The impact of body mass index in old age on cause-specific mortality
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To assess the association between Body Mass Index (BMI) and cause-specific mortality in older adults and to assess which BMI was associated with lowest mortality.
1,980 older adults, aged 70–75 years from the SENECA (Survey in Europe on Nutrition and the Elderly: a concerted action) study.
BMI, examined in 1988/1989, and mortality rates and causes of death during 10 years of follow-up.
Cox proportional hazards model including both BMI and BMI2, accounting for sex, smoking status, educational level and age at baseline showed that BMI was associated with all-cause mortality (p<0.01), cardiovascular mortality (p<0.01) and mortality from other causes (p<0.01), but not with cancer or respiratory mortality (p>0.3). The lowest all-cause mortality risk was found at 27.1 (95%CI 24.1, 29.3) kg/m2, and this risk was increased with statistical significance when higher than 31.4 kg/m2 and lower than 21.1 kg/m2. The lowest cardiovascular mortality risk was found at 25.6 (95%CI 17.1, 28.4) kg/m2, and was increased with statistical significance when higher than 30.9 kg/m2.
In this study, BMI was associated with all-cause mortality risk in older people. This risk was mostly driven by an increased cardiovascular mortality risk, as no association was found for mortality risk from cancer or respiratory disease. Our results indicate that the WHO cut-off point of 25 kg/m2 for overweight might be too low in old age, but more studies are needed to define specific cut-off points.
- Branca, F. N., Lobstein, T. In: Organization, D.W.H. eds. (2007) The challenge of obesity in the WHO European Region and the strategies for response. World Health Organization, Denmark
- Janssen, I., Mark, A.E. (2007) Elevated body mass index and mortality risk in the elderly. Obes Rev 8: pp. 41-59 CrossRef
- Flicker L, McCaul KA, Hankey GJ, Jamrozik K, Brown WJ, Byles JE, Almeida OP. Body mass index and survival in men and women aged 70 to 75. J Am Geriatr Soc; 58(2):234–241.
- Heiat, A., Vaccarino, V., Krumholz, H.M. (2001) An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Arch Intern Med 161: pp. 1194-1203 CrossRef
- Adams, K.F., Schatzkin, A., Harris, T.B., Kipnis, V., Mouw, T., Ballard-Barbash, R., Hollenbeck, A., Leitzmann, M.F. (2006) Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med 355: pp. 763-778 CrossRef
- Flegal, K.M., Graubard, B.I., Williamson, D.F., Gail, M.H. (2005) Excess deaths associated with underweight, overweight, and obesity. Jama 293: pp. 1861-1867 CrossRef
- Flegal, K.M., Graubard, B.I., Williamson, D.F., Gail, M.H. (2007) Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA 298: pp. 2028-2037 CrossRef
- Hof, M.A., Hautvast, J.G., Schroll, M., Vlachonikolis, I.G. (1991) Design, methods and participation. Euronut SENECA investigators. Eur J Clin Nutr 45Suppl3: pp. 5-22
- De Groot C VSW. Nutrition and the elderly: manual of operations. (Report 11). In: Investigators TE-S, ed. Wageningen, the Netherlands, 1988.
- Trichopoulou, A., Costacou, T., Bamia, C., Trichopoulos, D. (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348: pp. 2599-2608 CrossRef
- Knoops, K.T., Groot, L.C., Kromhout, D., Perrin, A.E., Moreiras-Varela, O., Menotti, A., Staveren, W.A. (2004) Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. Jama 292: pp. 1433-1439 CrossRef
- Voorrips, L.E., Ravelli, A.C., Dongelmans, P.C., Deurenberg, P., Staveren, W.A. (1991) A physical activity questionnaire for the elderly. Med Sci Sports Exerc 23: pp. 974-979
- International Classification of Diseases, Ninth Revision (ICD-9). World Health Organization, Geneva
- Kivimaki, M., Ferrie, J.E., Batty, G.D., Davey Smith, G., Elovainio, M., Marmot, M.G., Shipley, M.J. (2008) Optimal form of operationalizing BMI in relation to all-cause and causespecific mortality: the original Whitehall study. Obesity (Silver Spring) 16: pp. 1926-1932 CrossRef
- Manson, J.E., Colditz, G.A., Stampfer, M.J., Willett, W.C., Rosner, B., Monson, R.R., Speizer, F.E., Hennekens, C.H. (1990) A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 322: pp. 882-889 CrossRef
- Willett, W.C., Dietz, W.H., Colditz, G.A. (1999) Guidelines for healthy weight. N Engl J Med 341: pp. 427-434 CrossRef
- Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ, Moore SC, Tobias GS, Anton-Culver H, Freeman LB, Beeson WL, Clipp SL, English DR, Folsom AR, Freedman DM, Giles G, Hakansson N, Henderson KD, Hoffman-Bolton J, Hoppin JA, Koenig KL, Lee IM, Linet MS, Park Y, Pocobelli G, Schatzkin A, Sesso HD, Weiderpass E, Willcox BJ, Wolk A, Zeleniuch-Jacquotte A, Willett WC, Thun MJ. Body-mass index and mortality among 1.46 million white adults. N Engl J Med; 363(23):2211–2219.
