Body mass index as a predictor of mortality in community-dwelling seniors
First Online: 25 July 2013 Received: 14 October 2004 Accepted: 16 September 2005 DOI:
10.1007/BF03324650 Cite this article as: Inoue, K., Shono, T., Toyokawa, S. et al. Aging Clin Exp Res (2006) 18: 205. doi:10.1007/BF03324650 Abstract Background and aims: The relationship between body mass index (BMI) and mortality remains inconclusive in seniors. This study aimed at assessing this relationship in a community-dwelling elderly population in Japan. Methods: The subjects were 371 Japanese elders, 65 years old and older, who lived in a geographically well-defined rural community and had participated in a general health screening program in 1995. Both height and weight of subjects were measured directly by medical staff. Subjects were classified into three groups according to their BMI values: low, <18.5; normal, 18.5–25.0; and high, >25.0. Univariate analysis was applied to explore potential associations between mortality and possible confounders. Multivariate Cox proportional hazards models were used to analyze the association between mortality and BMI, after adjusting for other risk factors. Results: At baseline, 54 subjects (14.6%) had BMI values in the low range, 280 (75.5%) in the normal range, and 37 (10.0%) in the high range. All 371 subjects were followed prospectively for mortality. Over the next five years, 37 subjects had died. In univariate analysis, male sex, age, BMI and serum creatinine were associated with mortality. The mortality rate in the low BMI group was about twice that in the normal BMI group. No deaths were observed in the higher BMI group. In multivariate analysis, age and low BMI were associated with mortality. Conclusions: BMI may be a useful predictor of mortality among seniors living in the general, non-institutionalized population. Key words Body mass index cohort study community-dwelling elderly people mortality References
Katzmarzyk PT, Craig CL, Bouchard C. Original article underweight, overweight and obesity: relationships with mortality in the 13-year follow-up of the Canada Fitness Survey. J Clin Epidemiol 2001; 54: 916–20.
Seidell JC, Visscher TL, Hoogeveen RT. Overweight and obesity in the mortality rate data: current evidence and research issues. Med Sci Sports Exerc 1999; 31 (Suppl. 1): S597–601.
Troiano RP, Frongillo EA Jr, Sobal J, Levitsky DA. The relationship between body weight and mortality: a quantitative analysis of combined information from existing studies. Int J Obes 1996; 20: 63–75.
Manson JE, Willett WC, Stampfer MJ, et al. Body weight and mortality among women. N Engl J Med 1995; 51: 677–85.
Tsugane S, Sasaki S, Tsubono Y. Under- and overweight impact on mortality among middle-aged Japanese men and women: a 10- yr follow-up of JPHC study cohort I. Int J Obes 2002; 26: 529–37.
Allison DB, Gallagher D, Heo M, Pi-Sunyer FX, Heymsfield SB. Body mass index and all-cause mortality among people age 70 and over: the Longitudinal Study of Aging. Int J Obes 1997; 21: 424–31.
Diehr P, Bild DE, Harris TB, Duxbury A, Siscovick D, Rossi M. Body mass index and mortality in nonsmoking older adults: the Cardiovascular Health Study. Am J Public Health 1998; 88: 623–9.
Sergi G, Perissinotto E, Pisent C, et al. An adequate threshold for body mass index to detect underweight condition in elderly persons: the Italian Longitudinal Study on Aging (ILSA). J Gerontol 2005; 60: 866–71.
Seccareccia F, Lanti M, Menotti A, Scanga M. Role of body mass index in the prediction of all cause mortality in over 62,000 men and women. The Italian RIFLE Pooling Project. Risk Factor and Life Expectancy. J Epidemiol Community Health 1998; 52: 20–6.
Stevens J, Plankey MW, Williamson DF, et al. The body mass index-mortality relationship in white and African American women. Obes Res 1998; 6: 268–77.
Inoue K, Matsumoto M. Homebound status in a community- dwelling elderly population in Japan. Asia Pac J Public Health 2002; 76: 109–15.
World Health Organization. Obesity: preventing and managing the global epidemic. Geneva: WHO, 1998.
