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Height loss with advancing age in a hospitalized population of Polish men and women: Magnitude, pattern and associations with mortality

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The connection between the rate of height loss in older people and their general health status has been well documented in the medical literature. Our study was aimed at furthering the characterization of this interrelationship in the context of health indices and mortality in a hospitalized population of Polish adults. Data were collated from a literature review and from a longitudinal study of aging carried out in the Polish population which followed 142 physically healthy inmates, including 68 men and 74 women, for at least 25 years from the age of 45 onwards. Moreover, cross-sectional data were available from 225 inmates, including 113 men and 112 women. These subjects were confined at the same hospital. ANOVA, t-test, and regression analysis were employed. The results indicate that the onset of height loss emerges in the fourth and five decade of life and there is a gradual acceleration of reduction of height at later stages of ontogeny in both sexes. Postmenopausal women experience a more rapid loss of height compared with men. The individuals who had higher rate of loss of height (≥3 cm/decade) tend to be at greater risk of cardiovascular events and all-cause mortality. In conclusion, our findings suggest that a systematic assessment of the rate of loss of height can be useful for clinicians caring for elderly people because of its prognostic value in terms of morbidity and mortality.
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Anthropological Review • Vol. 78 (2), 157–168 (2015)
Height loss with advancing age in a hospitalized
population of Polish men and women: magnitude,
pattern and associations with mortality
Piotr Chmielewski1, Krzysztof Borysławski2, Krzysztof Chmielowiec3,
JolantaChmielowiec4
1Department of Anatomy, Faculty of Medicine, Wroclaw Medical University, Poland
2Department of Anthropology, Institute of Biology
Wroclaw University of Environmental and Life Sciences, Poland
3Regional Psychiatric Hospital for People with Mental Disorders in Cibórz, Lubuskie Province,
Poland
4Faculty of Education, Sociology and Health Sciences, University of Zielona Góra, Poland
AbstrAct: The connection between the rate of height loss in older people and their general health status has
been well documented in the medical literature. Our study was aimed at furthering the characterization of
this interrelationship in the context of health indices and mortality in a hospitalized population of Polish
adults. Data were collated from a literature review and from a longitudinal study of aging carried out in the
Polish population which followed 142 physically healthy inmates, including 68 men and 74 women, for at
least 25 years from the age of 45 onwards. Moreover, cross-sectional data were available from 225 inmates,
including 113 men and 112 women. These subjects were conned at the same hospital. ANOVA, t-test, and
regression analysis were employed. The results indicate that the onset of height loss emerges in the fourth
and ve decade of life and there is a gradual acceleration of reduction of height at later stages of ontogeny
in both sexes. Postmenopausal women experience a more rapid loss of height compared with men. The
individuals who had higher rate of loss of height (3 cm/decade) tend to be at greater risk of cardiovascular
events and all-cause mortality. In conclusion, our ndings suggest that a systematic assessment of the rate
of loss of height can be useful for clinicians caring for elderly people because of its prognostic value in
terms of morbidity and mortality.
Key words: aging, body height, changes with age, health, morbidity, mortality
Piotr Chmielewski, Krzysztof Borysławski, Krzysztof Chmielowiec, JolantaChmielowiec
Original Article: Received: March 21, 2015 Accepted for publication May 22, 2015
DOI: 10.1515/anre-2015-0011
© 2015 Polish Anthropological Society Unauthenticated
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158 Piotr Chmielewski, Krzysztof Borysławski, Krzysztof Chmielowiec, JolantaChmielowiec
Introduction
The ancient Egyptians used a hieroglyph-
ic symbol of a bent person leaning on a
staff for denoting the epithet ‘old’. That
sign was presumably the earliest depic-
tion of the ravages of osteoporosis in hu-
man history (Morley 2004). Nowadays
biological condition of a given popula-
tion is typically assessed using data on
adult stature, the degree of sexual dimor-
phism, and specic indicators of physio-
logical stress as essential criteria for eval-
uation. Body height is considered to be
a single morphological trait whose rate
of reduction with age provides useful in-
formation on general health status, phys-
ical tness, and biological condition in
older adults and elderly people. The rate
of height loss is correlated with chron-
ological age and the rate of weight loss
(Preedy 2012). The age-related changes
in body height and weight are normal-
ly appraised by anthropometric meas-
urements which are usually performed
during longitudinal and cross-sectional
studies of aging.
