R, Malaguti A, Castorina S, Roti E, Lechan RM . New paradigms in neuroendocrinology: relationships between obesity, systemic inflammation and the neuroendocrine system. _J

Endocrinol Invest_ 2004; 27: 182–186. Article  CAS  Google Scholar  * Das UN . Metabolic syndrome X: an inflammatory condition. _Curr Hypertens Rep_ 2004; 6: 66–73. Article  Google Scholar 

* Yaffe K, Lindquist K, Penninx B, Simonsick E, Pahor M, Kritchevsky S et al. Inflammatory markers and cognition in well-functioning African-American and white elders. _Neurology_ 2003; 61:

76–80. Article  CAS  Google Scholar  * Wilson CJ, Finch CE, Cohen HJ . Cytokines and cognition – the case for a head-to-toe inflammatory paradigm. _JAGS_ 2002; 50: 2041–2056. Article  Google

Scholar  * Gunning-Dixon FM, Raz N . The cognitive correlates of white matter abnormalities in normal aging: a quantitative review. _Neuropsychology_ 2000; 14: 224–232. Article  CAS  Google

Scholar  Download references ACKNOWLEDGEMENTS This work was supported by National Institutes of Health (NIH) Grants R29 AG15112, RO1 AG15112, and NIH K24 AG00930; a VA Merit Grant, Bristol

Myers Squibb Medical Imaging Inc., the Department of Veterans Affairs Baltimore Geriatric Research Education and Clinical Center, and the Geriatrics and Gerontology Education and Research

Program of the University of Maryland, Baltimore, MD, USA. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD,

USA S R Waldstein * Department of Medicine, Division of Gerontology, University of Maryland School of Medicine, Baltimore, MD, USA S R Waldstein & L I Katzel * Geriatric Research

Education and Clinical Center, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA S R Waldstein & L I Katzel Authors * S R Waldstein View author publications You can also

search for this author inPubMed Google Scholar * L I Katzel View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to S R

Waldstein. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Waldstein, S., Katzel, L. Interactive relations of central versus total obesity and blood

pressure to cognitive function. _Int J Obes_ 30, 201–207 (2006). https://doi.org/10.1038/sj.ijo.0803114 Download citation * Received: 10 January 2005 * Revised: 29 June 2005 * Accepted: 05

July 2005 * Published: 04 October 2005 * Issue Date: 01 January 2006 * DOI: https://doi.org/10.1038/sj.ijo.0803114 SHARE THIS ARTICLE Anyone you share the following link with will be able to

read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing

initiative KEYWORDS * central obesity * blood pressure * cognitive function * cognition * neuropsychology