National Institute of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults- the evidence report. Obes Res 1998; 6 (Suppl 2): S51–209.
Hsieh SD, Yoshinaga H, Muto T. Waist-to-height ratio, a simple and practical index for assessing central fat distribution and metabolic risk in Japanese men and women. Int J Obes Relat Metab Disord 2003; 27: 610–6.
Flodin L, Svensson S, Cederholm T. Body mass index as a predictor of 1 year mortality in geriatric patients. Clin Nutr 2000; 19: 121–5.
Miyazaki M, Babazono A, Ishii T, et al. Effects of low body mass index and smoking on all-cause mortality among middle-aged and elderly Japanese. J Epidemiol 2002; 12: 40–4.
Taylor DH Jr, Ostbye T. The effect of middle- and old-age body mass index on short-term mortality in older people. J Am Geriatr Soc 2001; 49: 1319–26.
Landi F, Zuccala G, Gambassi G, et al. Body mass index and mortality among older people living in the community. J Am Geriatr Soc 1999; 47: 1072–6.
Hogan DB, MacKnight C, Bergman H. Models, definitions, and criteria of frailty. Aging Clin Exp Res 2003 (Suppl); 15: S3–29.
Dyer AR. Long-term consequences of body mass index for cardiovascular mortality: the Chicago heart association detection project in industry study. Ann Epidemiol 2004; 14: 101–8.
Manson JE, Stampfer MJ, Hennekens CH, Willett WC. Body weight and longevity. A reassessment. JAMA 1987; 257: 353–8.
Bender R, Jockel KH, Trautner C, Spraul M, Berger M. Effect of age on excess mortality in obesity. JAMA 1999; 281: 1498–504.
Dorn JM, Schisterman EF, Winkelstein W Jr, Trevisan M. Body mass index and mortality in a general population sample of men and women. the Buffalo Health Study. Am J Epidemiol 1997; 146: 919–31.
Deschamps V, Astier X, Ferry M, Rainfray M, Emeriau JP, Bar-berger-Gateau P. Nutritional status of healthy elderly persons living in Dordogne, France, and relation with mortality and cognitive or functional decline. Eur J Clin Nutr 2002; 56: 305–12.
Grabowski DC, Ellis JE. High body mass index does not predict mortality in older people: analysis of the Longitudinal Study of Aging. J Am Geriatr Soc 2001; 49: 968–79.
Bo M, Massaia M, Raspo S, et al. Predictive factors of in-hospital mortality in older patients admitted to a medical intensive care unit. J Am Geriatr Soc 2003; 51: 529–33.
Stevens J, Keil JE, Waid LR, Gazes PC. Accuracy of current, 4- year, and 28-year self-reported body weight in an elderly population. Am J Epidemiol 1989; 12: 1156–63.
Rowland ML. Self-reported weight and height. Am J Clin Nutr 1990; 52: 1125–33.
Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath Jr CW. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 1999; 341: 1097–105.
Inoue M, Sobue T, Tugane S. Impact of body mass index on the risk of total cancer incidence and mortality among middle- aged Japanese: data from a large-scale population-based cohort study — the JPHC study. Cancer Causes Control 2004; 15: 671–80.
Inoue K, Matsumoto M. Nature and nurture in a diabetes epidemic. Pract Diab Int 2002; 19: 35–6.
Stamler J. Epidemic obesity in the United States. Arch Intern Med 1993; 153: 1040–4.
Folsom AR, Li Y, Rao X, et al. Body mass, fat distribution and cardiovascular risk factors in a lean population of south China. J Clin Epidemiol 1994; 16: 173–81.
Ferrara A, Barrett-Connor E, Shan J. Total, LDL, and HDL cholesterol decrease with age in older men and women: the Ran- cho Bernardo study 1984–1994. Circulation 1997; 96: 37–43.
Tiao JY, Semmens JB, Masarei JR, Lawrence-Brown MM. The effect of age on serum creatinine levels in an aging population: relevance to vascular surgery. Cardiovasc Surg 2002; 10: 445–51.
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