After maturity, body height declines
approximately by 1.02.0 cm per decade
due to compression of the intervertebral
discs, decits in bone mass of the ver-
tebral bodies, aging-associated changes
in muscles and joints, and other types
of postural deformities, including at
feet (Rossman 1979; Schulz 2006). In-
terestingly, stature tends to be slightly
taller in the morning and shorter in the
evening and thus the term ‘shrinkage’
concerns not only the age-related re-
duction in height, but also vertical and
postural changes in the vertebral column
throughout the day. The daily reduction
in height usually ranges from 1.0 to 1.5
cm and represents reversible types of
morphological changes which occur in
both young and old people (Wales and
Dangereld 1995).
Hooton (1947) opined that the pe-
riod of aging-associated and permanent
decline in nal adult stature commences
no later than 25 years of age, which was
in agreement with certain previous in-
vestigations (Bertillon 1885). Similarly,
Spirduso et al. 2005 contended that the
age of the onset of height loss is about
25 in men and 20 in women. On the oth-
er hand, both cross-sectional and longi-
tudinal studies of aging have found no
evidence of signicant age-related reduc-
tion in stature until age 45 (Susanne and
Orbach 1977; Noppa et al. 1980; Bagga
2013). According to Galloway (1988),
the starting point of decline occurs at
the age of 45 and the height loss can be
calculated as follows: 0.16 (age45). It
was established that middle-aged men
lose around 1.0 mm/year, while mid-
dle-aged women lose on average 1.25
mm/year. Sagiv et al. (2000) pointed out
that the rate of reduction in height tends
to be higher in women because of the
consequences of loss of estrogen during
menopause, which can lead to a signi-
cant reduction in bone mineral density,
osteopenia, osteomalacia, osteoporosis,
and eventually osteoporotic fractures.
In developed countries, most women go
through menopause between the ages of
45 and 55. The median age of menopause
for Polish women is 51.25 years; Q1=49;
Q3=54 years (Kaczmarek 2007). Howev-
er, obesity, asthenia, smoking, high level
of psychological stress, diseases, chemo-
therapy, unhealthy diet, malnutrition,
nutritional deciencies, racial and eth-
nic factors, and genetic inheritance can
result in premature ovarian failure and
early menopause, which in turn can ac-
celerate the rate of regressive changes in
stature.
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Height loss with advancing age in hospitalized adults 159
After age 75, the rate of diminution
in body height increases by 40 per cent
in men and by 60 per cent in women
(Giles and Hutchinson 1991). It is note-
worthy that the rate of decline in adult
stature with age has been documented to
be linked to physical activity as well as
nutritional status of elderly people (Sagiv
et al. 2000; Harvard Health Letter 2005;
Preedy 2012). Although the process of
reduction in adult height occurs as a
part of the normal aging process, the in-
creased rate of height loss may be linked
to a variety of health problems. Much as
age-related changes in body height after
maturity in healthy individuals are nor-
mally slow and relatively slight, the in-
creased rate of reduction in stature can
serve as an objective and reliable indica-
tor of health status and a simple clinical
risk factor of osteoporotic fractures, falls,
physical frailty and other health prob-
lems in elderly people.
Wannamethee and associates (2006)
reported that men with rapid height
loss tend to have higher mortality rate
and deaths from cardiovascular disease.
Hillier and associates (2012) tested the
hypothesis of such dynamics and inter-
relationships and their results supported
the hypothesis in respect of mortality in
women. It is well known that stature de-
creases with increasing age in both sexes
and in all races but the relationship be-
tween marked rate of loss of height and
health status has not been systematical-
ly investigated in the Polish population.
Likewise, there is little information on
the patterns and determinants of changes
with age in physical tness and biological
condition of elderly people in medical in-
stitutions. The present study is aimed at
evaluating the relationship between the
rate of retrograde changes in stature of
older men and women and their wellness
in terms of mortality, morbidity, and gen-
eral biological condition.
Materials and methods
Two types of materials were used in the
present investigation to demonstrate
the relationship between the rate of loss
of height in older men and women and
their biological condition. We have col-
lated extensive data on health proles,
morbidity, and mortality from a literature
review and from a longitudinal study of
aging carried out at the Regional Psychi-
atric Hospital in Cibórz, Lubuskie Prov-
ince, Poland, subsequently referred to as
the Polish Longitudinal Study of Aging
(PLSA). Research techniques and meth-
ods of the study were standardized. All
measurements were performed in accord-
ance with internationally accepted stand-
ards and requirements (Martin and Saller
1957).
