The Impact of Body Mass Index and Weight Changes on Disability Transitions and Mortality in Brazilian Older Adults

Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 1206 South 4th Street, Champaign, IL 61820, USA.
Journal of aging research 04/2013; 2013(1):905094. DOI: 10.1155/2013/905094
Source: PubMed


The aim of this study was to examine the association between body mass index and weight changes on disability transitions and mortality among Brazilian older adults. Longitudinal data from the Health, Well-Being, and Aging in Latin America and the Caribbean Study conducted in São Paulo, Brazil (2000 and 2006), were used to examine the impact of obesity on disability and mortality and of weight changes on health transitions related to disability. Logistic and multinomial regression models were used in the analyses. Individuals who were obese were more likely than those of normal weight to have limitations on activities of daily living (ADL), instrumental activity of daily living (IADL), and Nagi's limitations. Obesity was associated with higher incidence of ADL and IADL limitations and with lower recovery from Nagi's limitations. Compared to those who maintained their weight, those who gained weight experienced higher incidence of ADL and Nagi's limitations, even after controlling for initial body mass index. Higher mortality among overweight individuals was only found when the reference category was "remaining free of Nagi limitations." The findings of the study underline the importance of maintaining normal weight for preventing disability at older ages.

Download full-text


Available from: Yeda Duarte, Jul 17, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Americans are becoming obese earlier in their lives, increasing the average exposure to obesity. Nonetheless, the impact of long-term obesity on later life functioning is not well known.Methods We analyzed data from 7,258 adults aged 60-79 from the U.S. 1999-2010 National Health and Nutrition Examination Survey (NHANES). Respondents were defined as limited if they reported 'some difficulty' 'much difficulty' or 'unable to do' any of eight functional tasks. Respondents were defined as severely limited if they reported 'much difficulty' or 'unable to do' any task. Generalized regression models (logistic and Poisson) predicted the relative odds of any limitation, severe limitation, the total number of limitations, and each individual limitation as a function of BMI at age 25 and current BMI. Models were adjusted for age, sex, race/ethnicity, and level of education.ResultsOverall, being overweight or obese at age 25 was associated with higher odds of being functionally limited, but these associations were greatly diminished or eliminated after adjustment for current BMI. For example, those obese at age 25 had 2.38 times the odds (95% CI: 1.77, 3.20) of reporting any functional limitations compared to those normal weight at 25, but only 1.28 times the odds (95% CI: 0.93, 1.76) after adjustment for current BMI. For severe limitations, the corresponding results were 2.72 (95% CI: 2.13-3.46) and 1.32 (95% CI:1.00-1.75) before and after adjustment for current BMI. Some associations between obesity at age 25 and individual tasks remained significant after adjustment for current BMI.Conclusions We conclude that long-term overweight/obesity are significantly associated with later life functional limitations, though this is largely explained by their strong association with higher levels of later-life BMI. Prevention of additional weight gain for those who are overweight or obese early in life could help mitigate their risk of future loss of functioning.International Journal of Obesity accepted article preview online, 31 July 2014; doi:10.1038/ijo.2014.150.
    International journal of obesity (2005) 07/2014; 39(3). DOI:10.1038/ijo.2014.150 · 5.00 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: The majority of studies on the effects of adiposity on mortality in the elderly have been conducted in developed countries with mixed results. We investigated the association between adiposity and mortality in a cohort of community-dwelling elderly in Sao Paulo, Brazil. Methods: Body mass index (BMI), waist circumference, waist-to-hip ratio, and type 2 diabetes were evaluated in 1,882 participants (mean age 71.0 ± 8.3 years old, 61% female). Mortality was confirmed by national vital statistics records during a maximum of 10 years of follow-up. Proportional hazards models were used to estimate hazard ratios (HRs) for mortality after adjusting for sociodemographics and comorbidities. In a subsample of 897 participants, the effects of changes in measures of adiposity on mortality were investigated during a median follow-up of 4.6 years. Results: Having type-2 diabetes at baseline was associated with increased mortality (HR = 1.44, 95% CI: 1.17-1.77), with a higher HR among men. When compared with normal weight participants (BMI = 20-<25kg/m(2)), overweight and obesity were not associated with mortality (overweight: HR = 0.84 [0.70, 1.02]; obesity: HR = 0.82 [0.64, 1.06]), whereas participants with low-normal weight (BMI = 18.5<20 kg/m(2)) had increased risk of death (HR = 1.51 [1.08-2.10]). Higher waist circumference and waist-to-hip ratio were not associated with increased mortality. Weight gain was protective against mortality in all BMI categories, except in obese participants, and weight loss increased the risk of death in all BMI categories by 42-63%. Conclusions: In community-dwelling elderly in Sao Paulo, overweight and obesity were not associated with a higher risk of death, and weight gain seemed to reduce mortality, except in the obese.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 09/2014; 70(4). DOI:10.1093/gerona/glu165 · 5.42 Impact Factor