Effect of current and midlife obesity status on mortality risk in the elderly.

School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
Obesity (Impact Factor: 4.39). 09/2008; 16(11):2504-9. DOI: 10.1038/oby.2008.400
Source: PubMed

ABSTRACT The primary purpose of this study was to determine whether current and midlife obesity status provide independent information on mortality risk in elderly persons. Analyses were based on 3,238 participants from the original Framingham Heart Study (FHS) cohort who lived to at least 70 years of age and who had BMI measures from when they were in their 50s. Within this group of 70-year olds, obesity based on current BMI was associated with a 21% increased risk of mortality (P = 0.019) whereas obesity in 70-year olds based on BMI measures obtained at around 50 years of age was associated with a 55% increased risk of mortality (P < 0.0001). Compared to 70-year olds who were nonobese at both 50 and 70 years of age, mortality risk was increased by 47% (P < 0.001) in those who were obese at both 50 and 70 years of age, increased by 56% (P < 0.001) in those who were obese at 50 years of age and nonobese at 70 years of age, and not significantly different (P > 0.9) in those who were nonobese at 50 years of age and obese at 70 years of age. In summary, in this cohort of elderly adults, midlife and current BMI had independent effects on mortality risk. Specifically, although mortality risk was increased in obese older adults who were already obese at midlife, this was not the case for newly obese older adults. Conversely, nonobese older adults who were obese at midlife had an increased mortality risk. These observations imply that it is imperative to consider an elderly adult's BMI in context of their BMI at midlife.

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    ABSTRACT: AimTo determine the impact of body mass index and the presence of metabolic syndrome (MetS) on cardiovascular disease (CVD) and mortality events in an elderly Tehranian population.MethodsA population-based cohort of 1199 participants aged ≥65 years were followed for a mean of 9.74 years. Participants were stratified according to body mass index categories and MetS status. Cox regression analyses were used to estimate the hazard ratio of CVD and mortality events, given overweight participants without MetS as reference.ResultDuring follow up, 271 CVD events and 239 deaths (106 CVD deaths) occurred. Regarding CVD, multivariate-adjusted hazard ratios for CVD events in normal weight and obese participants without MetS were 1.21 (95% CI 0.77–1.91) and 1.46 (95% CI 0.64–3.34), respectively, and for normal weight, overweight and obese participants with MetS were 2.07 (95% CI 1.23–3.28), 1.72 (95% CI 1.13–2.62), and 1.53 (95% CI 0.95–2.45), respectively. Corresponding hazard ratios for CVD mortality were 2.08 (95% CI 0.93–4.82), 1.07 (95% CI 0.13–8.78), 3.71 (95% CI 1.55–8.85), 2.42 (95% CI 1.06–5.51) and 3.31 (95% CI 1.39–7.88), and for all-cause mortality were 1.41 (95% CI 0.9–2.23), 1.33 (95% CI 0.51–3.47), 1.84 (95% CI 1.1–3.09), 1.46 (95% CI 0.93–2.34) and 1.5 (95% CI 0.91–2.56), respectively. In the presence of diabetes in place of MetS, all of the diabetic participants regardless of body mass index category highlighted a significant risk for CVD and mortality events.Conclusion Among the elderly population, the presence of MetS was necessary for exploring the risk of CVD events and its mortality; however, only the normal weight population with MetS had a significant risk for all-cause mortality Geriatr Gerontol Int 2014; ●●: ●●–●●.
    Geriatrics & Gerontology International 05/2014; DOI:10.1111/ggi.12295 · 1.58 Impact Factor
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    ABSTRACT: The purpose of this review was to describe the health consequences of obesity in older adults. Although obesity is associated with risk of cardiovascular disease, type 2 diabetes, hypertension, and dyslipidemia in the elderly, the association appears to be weaker in older compared to younger adults. Obesity in older adults is also associated with significantly higher risk of osteoarthritis, postmenopausal breast cancer, and impairments in physi-cal function. However, the influence of obesity on mortality risk, osteoporosis, fracture risk, and cognitive function in older adults is not well understood. Intentional weight loss in obese older adults may be beneficial for metabolic health and physical function, but more long-term studies are needed. When examining the influence of obesity on different health parameters, future studies should consider using alternative measures of obesity beyond body mass index (BMI), such as waist circumference, and also investigate how body weight changes across the lifespan may influence health. The association between obesity and different health parameters in older adults appears to be more complex than in younger adults, and thus requires further investigation. TYPE: review FUNDING: authors disclose no funding sources. COMPETING INTERESTS: Authors disclose no potential conflicts of interest. COPYRIGHT: © the authors, publisher and licensee libertas academica limited. this is an open-access article distributed under the terms of the Creative Commons CC-By-nC 3.0 license.
    Healthy Aging & Clinical Care in the Elderly 01/2014; 6:25-32. DOI:10.4137/HaCCe.S12500
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    ABSTRACT: Recent studies indicate that socioeconomic inequalities in health extend into the elderly population, even within the most highly developed welfare states. One potential explanation for socioeconomic inequalities in health focuses on the role of health behaviors, but little is known about the degree to which health behaviors account for health inequalities among older adults, in particular. Using data from the Health and Retirement Study (N = 19,245), this study examined the degree to which four behavioral risk factors - smoking, obesity, physical inactivity, and heavy drinking - are associated with socioeconomic position among adults aged 51 and older, and whether these behaviors mediate socioeconomic differences in mortality, and the onset of disability among those who were disability-free at baseline, over a 10-year period from 1998 to 2008. Results indicate that the odds of both smoking and physical inactivity are higher among persons with lower wealth, with similar stratification in obesity, but primarily among women. The odds of heavy drinking decrease at lower levels of wealth. Significant socioeconomic inequalities in mortality and disability onset are apparent among older men and women; however, the role that health behaviors play in accounting for these inequalities differs by age and gender. For example, these health behaviors account for between 23 and 45% of the mortality disparities among men and middle aged women, but only about 5% of the disparities found among women over 65 years. Meanwhile, these health behaviors appear to account for about 33% of the disparities in disability onset found among women survivors, and about 9-14% among men survivors. These findings suggest that within the U.S. elderly population, behavioral risks such as smoking and physical inactivity contribute moderately to maintaining socioeconomic inequalities in health. As such, promoting healthier lifestyles among the socioeconomically disadvantaged older adults should help to reduce later life health inequalities.
    Social Science [?] Medicine 01/2014; 101:52-60. DOI:10.1016/j.socscimed.2013.10.040 · 2.56 Impact Factor

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