Measurements of height were taken
using a standard stadiometer, graduated
to the nearest 0.1 cm. All measurements
were performed for a very long time by
generally the same nurses and with such
large number of measurements we were
able to use means with standard errors
in the regression analysis. In the sample,
therefore, an error of measurement does
not necessarily affect the results unless
it is made systematically. Mean values of
retrograde changes in stature in the con-
secutive ve-year periods were estimated,
thereby eliminating the undesirable effect
of reversible daily changes in body height.
ANOVA, Student’s t-test, and regression
analysis were performed to compare the
groups of the study subjects.
To determine and compare rates and
patterns of regressive changes in stature
with age as well as derive mathematical
formulae, ANOVA, Student’s t-test, and
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160 Piotr Chmielewski, Krzysztof Borysławski, Krzysztof Chmielowiec, JolantaChmielowiec
regression analysis were run. The method
of least squares was used. A given func-
tion of regression was conrmed as the
best tting model only when a coefcient
of determination (R2) reached the high-
est value and a parameter (β0) as well as a
coefcient of regression (β1) were statis-
tically signicant at p<0.05. For the pur-
pose of the study, ve types of functions
were tested: (1) linear function: y=β1 age
+ β0, (2) logarithmic function: y=β1 ln
age + β0, (3) polynomial function: y=β1
age2 + β2 age + β0, (4) exponential type
I: y=β1 agea, and (5) exponential type II:
y=β1 ea(age), where (y) stands for a value of
an analyzed characteristic changing with
age, (β2) represents the second coef-
cient of regression, (a) denotes the ex-
ponent, and (e) is the base of the natural
logarithm.
In the Polish People’s Republic, the
hospital functioned as long-term shel-
ter accommodation for people with so-
cial recommendation. Therefore, some
of the inmates were perfectly healthy
in every respect. On the basis of docu-
ments that had been stored at the archive
of case history at the hospital, we creat-
ed a large computerized database in the
years 2005–2007. The medical les were
anonymized so as not to divulge any per-
sonal and condential information.
Out of the total number of inmates
who had lived at the hospital in the years
1960–2000 (N=3,500), we selected lon-
gitudinal data on health proles and re-
gressive changes with age in numerous
biological traits from 142 physically
healthy subjects, including 68 men and
74 women, who had stayed there contin-
uously for at least 25 years. 74% of the
chosen inmates (N=105) were healthy
and their stay at the hospital was a so-
cially and politically motivated decision,
whereas 26% (N=37) of patients were
physically healthy with mild mental
disorders. The term “healthy” means
here “in a state of good tness because
of the absence of any physical or men-
tal illness”. The majority of the chosen
group of inmates had never been treated
with psychoactive drugs. Subsequently,
the group was divided into three catego-
ries of the rate of height loss: <1.0 cm/
decade, 1.0–2.9 cm, and 3.0 cm/decade
(Table 1).
Moreover, cross-sectional data were
available from 225 inmates, including
113 men and 112 women, who were con-
ned at the same hospital but differed
signicantly in lifespan. Age at death
of each individual was determined on
the basis of death certicate and subse-
quently the cross-sectional sample was
divided into the following categories of
lifespan: 53 years of age (N=34, includ-
ing 22 males and 12 females), 63 years of
age (N=57, including 27 males and 30
females), 68 years of age (N=89, includ-
ing 49 males and 40 females), and 76+
years of age (N=45, including 15 males
and 30 females).
Table 1. Number of subjects from the PLSA by rate of height loss per decade
HL (cm) Men Women Total
<1 6 4 10
1–2.9 51 58 109
3 11 12 23
Total 68 74 142
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Height loss with advancing age in hospitalized adults 161
Results
The baseline anthropometric characteris-
tics of the study sample from the Polish
Longitudinal Study of Aging are shown
in Table 2. Men were signicantly taller
than women in each age category (t-test,
p<0.001) and had lower age at death.
