Association of Body Mass Index and Weight Change with All-Cause Mortality in the Elderly

Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California, United States
American Journal of Epidemiology (Impact Factor: 5.23). 06/2006; 163(10):938-49. DOI: 10.1093/aje/kwj114
Source: PubMed


The authors explored the relation of body mass index (BMI; weight (kg)/height (m)(2)) and weight change to all-cause mortality in the elderly, using data from a large, population-based California cohort study, the Leisure World Cohort Study. They estimated relative risks of mortality associated with self-reported BMI at study entry, BMI at age 21 years, and weight change between age 21 and study entry. Participants were categorized as underweight (BMI <18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9), or obese (BMI >or=30). Of 13,451 participants aged 73 years (on average) at study entry (1981-1985), 11,203 died during 23 years of follow-up (1981-2004). Relative to normal weight, being underweight (relative risk (RR) = 1.51, 95% confidence interval (CI): 1.38, 1.65) or obese (RR = 1.25, 95% CI: 1.13, 1.38) at study entry was associated with increased mortality. People who were either overweight or obese at age 21 also had increased mortality (RR = 1.17, 95% CI: 1.09, 1.25). Participants who lost weight between age 21 and study entry had increased mortality regardless of their BMI category at age 21. Obesity was significantly associated with increased mortality only among persons under age 75 years and among never or past smokers. This study highlights the influence on older-age mortality risk of being overweight or obese in young adulthood and underweight or obese in later life.

Download full-text


Available from: María M Corrada, Jun 20, 2014
  • Source
    • "The Body Mass Index (BMI) is widely used in the assessment of under-nutrition or frailty in elderly people. However, the association between BMI and mortality in elderly people is still debated (Corrada et al., 2006; Flegal et al., 2011; Thinggaard et al., 2010; Wijnhoven et al., 2010). In the oldest old, the condition of being underweight (BMI b 18.5 kg/m 2 ) has been recognized as one of the most relevant predictors of mortality in centenarians (Gueresi and Miglio, 2010) and, conversely , high BMI scores emerged as significant predictors of survival in nonagenarian siblings (Cevenini et al., 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Being indicators of nutritional and functional status, anthropometric characters may have great prognostic significance for survival at extremely advanced ages. For ethical and practical reasons however it is advisable to use characters such as arm measurements easily measurable even in bedridden subjects. This study compares the influence of some upper arm measurements and of Body Mass Index (BMI) on survival of the 77 subjects aged 98years and over (98+) recruited within the MALVA project, one of the first Italian population-based studies on extremely old people. Adopting methods for multiple imputation of missing values, Gompertz regression models adjusted for gender and age were estimated for each anthropometric character or combination of characters, i.e. BMI; mid-upper arm circumference (MUAC)+elbow breadth (EB)+triceps skinfold thickness (TSF); corrected arm muscle area (CAMA). Being underweight and having a low CAMA and a low MUAC/high EB were positively associated with an increased risk of death, while no significant association was found with the condition of being overweight/obese and the triceps skinfold thickness. When anthropometric variables were included in regression models along with covariates relating to nutritional and functional status, BMI and MUAC, but not CAMA, emerged as protective factors. It is suggested that MUAC can be recommended in evaluating the health status of extremely old people and that measuring EB may help to estimate the non-boney component of the arm.
    Full-text · Article · Aug 2014 · Experimental Gerontology
  • Source
    • "Our results show that obesity effects were attenuated during aging, despite the alterations first observed at young ages. Increasing evidence suggests that the association between obesity and mortality declines with advancing age in both genders [76]. Therefore, it might be important to discuss the paradigm that obesity is always associated with a significantly higher risk of all-cause mortality [77], because it is unknown if the obesity-mortality association is sustained at old age. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Obesity, from children to the elderly, has increased in the world at an alarming rate over the past three decades, implying long-term detrimental consequences for individual's health. Obesity and aging are known to be risk factors for metabolic disorder development, insulin resistance and inflammation, but their relationship is not fully understood. Prevention and appropriate therapies for metabolic disorders and physical disabilities in older adults have become a major public health challenge. Hence, the aim of this study was to evaluate inflammation markers, biochemical parameters and glucose homeostasis during the obese-aging process, to understand the relationship between obesity and health span during the lifetime. In order to do this, the monosodium glutamate (MSG) obesity mice model was used, and data were evaluated at 4, 8, 12, 16 and 20 months in both female and male mice. Our results showed that obesity was a major factor contributing to premature alterations in MSG-treated mice metabolism; however, at older ages, obesity effects were attenuated and MSG-mice became more similar to normal mice. At a younger age (four months old), the Lee index, triglycerides, total cholesterol, TNF-α and transaminases levels increased; while adiponectin decreased and glucose tolerance and insulin sensitivity levels were remarkably altered. However, from 16 months old-on, the Lee index and TNF-α levels diminished significantly, while adiponectin increased, and glucose and insulin homeostasis was recovered. In summary, MSG-treated obese mice showed metabolic changes and differential susceptibility by gender throughout life and during the aging process. Understanding metabolic differences between genders during the lifespan will allow the discovery of specific preventive treatment strategies for chronic diseases and functional decline.
    Full-text · Article · Jul 2014 · International Journal of Molecular Sciences
  • Source
    • "In the present study, BMI was not significantly associated with nighttime BP, whereas, we previously reported that LAN exposure !3 lux is associated with obesity (Obayashi et al., 2013). In previous epidemiological studies in elderly individuals, the associations of BMI with cardiovascular and all-cause mortality were not linear but U-shaped (Corrada et al., 2006; Romero- Corral et al., 2006). In addition, the prevalence of obese elderly (BMI ! "
    [Show abstract] [Hide abstract]
    ABSTRACT: Circadian misalignment between internal and environmental rhythms dysregulates blood pressure (BP) variability because of disruption of the biological clock, resulting in increased nighttime BP. Although exposure to light-at-night is associated with the circadian misalignment, it remains unclear whether exposure to light-at-night in home settings is associated with nighttime BP. In this cross-sectional analysis of 528 elderly individuals (mean age: 72.8 years), we measured bedroom light intensity at 1-min intervals on two consecutive nights along with ambulatory BP, overnight urinary melatonin excretion and actigraphy. With regard to adjusted mean comparisons using analysis of covariance, the light-at-night group (average: ≥5 lux; n = 109) showed significantly higher nighttime systolic BP (SBP; adjusted mean: 120.8 vs. 116.5 mmHg, p = 0.01) and diastolic BP (70.1 vs. 67.1 mmHg, p < 0.01) compared with the Darker group (average: <5 lux; n = 419) independently of potential confounding factors including overnight urinary melatonin excretion and actigraphic sleep quality. We observed consistent associations between light-at-night and nighttime BP in different cutoff values for light-at-night intensity (i.e. 3 and 10 lux). In conclusion, exposure to light-at-night in home settings is significantly associated with increased nighttime BP in elderly individuals independently of overnight urinary melatonin excretion. A 4.3 mmHg increase in nighttime SBP is associated with a 6.1% increase in total mortality, which corresponds to approximately 10 000 annual excess deaths in Japanese elderly population.
    Full-text · Article · Mar 2014 · Chronobiology International
Show more