Comparison of body mass index range criteria and their association with cognition, functioning and depression: a cross-sectional study in Mexican older adults

Abstract

BackgroundWorld population is living longer, demanding adjustments in public health policies. Body mass index (BMI) is widely known and used as a parameter and predictor of health status although an adapted criterion for older adults is usually overlooked. BMI has been extensively analysed in relation to mortality but fewer studies address its association with cognition, functioning and depression in older adults. The present study aimed at 1) comparing BMI distribution according to the ranges proposed by the World Health Organization (WHO) and the United States National Research Council Committee on Diet and Health (CDH), 2) analysing their association with cognitive functioning, physical functioning and depression and 3) analysing a possible, interaction of BMI criteria with sex on the outcome measures.MethodsThis cross-sectional study included 395 participants recruited by convenience sampling; 283 (71.6%) women and 112 (24.58%) men. Mean age was 74.68 (SD = 8.50, range: 60–98). Outcome measures included the Short Portable Mental State Questionnaire for cognitive status, the Barthel’s Index of Activities of Daily Living for physical functioning, and the Geriatric Depression Scale.ResultsWHO criterion classified most cases (65.3%) as overweight, followed by normal weight (32.2%) and underweight (2.5%) whereas CDH criterion considered most (48.1%) as normal weight, and followed by overweight (31.4%) and underweight (20.5%). Analysing cognitive status, independent physical functioning and depression mean scores, significant differences (p ≤ .001) were found when comparing the three weight groups (underweight, normal weight and overweight) using either the WHO- or the CDH criterion. Post-hoc tests revealed that in all comparisons the underweight group scored the lowest in all three outcome measures. According to the CDH criterion, overweight was favourable for females but unfavourable for males regarding cognitive status (interaction F(2,389) = 4.52, p ≤ .01) and independent functioning (interaction F(2,389) = 3.86, p ≤ .05).ConclusionsBMI and its associations to relevant outcome measures in the older adults must rely on criteria that take into account the particular features of this population, such as the CDH criterion. Underweight was associated with decremented cognition, less independent physical functioning and more depression. Overweight seemed favourable for women but unfavourable for men.

Association between successful aging transitions and depressive symptoms among older Korean adults: findings from the Korean longitudinal study of aging (2006–2018)

“…Furthermore, the relationship between alcohol consumption, successful aging, and depression has been previously deemed important [28], with those not meeting SA criteria turning to alcohol consumption to cope with dissatisfaction and depression. One study linked NSA with low BMI [32], while another showed that older adults who were underweight were more likely to experience depressive symptoms than their normal or overweight counterparts [33,34].…”

Synergistic Impact of Body Mass Index and Cognitive Function on All-Cause Mortality in Older Adults: A Nationwide Longitudinal Study

“…There is a close association between BMI and cognitive function in older adults. Previous studies of older adults across various ethnic groups revealed that being underweight is associated with an increased risk of cognitive decline ( 18 – 20 ) and that BMI and cognitive function share a genetic basis ( 21 , 22 ). Although these factors are important contributors to the survival and well-being of older adults, their combined effects on the risk of mortality remain unclear and require further investigation.…”

<p>Being Underweight Is Associated with Worse Surgical Outcomes of Total Knee Arthroplasty Compared to Normal Body Mass Index in Elderly Patients</p>

“…This is the first study to assess the effect of being underweight on clinical and radiologic outcomes of TKA. In many older female patients, being underweight might be associated with sarcopenia or nutritional deficiencies as well as worse cognitive status or depression 16,21,22 In addition, there have been several studies explaining the underweight of elderly patients with chronic pain, osteoporosis, and the associated frailty, which may be Figure 1 Clinical outcomes based on follow-up periods after total knee arthroplasty in underweight patients and normal body mass index (BMI). The y-axes indicate the AKS knee score, AKS function score, WOMAC score and PF scale, respectively.…”

“…15 Several studies suggested that being underweight in elderly patients could be a predictor of various unhealthy conditions such as undernutrition, worse cognitive status or depression as well as functional disability. [16][17][18] Therefore, TKA in elderly underweight patients could have poor surgical outcomes.…”