Causes of death were predominantly
age-related diseases such as ‘cardio- res-
piratory failure’, cardiovascular disease,
stroke, and cancer. Fig. 1 depicts the dis-
tribution of main causes of death in the
subjects from the Polish population on
the basis of death certicates.
The total loss of height through the
25-year period under study was calcu-
lated to be 5.6 cm, i.e. 2.2 cm/decade or
3.3% in men and 5.5 cm, i.e. 2.2 cm/dec-
ade or 3.4% in women, respectively. The
best tting regression model of changes
with age in adult stature was logarithmic
for men (y=–12.5279 ln(x) + 217.3984,
R2=0.999) and linear for women
(y=– 0.2082x + 166.4192, R2=0.995).
The goodness of t was statistically sig-
nicant (p<0.05). The greatest decrease
in height (1.4 cm, which accounted for
25% of the total height loss) occurred in
the rst ve-year period in men, i.e. in
the age category 45–50, while in women
the greatest reduction in height (1.3 cm,
which comprised 24% of the total loss
of stature) occurred in the last ve-year
period, i.e. in the age category 65–70. In
both sexes, the smallest decrease in stat-
ure occurred in the third age category
55–60 and amounted to 0.9 cm in both
sexes, which was equivalent to 16% of
the total loss of height in men and 16.7%
in women. The rate of decline increased
in older age groups of men and women.
The reduction in height of men averaged
2.0 cm between the ages of 50 and 60 and
2.2 cm in the last decade of the study, i.e.
age 60–70. In women, the decline aver-
aged 2.0 and 2.3 cm, respectively. In the
subjects from the cross-sectional group
who differed in lifespan, the best tting
model proved to be polynomial in men
(y=0.0074x2 – 0.8226x + 191.0143,
R2=0.998) and exponential type II in
women (y=152.3382e0.0003x, R2=0.836).
The goodness of t for both these mod-
els was statistically signicant (p<0.05).
As regards biological condition of the
subjects and its association with the rate
of decline in stature, individuals with
low, average, and high rate of reduction
in height (i.e. the rate of loss of height
<1.0 cm/decade, 1.0–2.9 cm, and 3.0
cm/decade, respectively; Table 1) dif-
fered in a number of indicators of health
and survival probabilities, i.e. all-cause
and cause-specic mortality. Taller sub-
jects from the Polish Longitudinal Study
Table 2. Changes in body height (arithmetic mean ± standard deviation) of the inmates from the PLSA in
the consecutive age categories. Statistical signicances of the differences were determined by Student’s
t-test (*p<0.05, **p<0.01, ***p<0.001)
Age Men
(N=68)
Women
(N=74)
Student’s
t-test p-value
45 169.7 (6.7) 157.1 (7.2) –11.13 ***
50 168.3 (6.6) 156.0 (7.1) –10.72 ***
55 167.2 (6.8) 154.9 (7.0) –10.54 ***
60 166.3 (6.9) 154.0 (6.8) –10.42 ***
65 165.2 (6.9) 153.0 (6.7) –10.51 ***
70 164.1 (7.1) 151.7 (6.3) –11.06 ***
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162 Piotr Chmielewski, Krzysztof Borysławski, Krzysztof Chmielowiec, JolantaChmielowiec
of Aging and those who lost less height
had longer life expectancies compared
with shorter subjects and those who had
a substantial reduction in height (ANO-
VA, p<0.05).
Discussion
The ndings of our investigation are in
line with previous studies (Susanne and
Orbach 1977; Noppa et al. 1980; Hern-
don 1986; van Leer et al. 1992; Center
et al. 1998; Kantor et al. 2004; Siminoski
et al. 2006; Wannamethee et al. 2006;
Moayyeri et al. 2008; Hannan et al. 2012;
Hillier et al. 2012; Bagga 2013). In both
sexes, height loss with advancing age
was a common process and an inevitable
effect of aging. As expected, the process
of gradual decrease in body height with
aging developed silently in the fourth
decade of life and occurred even in indi-
viduals who continued to be physically
active (Sagiv et al. 2000; Spirduso et al.
2005; Schulz 2006; Preedy 2012).
