A systematic review of the literature concerning the relationship between obesity and mortality in the elderly

Donini, Lorenzo Maria; Savina, C.; Gennaro, E. De; Felice, M. R. De; Rosano, Aldo; Pandolfo, Mayme Mary; Balzo, Valeria del; Cannella, C.; Ritz, Patrick; Chumlea, Wm. Cameron

doi:10.1007/s12603-011-0073-x

Cited by 89 publications

(78 citation statements)

References 45 publications

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“…Within the context of cardiovascular diseases, several studies have shown a survival benefit in non-CKD elderly patients after intentional weight loss. 20 The present results are not in agreement with this in hemodialysis patients, but it did not distinguish between intentional and unintentional weight losses.…”

Section: Discussioncontrasting

confidence: 99%

“…19 However, the majority of previous studies that evaluated the association between BMI and survival in general geriatric populations found a U-shaped relationship in which the lowest mortality rates corresponded to BMIs ranging between 23.5 and 27.5 kg/m 2 . 20 In the present study of European elderly hemodialysis patients, there were only 11.2% obese patients, which is 10% less than the proportion reported by Kalantar-Zadeh et al 21 in a nonelderly hemodialysis population in the United States.…”

Section: Discussioncontrasting

confidence: 58%

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Impact of BMI Variations on Survival in Elderly Hemodialysis Patients

Villain¹,

Écochard²,

Genet³

et al. 2015

Journal of Renal Nutrition

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 58%

Impact of BMI Variations on Survival in Elderly Hemodialysis Patients

Villain¹,

Écochard²,

Genet³

et al. 2015

Journal of Renal Nutrition

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“…64 However, the results of one systematic review found an increased mortality in obese older adults. 103 Energy reserves during time of stress, illness and trauma, protection against osteoporosis, lower risk of falls, and reduced post-fall trauma, may explain some of the observed protective effect seen in studies of overweight and obesity with mortality in older adults. Results could also be complicated by disease burden, health and hydration status, as well as limitations with anthropometric measurements in this population.…”

Section: Body Weight and Compositionmentioning

confidence: 99%

Position of the Academy of Nutrition and Dietetics: Food and Nutrition for Older Adults: Promoting Health and Wellness

Bernstein

Muñoz

2012

Journal of the Academy of Nutrition and Dietetics

237

163

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“…Thus BMI depends not only on adiposity but also on the loss of muscle mass which has opposing effects on mortality (13) , so that BMI may not be a good indicator of obesity in the elderly. It is suggested that measures of adiposity such as waist circumference (WC) or the waist:hip ratio, which better reflect visceral fat, may be more useful at assessing obesity risk as they are better at predicting CVD and mortality in older subjects (22)(23)(24)(25)(26) . Central obesity has been defined as a WC > 102 cm for men and >88 cm for women, or a waist:hip ratio ⩾0·9 for men and ⩾0·85 for women (27) .…”

mentioning

confidence: 99%

Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity

2015

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Conference on 'Nutrition and age-related muscle loss, sarcopenia and cachexia' Symposium 4: Sarcopenia and cachexia and social, clinical and public health dimensionsMuscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity S. Goya Wannamethee* and Janice L. AtkinsDepartment of Primary Care and Population Health, University College London, Royal Free Campus, London NW3 2PF, UK This paper reviews the health implications of obesity, sarcopenia and sarcopenic obesity on CVD and mortality in older adults and discusses the obesity paradox seen in patients with CVD. Obesity is a major public health problem with increasing prevalence worldwide. It is an established risk factor for cardiovascular morbidity and mortality in adult populations. However, there is controversy surrounding the effects of obesity as measured by BMI in older people, and overweight and obesity (BMI ⩾ 25 kg/m 2 ) are apparently associated with increased survival in those with CVD (obesity paradox). Ageing is associated with an increase in visceral fat and a progressive loss of muscle mass which have opposing effects on mortality. Thus BMI is not a good indicator of obesity in older adults. Sarcopenia, the age-associated loss of skeletal muscle mass, is a major concern in ageing populations and has been associated with metabolic impairment, CVD risk factors, physical disability and mortality. Sarcopenia often coexists with obesity. Sarcopenic obesity is a new category of obesity in older adults who have high adiposity coupled with low muscle mass. To fully understand the effect of obesity on mortality in the elderly it is important to take muscle mass into account. The evidence suggests that sarcopenia with obesity may be associated with higher levels of metabolic disorders and an increased risk of mortality than obesity or sarcopenia alone. Efforts to promote healthy ageing should focus on both preventing obesity and maintaining or increasing muscle mass.Obesity: Muscle: Sarcopenia: CVD: Mortality: Older adults Obesity, i.e. excess body fat usually defined as BMI ⩾ 30 kg/m 2 , is a major public health problem and is well recognised as a risk factor for cardiovascular morbidity and mortality in adult populations. Obesity prevalence in middle-aged and older adults continues to increase worldwide and has doubled since 1980 (1,2) . However, there is controversy surrounding the effects of overweight and obesity in older people, with many studies showing that being overweight, as defined by BMI of 25-29 kg/m 2 , does not appear to be as harmful in the elderly as in middle-aged populations and may even be associated with lower, rather than higher, mortality (3)(4)(5) . In addition, a large body of evidence indicates that overweight and obesity (BMI ⩾ 25 kg/m 2 ) are associated with increased survival in patients with CVD and in particular those with heart failure, an unexpected finding termed the obesity paradox (6)(7)(8)(9)(10) . The mechanisms of these paradoxical association remain largely unexplained but a number of explana...

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A systematic review of the literature concerning the relationship between obesity and mortality in the elderly

Cited by 89 publications

References 45 publications

Impact of BMI Variations on Survival in Elderly Hemodialysis Patients

Impact of BMI Variations on Survival in Elderly Hemodialysis Patients

Position of the Academy of Nutrition and Dietetics: Food and Nutrition for Older Adults: Promoting Health and Wellness

Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity

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