Body mass index, weight change and mortality in the elderly. A 15 y longitudinal population study of 70 y olds

Dey, DK; Rothenberg, Elisabet; Sundh, Valter; Bosæus, Ingvar; Steen, Bertil

doi:10.1038/sj.ejcn.1601208

Cited by 179 publications

(125 citation statements)

References 47 publications

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“…However, six 48,49,53,54,59,66 out of seven showed lower mortality in subjects with lower BMI, or at least a U-shaped relation between BMI and mortality. It is important to note that none of these studies were able to distinguish between intentional and unintentional weight loss.…”

Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 88%

“…In Table 2 we have summarized the most recent studies (published from 1997 to 2004 with at least 4.5 y of followup) [47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] that considered the relationship between BMI and mortality. Interpretation of these data is complicated by variation across studies in the outcome considered, confounders accounted for in the analysis (especially control for smoking and concurrent illness), the measure of obesity considered and the length of study follow-up.…”

Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 99%

“…Seven [48][49][50]53,54,59,66 out of 20 studies presented in Table 2 were able to take into account weight changes in the relation between obesity and mortality. However, six 48,49,53,54,59,66 out of seven showed lower mortality in subjects with lower BMI, or at least a U-shaped relation between BMI and mortality.…”

Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 99%

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Health consequences of obesity in the elderly: a review of four unresolved questions

et al. 2005

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Obesity prevalence is growing progressively even among older age groups. Controversy exists about the potential harms of obesity in the elderly. Debate persists about the relation between obesity in old age and total or disease-specific mortality, the definition of obesity in the elderly, its clinical relevance, and about the need for its treatment. Knowledge of age-related body composition and fat distribution changes will help us to better understand the relationships between obesity, morbidity and mortality in the elderly. Review of the literature supports that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages. Weight gain or fat redistribution in older age may still confer adverse health risks (for earlier mortality, comorbidities conferring independent adverse health risks, or for functional decline). Evaluation of comorbidity and weight history should be performed in the elderly in order to generate a comprehensive assessment of the potential adverse health effects of overweight or obesity. The risks of obesity in the elderly have been underestimated by a number of confounders such as survival effect, competing mortalities, relatively shortened life expectancy in older persons, smoking, weight change and unintentional weight loss. Identification of elderly subjects with sarcopenic obesity is probably clinically relevant, but the definition of sarcopenic obesity, the benefits of its clinical identification, as well as its relation to clinical consequences require further study. Studies on the effect of voluntary weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5-10% of initial body weight) may be beneficial. In older as well as in younger adults, voluntary weight loss may help to prevent the adverse health consequences of obesity.

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Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 88%

Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 99%

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Health consequences of obesity in the elderly: a review of four unresolved questions

et al. 2005

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“…In Sweden, one-third of aged residents living in old people's homes were malnourished (Saletti et al, 2000). Malnutrition, low body mass index (BMI) and unintentional weight loss are risk factors for mortality and have a negative influence on the functional status and psychosocial well-being of the aged population (Takala et al, 1994;Dey et al, 2001;Crogan & Pasvogel, 2003). Protein malnutrition is associated with falls, sarcopenia and hip fractures (Morley & Silver, 1995).…”

Section: Introductionmentioning

confidence: 99%

Malnutrition and associated factors among aged residents in all nursing homes in Helsinki

Muurinen²,

et al. 2005

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Objective: To acquire information about nutritional problems and factors associated with them in all nursing homes in Helsinki, Finland. Design: Descriptive, cross-sectional study. The residents were assessed by the Mini Nutritional Assessment test (MNA) and information was gathered about residents' backgrounds, functional status, diseases and about daily routines in institutions providing nutritional care. Setting: All nursing homes in Helsinki community, the capital of Finland. Subjects: Of 2424 eligible subjects, 2114 (87%) aged residents, mean age 82 y, were examined. Results: One-third (29%) of the studied residents suffered from malnutrition (MNAo17), and 60% were at risk (MNA 17-23.5). Malnutrition was associated with the female gender, a longer stay in the nursing home, functional impairment, dementia, stroke, constipation and difficulties in swallowing. In addition, eating less than half of the offered food portion, not eating snacks and resident's weight control at long intervals were associated with malnutrition. In logistic regression analysis mainly patientrelated factors predicted malnutrition: impaired functioning (OR 3.71, 95% CI 2.76-4.99), swallowing difficulties (OR 3.03, 95% CI 2.10-4.37), dementia (OR 2.06, 95% CI 1.45-2.93), constipation (OR 1.84, 95% CI 1.38-2.47), but also eating less than half of the offered food portion (OR 3.03, 95% CI 2.21-4.15). Conclusions: Although internal factors explain most about the poor nutritional status of aged residents in nursing homes, the factors related to nutritional care need further investigation to clarify their role in maintaining the nutritional status of aged residents.

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“…Conflicting results regarding the shape of the relationship have included a positive, 1 a J-shaped 2 or U-shaped, 3,4 an inverse 5 and a null 6 association. Rising prevalence of overweight and obesity in the United States 7 and other parts of the world 8 in recent decades underscores the timeliness of understanding the relation between body mass index (BMI; the weight in kilograms divided by the square of height in meters) and mortality.…”

Section: Introductionmentioning

confidence: 99%

Past body mass index and risk of mortality among women

et al. 2008

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Background: Epidemiologic studies of body mass index (BMI) in relation to mortality commonly exclude persons with health conditions and/or a history of smoking to prevent bias resulting from illness-related weight loss ('reverse causation'). Analysis of BMI from an earlier time period may minimize reverse causation without requiring exclusion of participants based on disease or smoking history. Methods: We prospectively examined BMI based on technician measurements of weight and height from 10 years prior to start of follow-up in relation to subsequent mortality in a cohort of 50 186 women who were 40-93 years old at baseline in [1987][1988][1989]. Deaths were ascertained through the US National Death Index. Proportional hazards regression was used to estimate hazard ratios (HRs) of mortality, adjusted for age, education, race/ethnicity, income, menopausal hormone use, smoking and physical activity. Results: During 10 years of follow-up through 1997, 5201 women died. Overall, we observed a J-shaped association between BMI and mortality, with increased risk for women who were underweight, overweight or obese. The HRs and 95% confidence intervals of mortality for BMI categories of o18. 5, 18.5-20.9, 21.0-23.4 (reference), 23.5-24.9, 25.0-27.4, 27.5-29.9, 30.0-34.9 and 35.0 þ kg m À2 were 1.43 (1.19, 1.72), 1.07 (0.98, 1.17), 1.00 (reference), 1.10 (1.00, 1.20), 1.20 (1.11, 1.31), 1.23 (1.11, 1.37), 1.60 (1.44, 1.77) and 1.92 (1.64, 2.24). There was little evidence that pre-existing conditions (heart disease, diabetes and/or cancer) or smoking history modified the past BMI and mortality relation (P ¼ 0.54 and 0.76). Conclusions:In this large cohort of women, BMI based on technician measurements of weight and height from 10 years prior to baseline showed increased risk for mortality across the range of overweight and obesity, regardless of disease and smoking history. Observed associations between overweight, obesity and mortality in healthy individuals may also apply to persons with a history of disease or smoking.

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Body mass index, weight change and mortality in the elderly. A 15 y longitudinal population study of 70 y olds

Cited by 179 publications

References 47 publications

Health consequences of obesity in the elderly: a review of four unresolved questions

Health consequences of obesity in the elderly: a review of four unresolved questions

Malnutrition and associated factors among aged residents in all nursing homes in Helsinki

Past body mass index and risk of mortality among women

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