The onset of reduction has not been
established and there is a lack of agree-
ment in the anthropological literature as
to whether scant regressive changes in -
nal adult stature before age 35 should be
attributed to aging-associated decline or
the simultaneous effect of height shrink-
age during the day. The latter can be an
obstacle to anthropometric evaluation
of the starting point of age-related re-
duction if measurements are performed
at different times of the day. Cross-sec-
tional data are encumbered with the co-
hort effect and secular changes in height
ought to be estimated. The use of longi-
tudinal data on aging prole is therefore
more judicious. Other researchers have
found that the starting point of reduc-
tion in height was in the fth decade of
life and accelerated in subsequent years
(Bagga 2013). Be that as it may, height
loss before the age range of 35–45 is
Fig. 1. Leading causes of death of the subjects from the Polish population in total, by sex, and for all ages
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Height loss with advancing age in hospitalized adults 163
rather exiguous, if any, and there is the
issue of inter-individual variability.
Between the ages of 30 and 90, the
reduction in height of a healthy person
averages 1–1.5 cm per decade, i.e. the
total loss is approximately 5 per cent of
adult stature. However, the aging-asso-
ciated retrograde change in body height
of elderly people ranges from 1.0 to 3.0
cm per decade. The rate of reduction de-
pends on age, sex, race, ethnic factors,
place of living (rural/urban areas), health
status, and physical activity (Sagiv et al.
2000; Preedy 2012). In middle and late
adulthood, the subjects from the Polish
Longitudinal Study of Aging lived for
many years under identical and relative-
ly prosperous environmental conditions,
which boost the value of the study sam-
ple. The inter-individual variability was
effectively limited because the inmates
did not differ in chronological age, race,
diet, nutritional status, leisure activi-
ties, amount of sleep, etc. All the indi-
viduals were physically healthy and thus
the problem of chronic diseases among
longitudinally examined older adults was
solved by retrospective selection of lon-
gitudinal data from healthy inmates only.
Table 3 presents a crude comparison
of the subjects from the literature review
in terms of their number, age range, and
initial gender difference in body height.
Polish men were signicantly shorter
than men from Finland, Sweden, Bel-
gium, the United Kingdom, the Nether-
lands, and the United States of America
(p<0.05), but they were taller compared
with men from China and Mexico (Fig.
2). No signicant differences in height
were found between the examined group
of subjects and men from the Czech Re-
public, Italy, Brazil, and Greece. Men
from Poland were at substantially high-
er risk of cardiovascular disease (ANO-
VA, p<0.05). Average height of women
from the Polish Longitudinal Study of
Aging was lower compared with height
of women from Finland, Sweden, the
Netherlands, Belgium, Lithuania, the
Table 3. Comparison of the analyzed groups of men and women from different regions of the world: total
number of subjects, age range, and initial sex difference in body height
Population Sex difference (cm) Authors
Belgium (N=4122; 25–74) 12.2 Zhang et al. 2000
Brazil (N=305; 60–70) 12.0 de Menezes et al. 2005
China (N=4122; 60–70) 11.0 Launer and Harris 1996
The Czech Republic (N=1432; 25–64) Bobak et al. 1999
Finland (N=4122; 65–75) 14.0 Launer and Harris 1996
Greece (N=46; 70–79) 13.0 ”
Italy (N=484; 65–75) 11.0 ”
Lithuania (N=40; 60–65) Ožeraitienė and Būtėnaitė 2006
Mexico (N=1574; 60–70) 9.9 Sánchez-García et al. 2007
The Netherlands (N=72; 40–80) 14.0 Launer and Harris 1996
Poland (N=142; 45–70) 12.6 PLSA
Sweden (N=126; 65–75) 13.0 Launer and Harris 1996
The United Kingdom (N=147; 40–75) 13.0 Lean et al. 1996
The United States (N=9019; 40–80) 13.0 Zhu et al. 2002
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164 Piotr Chmielewski, Krzysztof Borysławski, Krzysztof Chmielowiec, JolantaChmielowiec
United Kingdom, and the United States
of America (Fig. 3). The analyzed group
of women from the Polish Longitudinal
Study of Aging had on average taller stat-
ure compared with subjects from China.
There were no signicant differences in
height between women from the Polish
Longitudinal Study of Aging and those
from Italy, Greece, the Czech Republic,
Mexico, and Brazil. Interestingly, no sig-
nicant changes with age in stature were
observed in men from Mexico aged 60 to
70 (cf. Fig. 2). Between the ages of 65
and 75, men from Finland and China lost
around 1.0 cm, while men from Brazil, It-
aly and the United States had a reduction
in height that was twice higher, albeit no
differences between the rates of decline
were found (ANOVA, p>0.05). In wom-
en from Brazil, Italy, Finland, and the
United States height declined by about
2.0 cm within the same space of time.