- Hof, M.A., Burema, J. (1996) Assessment of bias in the SENECA study. Eur J Clin Nutr 50: pp. S4-S8
- Sorkin, J.D., Muller, D.C., Andres, R. (1999) Longitudinal change in height of men and women: implications for interpretation of the body mass index: the Baltimore Longitudinal Study of Aging. Am J Epidemiol 150: pp. 969-977
- Zamboni, M., Mazzali, G., Zoico, E., Harris, T.B., Meigs, J.B., Francesco, V., Fantin, F., Bissoli, L., Bosello, O. (2005) Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes (Lond) 29: pp. 1011-1029 CrossRef
- Snih, S., Ottenbacher, K.J., Markides, K.S., Kuo, Y.F., Eschbach, K., Goodwin, J.S. (2007) The effect of obesity on disability vs mortality in older Americans. Arch Intern Med 167: pp. 774-780 CrossRef
- Locher, J.L., Roth, D.L., Ritchie, C.S., Cox, K., Sawyer, P., Bodner, E.V., Allman, R.M. (2007) Body mass index, weight loss, and mortality in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 62: pp. 1389-1392 CrossRef
- Wannamethee, S.G., Shaper, A.G., Lennon, L., Whincup, P.H. (2007) Decreased muscle mass and increased central adiposity are independently related to mortality in older men. Am J Clin Nutr 86: pp. 1339-1346
- Baik, I., Ascherio, A., Rimm, E.B., Giovannucci, E., Spiegelman, D., Stampfer, M.J., Willett, W.C. (2000) Adiposity and mortality in men. Am J Epidemiol 152: pp. 264-271 CrossRef
- Breeze, E., Clarke, R., Shipley, M.J., Marmot, M.G., Fletcher, A.E. (2006) Cause-specific mortality in old age in relation to body mass index in middle age and in old age: follow-up of the Whitehall cohort of male civil servants. Int J Epidemiol 35: pp. 169-178 CrossRef
- Dyer, A.R., Stamler, J., Garside, D.B., Greenland, P. (2004) Long-term consequences of body mass index for cardiovascular mortality: the Chicago Heart Association Detection Project in Industry study. Ann Epidemiol 14: pp. 101-108 CrossRef
- Ni Mhurchu, C., Rodgers, A., Pan, W.H., Gu, D.F., Woodward, M. (2004) Body mass index and cardiovascular disease in the Asia-Pacific Region: an overview of 33 cohorts involving 310 000 participants. Int J Epidemiol 33: pp. 751-758 CrossRef
- Whitlock, G., Lewington, S., Sherliker, P., Clarke, R., Emberson, J., Halsey, J., Qizilbash, N., Collins, R., Peto, R. (2009) Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 373: pp. 1083-1096 CrossRef
- Engeland, A., Bjorge, T., Selmer, R.M., Tverdal, A. (2003) Height and body mass index in relation to total mortality. Epidemiology 14: pp. 293-299
- The impact of body mass index in old age on cause-specific mortality
The journal of nutrition, health & aging
Volume 16, Issue 1 , pp 100-106
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- 1. National Institute for Public Health and the Environment, Centre for Prevention and Health Services Research, Bilthoven, the Netherlands
- 2. Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
- 3. National Institute for Public Health and the Environment, Centre for Prevention and Health Services Research, PO Box 1, 3720 BA, Bilthoven, The Netherlands