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Background and Purpose Associations between alterations in body mass index (BMI) and cognitive function have been reported in Parkinson’s disease (PD). We investigated whether the BMI at a PD diagnosis is associated with cognitive decline and the future development of dementia. Methods We recruited 70 patients with de novo PD who underwent neuropsychological testing every 3 years and were followed up for more than 6 years. We classifed patients into the following three groups based on their BMI at the diagnosis: under-/normal weight (n=21), overweight (n=22), and obese (n=27). We evaluated diferences in the rate of cognitive decline over time among the groups using linear mixed models and the conversion rate to dementia using survival analysis. Results Te obese patients with PD showed a slower deterioration of global cognitive function as well as language and memory functions than did the under-/normal-weight group during the 6-year follow-up. Te three BMI groups showed diferent rates of conversion to dementia (log-rank test: p=0.026). Te combined overweight and obese group showed a lower risk of developing dementia compared with the under-/normal-weight group (hazard ratio= 0.36, 95% CI=0.12–0.82, p=0.046). Conclusions We have demonstrated that a higher-than-normal BMI at the time of a PD diagnosis has a protective efect against the deterioration of cognitive function and the conversion to dementia.