Higher rate of decrease in stature was
observed in women from China (nearly
4.0 cm/decade) and from the Nether-
lands (about 3.0 cm/decade). In general,
between the ages of 70 and 80, the reduc-
tion in height amounted to nearly 2.0 cm
in men and over 2.0 cm in women.
The strength of the analyzed rela-
tionship between the rate of decline in
stature and biological condition of men
and women is likely to vary among older
individuals from different regions of the
world (cf. Moayyeri et al. 2008) and usu-
ally depends on initial age of reduction in
height, sex, general health status, medical
care, socioeconomic differentiation, and
physical activity level (Moayyeri 2008).
The rate of decrease in height with aging
in the subjects from the Polish Longitu-
dinal Study of Aging is commensurate
with the rate of height loss for other in-
vestigated populations. Postmenopausal
women experience a more rapid loss of
height at later stages of ontogeny com-
pared with men, which is in agreement
with results of other studies (Sorkin et
Fig. 2. The rate of height reduction with age in men from the analyzed populations expressed as cross-sec-
tional and longitudinal changes in height in the consecutive ve-year periods under study
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Height loss with advancing age in hospitalized adults 165
al. 1999; Hillier et al. 2012; Preedy 2012).
Individuals with mobility problems, hy-
pokinesia, and those who lead sedentary
lifestyle are more likely to develop other
negative health-related outcomes which
can further aggravate the problem of re-
gressive changes in body height. By and
large, physical inactivity in older people
due to sedentary lifestyle, mobility prob-
lems, hypokinesia, and iatrogenic effects
of lengthy hospitalization can lead to an
increased rate of reduction in stature. At
the same time, these problems are linked
to higher risk of developing cardiovascu-
lar disease in older patients.
Numerous anthropological and epi-
demiological studies have shown that a
rapid loss of height with age can be a re-
liable indicator of increased risk of oste-
oporosis, fractures, falls, physical frailty,
and susceptibility to certain aging-asso-
ciated diseases. For example, a large pro-
spective study that followed 4,213 men
whose stature was assessed between the
ages of 40 and 59 and again 20 years later
(i.e. between the ages of 60–79) showed
that a rapid loss of height (i.e. 3 cm)
was independently associated with an
increased risk of all-cause as well as
cause-specic mortality (Wannamethee
et al. 2006). Marked rate of loss of height
with age and morbidity rate were corre-
lated except for risk of cancer and dia-
betes mellitus. Wannamethee and asso-
ciates (2006) established that the rapid
loss of height (3 cm over 20 years) was
associated with increased mortality even
after adjustment for several important
confounding factors such as age, social
class, smoking, alcohol intake, physical
activity, body mass index, preexisting
coronary heart disease, stroke, diabetes
mellitus, systolic blood pressure, serum
total cholesterol, high-density lipopro-
tein cholesterol, and some other con-
founders. Therefore, they showed that
rapid loss of height in older men (and
not necessarily only in older men with
Fig. 3. The rate of height reduction with age in women from the analyzed populations expressed as
cross-sectional and longitudinal changes in height in the consecutive ve-year periods under study
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166 Piotr Chmielewski, Krzysztof Borysławski, Krzysztof Chmielowiec, JolantaChmielowiec
preexisting cardiovascular disease) is
linked to an increased risk of both car-
diovascular disease and all-cause mortal-
ity. Height loss greater than 5 cm over
15 years in older women (N=3,124) was
associated with a substantially increased
risk of hip fracture, non-vertebral frac-
ture, and mortality, independently of the
occurrence of vertebral fractures and re-
duced bone mineral density (Hillier et al.
2012).
Furthermore, it was earlier demon-
strated that middle-aged and older men
and women with annual height loss>0.5
cm are at signicantly higher risk of os-
teoporotic fractures and their negative
after-effects (Wannamethee et al. 2006).
Moayyeri et al. (2008) established that
the the rate of loss of height greater than
2 cm within four years is a strong pre-
dictor of future osteoporotic fractures.
The study concluded that serial measure-
ments of height should be recommended
as part of a basic geriatric assessment.
