Abstract
Background
Cognitive function is a major concern in aging society. Current studies on the impact of body weight changes on cognitive abilities present conflicting results. This study explored the relationship between weight changes during adulthood and cognitive function in later life
Methods
Data were obtained from the National Health and Nutrition Examination Survey (NHANES) and a total of 5097 participants aged 60 years or older with recalled weight at young and middle adulthood were included. Absolute weight change was categorized into five groups: weight loss of at least 2.5 kg, weight change within 2.5 kg (reference group), weight gain of at least 2.5 kg but less than 10.0 kg, weight gain of at least 10 kg but less than 20.0 kg, and weight gain of at least 20.0 kg. Cognitive function was assessed using the Digit Symbol Substitution Test (DSST). Logistic regression models adjusted for covariates were used to compute the odds ratios (ORs) and 95% confidence intervals (CIs) for the association between weight changes and cognitive function.
Results
From age 25 to 10 years before survey, participants with small to moderate weight gain (increase of ≥2.5 kg and <10 kg) exhibited a decreased risk of cognitive impairment compared to those with stable weight (weight change within 2.5 kg), with an OR of 0.64 (95% CI = 0.48 to 0.85, P = 0.003). For moderate to substantial weight gain (increase of ≥10 kg and <20 kg), the OR was 0.61 (95% CI = 0.46–0.79, P < 0.001). From age 25 years to survey, the OR for moderate to substantial weight gain was 0.66 (95% CI = 0.50–0.89, P = 0.007). Restricted cubic spline indicated a U-shaped relationship between the absolute weight change and cognitive function.
Conclusions
Moderate weight gain from early adulthood to late life was associated with a reduced risk of cognitive impairment, while weight loss showed a non-significant trend toward increased risk
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Subjects
- Epidemiology
- Obesity
Data availability
All data analyzed in the current study are freely accessible on the NHANES website (https://www.cdc.gov/nchs/nhanes/index.htm)
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Acknowledgements
We acknowledge the NHANES database for providing the platform and contributors for uploading meaningful datasets. We thank all participants included in the present study. We also gratefully acknowledge the Qingdao Key Laboratory of Respiratory Comorbidity Remodeling and Precision Prevention and the NHC Key Laboratory of Cardiopulmonary Rehabilitation and Functional Recovery for their academic and institutional support
Funding
This work was supported by the National Natural Science Foundation of China (72304122), Shandong Provincial Natural Science Foundation (ZR2024MG047)
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Author notes
These authors contributed equally: Yulu Zhong, Bin Guo, Yaoyao Wang
Authors and Affiliations
Department of Respiratory and Critical Care Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
Yulu Zhong, Yaoyao Wang, Qinghai Li, Xinjuan Yu & Tao Wang
Department of Medicine, Qingdao Municipal Hospital, Medical College, Qingdao University, Qingdao, China
Yulu Zhong, Yaoyao Wang & Yinan Li
Office of High-Quality Development, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
Bin Guo
Department of Gynaecology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
Jimei Guo
Shandong Key Laboratory of Neurorehabilitation, School of Medicine, University of Health and Rehabilitation Sciences, Qingdao, China
Tao Wang
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Contributions
The authors’ responsibilities were as follows—YLZ and BG conceived of and designed the study; XJY and YYW performed the data collection, management and analyses; QHL and YNL interpreted the results and drafted the manuscript; TW and JMG critically edited the manuscript. All authors read and approved the final manuscript
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The authors declare no competing interests
Ethical approval and consent to participate
The study protocol was approved by the NHANES Institutional Review Board, and was performed in accordance with the Declaration of Helsinki, with all NHANES participants providing signed informed consent
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Cite this article
Zhong, Y., Guo, B., Wang, Y. et al. The relationship between changes in body weight and cognitive function in the elderly.
Int J Obes (2026). https://doi.org/10.1038/s41366-026-02182-4
Received:27 August 2025
Revised:12 May 2026
Accepted:08 June 2026
Published:28 July 2026
Version of record:28 July 2026
DOI
:https://doi.org/10.1038/s41366-026-02182-4
