Frailty and Body Mass Index as Predictors of 3-Year Mortality in Older Adults Living in the Community

Abstract

Background: Frailty and body mass index (BMI) are known to be predictive of late life mortality, but little is known about the combined effects of frailty and BMI on mortality. Objective: This study investigated the influence of frailty status and BMI category on mortality in older adults. Methods: Data were from the Living Profiles of Older People Survey, a national survey of community-dwelling older people in Korea, with a baseline study of 11,844 Koreans aged 65 years and older in 2008 and a 3-year follow-up for mortality. Frailty was categorized as not frail, prefrail, and frail, based on five indicators (weight loss, exhaustion, physical activity, walking speed, and grip strength). BMI (kg/m²) was classified as underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9), or obese (≥30.0). A Cox proportional model was used to analyze the association of the combined frailty and BMI categories with all-cause mortality, adjusting for sociodemographics and health-related factors. Results: Adjusting for covariates, compared with the normal-weight nonfrail counterpart, the underweight or normal-weight prefrail/frail status demonstrated significantly increased rates of death. The obese frail respondents showed a significantly higher mortality risk (hazard ratio, 3.89; 95% confidence interval, 1.14-13.28). The overweight prefrail/frail group, however, exhibited no significant association with mortality. Conclusion: Among older people who were of normal weight or underweight, greater frailty was associated with poorer survival. Whereas being overweight tended to be neutral of the influence of frailty on mortality, the obese frail exhibited a significantly elevated rate of death.

Association Between Anthropometric Measures and Long‐Term Survival in Frail Older Women: Observations from the Women's Health Initiative Study

“…The Study of Osteoporotic Fractures in older women showed that frailty affects mortality across all categories of BMI, although examination of the tables reported in the manuscript indicated that the effect of frailty on mortality tends to be less pronounced for overweight and obese women. 11 Another study showed that obesity in persons with frailty was associated with greater mortality than in nonfrail normal-weight individuals, 13 although these findings should be interpreted in light of the type of reference group used. Both studies used nonfrail participants as the comparison category, which allowed for testing of effect modification according to frailty status rather than examining the effect of BMI on mortality in those with frailty.…”

Body Mass Index and Mortality according to Gender in a Community-Dwelling Elderly Population: The 3-Year Follow-up Findings from the Living Profiles of Older People Surveys in Korea

“…Research in South Korea on the effects of frailty and BMI on mortality rates in community-dwelling elderly people showed that frailty and BMI significantly increased the mortality rate in men and women 20). In our study, the analysis was stratified according to sex, and the association between BMI and mortality rate was statistically significant in men, but not in women, after adjusting for confounding variables.…”

“…A number of studies have reported the association between BMI and mortality in South Korea 41617181920). However, there are limited studies specifically investigating the association between BMI and mortality according to sex in the elderly.…”

Criterios de fragilidad en personas mayores que viven en la comunidad: una actualización de la literatura

“…En relación a lo previo, se ha reportado que índices de masa corporal (IMC) mayores a 30 15 y adiposidad central fueron predictivos de fragilidad 21 . Asimismo, un estudio realizado en Corea en el año 2014 estableció que los encuestados frágiles obesos mostraron mayor riesgo de mortalidad 22 . Concordante con lo anterior, existe evidencia que establece que la multimorbilidad es un predictor de fragilidad 17 .…”