Regrettably, such measurements are not
routinely performed by clinicians caring
for older people. Many researchers have
come to the conclusion that astute cli-
nicians who systematically evaluate re-
gressive changes with age in height of
their charges are able to correctly predict
the increased risk of fractures, morbidi-
ty, and mortality among elderly patients
(Wannamethee et al. 2006; Moayyeri et
al. 2008; Hillier et al. 2012).
Conclusions
Age-related reduction in adult stature
is an ineluctable process which devel-
ops even in healthy and physically active
persons. After menopause, older women
experience a more rapid decrease in their
height. The interrelationship between
the higher rate of decline in stature with
age and the increased risk of morbidity
and mortality depends on certain biolog-
ical and socioeconomic factors. Patients
who experience a substantial loss of
height are at higher risks of cardiovascu-
lar disease and all-cause mortality. The
rate of regressive changes with age in
body height can be used as an inexpen-
sive and reliable measure of health status
and general biological condition of older
individuals. Furthermore, the rate of loss
of height may provide useful prognostic
information for geriatric clinicians caring
for elderly people.
Authors’ contributions
PCh conceived the study, interpreted the
results and wrote the paper; KB super-
vised the research and was a proofreader;
KCh collected the data and performed
statistical analysis; JCh helped collect and
interpret the data and provided a critical
review. All authors read and approved
the nal version of the manuscript.
Conict of interest
The authors declare that there is no con-
ict of interest.
Corresponding author
Piotr Chmielewski
Department of Anatomy, Faculty of
Medicine, Wroclaw Medical University,
Chałubińskiego 6a, 50-368 Wrocław, Po-
land, e-mail address:
piotr.chmielewski@umed.wroc.pl
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... The decline in body height and the risk of death in older people STRESZCZENIE ABSTRACT rozmiarów ciała, niektórych czynników psychobiologicznych, a przede wszystkim od trybu i stylu życia, w tym diety i poziomu aktywności fizycznej [1]. Przykładem typowych i naturalnych zmian wstecznych jest postępująca z wiekiem utrata wysokości ciała, osiągniętej po ukończeniu procesów wzrostu organizmu [3,4]. ...
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... In the years 1960-2000, the asylum provided care for impoverished people from the lower socio-economic strata, and functioned as long-term sheltered accommodation for people with social recommendations. The reason for keeping these people there for many years was to separate them from the rest of the socialistic society, which was a socially and politically motivated decision Chmielewski et al. 2015a;2015b;2016) Medical data on health profiles, which were stored at the archive of case history, concerned a population of 3500 patients. Longitudinal data were available from 142 physically healthy individuals, including 68 men and 74 women, who were 45 years old at the commencement and 70 years old at the end of the period under study. ...
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... It has previously been established that body height is a good and reliable proxy for health status at both progressive and regressive stages of ontogeny, and tallness is believed to be associated with better health, higher SES, reduced all-cause mortality, and longer life expectancy (Waaler 1984;Nyström Peck and Vågerö 1987;Holl et al. 1991;Allebeck and Bergh 1992;Elo and Preston 1992;Herbert et al. 1993;Power and Matthews 1997;Silventoinen et al. 1999;Cavelaars et al. 2000;Jousilahti et al. 2000;Lawlor et al. 2002;2004;Engeland et al. 2003 Chmielewski et al. 2015a;2015b;2016a;2016b;Perkins et al. 2016). The better health status, nutrition, environmental conditions, medical care, and prophylaxis during the progressive development, the taller the individuals are in a given population. ...
... First, individuals born earlier were significantly shorter than those who were born later (the secular changes in height), and the latter lived significantly shorter than the former (the cohort effect) because the lifetime of each subject lasted until the fixed limit of the years 2004-2008. Second, long-lived subjects are also shorter, on average, than their short-lived peers as they experience the regressive changes in body height for a relatively longer time (Sorkin et al. 1999;Chmielewski et al. 2015a;2015b;2016b). Although only the first effect was controlled in the present study, the second one is unlikely to blur the longevity picture. ...
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... Samaras points to the inverse relationship between adult height and longevity within homogenous populations with relatively high socioeconomic status, which can result from relatively lower risk of cancer as well as lower risk of some other chronic diseases in shorter individuals compared with taller and Unauthenticated Download Date | 12/30/19 2:55 PM stouter ones (Gunnel et al. 2001;Percik and Stumvoll 2009;Cairns and Green 2013;Kabat et al. 2013). In fact, these two completely different views may coincide because the biological causes and consequences of both very short and very tall stature can be deleterious to health in old age (Chmielewski et al. 2015a;2015b;2016b;Chmielewski 2016;Chmielewski and Borysławski 2016). For example, the findings that shorter people tend to live longer compared with taller ones are understandable in the light of the entropy hypothesis since smaller bodies are composed of fewer cells and contain relatively lower levels of growth hormone (GH) and IGF-1 which are involved in growth and cell proliferation (Samaras 2007;Bartke 2012;Bianconi et al. 2013;He et al. 2014). ...
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... Valószínű, hogy a testsúly-és testmagasságadatok megjelölése az életkor előrehaladtával egyre pontatlanabbá válik, a hiba az értékek felidézésével lehet kapcsolatos. A testmagasságra vonatkozó pontatlanságot magyarázhatja az életkori testmagasságcsökkenés, amely már a negyven-ötvenéveseknél elkezdődik, és évtizedenként az 1-2 cm-t is elérheti (Chmielewski et al., 2015), de a 80 éves férfiaknál összességében átlagosan 5, nőknél pedig 8 cm is lehet a csökkenés (Sorkin et al., 1999). Ugyanakkor nem biztos, hogy ez mindenkiben tudatosul, ezért önbevallásnál a valamikor fiatalabb életkorban mért testmagasságot mondják a kérdezőknek. ...
... These subjects were patients and residents of the psychiatric hospital in Cibórz (Lubuskie Province, Poland) and from a residential home which provided care for older and ill people from the lower socioeconomic strata. In the PLSA, rate and pattern of age-related changes in numerous biological parameters in longitudinally studied subjects were compared with cross-sectional data from 225 individuals who differed in lifespan (Chmielewski et al. 2015a;2015b). The cross-sectional analysis revealed that the highest age at death was associated with lower but normal total leukocyte counts and granulocyte counts (Chmielewski et al. 2016b). ...
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... This fact boosts the value of the study sample and makes it quite unique. Further details of the study sample and data collection are described elsewhere (Borysławski et al. 2015;Chmielewski et al. 2015a;2015b;2016). To analyze changes with age in the selected parameters as well as test possible differences in the individuals who differed in body size, three anthropometric measures were used and three dichotomous divisions of the study sample were made. ...
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In elderly people, anemia occurs with increasing frequency with each advancing decade and can be a harbinger of very serious health conditions, including gastrointestinal bleeding, gastric and duodenal ulcers, and cancer. Therefore, age-dependant changes in hematological parameters deserve special attention. Nonetheless, very few longitudinal studies of aging have focused on possible associations between basic anthropometric characteristics and hematological parameters in older people. Here, we present some evidence that body size can be associated with red blood cell count as well as some other selected hematological parameters in adults aged 45 to 70 years. Longitudinal data on anthropometric and hematological parameters have been obtained from physically healthy residents at the Regional Psychiatric Hospital for People with Mental Disorders in Cibórz, Lubuskie Province, Poland (142 individuals, including 68 men and 74 women). The residents who took psychoactive drugs were excluded from the study. To evaluate the studied relationships, three anthropometric traits were used and three dichotomous divisions of the study sample were made. The medians of body height, body weight, and body mass index at the age of 45 years were used to divide the sample into: shorter and taller, lighter and heavier, and slimmer and stouter individuals, respectively. Student's t-test, Pearson's correlation, and regression analysis were employed. The results of the present study suggest that the relationship between body size and red blood cell count is slightly more pronounced in men and its strength depends on age. However, the correlations between body size and red blood cell count proved to be weak in both sexes. With aging, the strength of the relation decreased gradually, which might have been caused by the aging-associated changes in the hematopoietic system, anemia, or was an artifact. Further studies are needed to elucidate the unclear association between body size and hematological parameters in older adults.
... Interestingly, this dualism corresponds to the well-known problem of aging as a disease and aging as normal part of development. Thus, a number of multi-level structural and functional changes with age in numerous biological traits (Borysławski et al. 2015;Chmielewski et al. 2015a;2015b) inevitably lead to death and determine lifespan. A variant of this approach is the widespread and popularized disposable soma theory proposed by Kirkwood (1977;. ...
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