Skip to main content
SpringerLink
Log in

The impact of body mass index in old age on cause-specific mortality

  • BMI and Mortality in Old Age
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

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.

Design

Prospective study.

Setting

European towns.

Participants

1,980 older adults, aged 70–75 years from the SENECA (Survey in Europe on Nutrition and the Elderly: a concerted action) study.

Measurements

BMI, examined in 1988/1989, and mortality rates and causes of death during 10 years of follow-up.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Branca F NH, Lobstein T. The challenge of obesity in the WHO European Region and the strategies for response. In: Organization DWH, ed Denmark: World Health Organization, 2007.

    Google Scholar 

  2. Janssen I, Mark AE. Elevated body mass index and mortality risk in the elderly. Obes Rev 2007;8(1):41–59.

    Article  PubMed  CAS  Google Scholar 

  3. 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.

  4. Heiat A, Vaccarino V, Krumholz HM. An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Arch Intern Med 2001;161(9):1194–1203.

    Article  PubMed  CAS  Google Scholar 

  5. Adams KF, Schatzkin A, Harris TB, Kipnis V, Mouw T, Ballard-Barbash R, Hollenbeck A, Leitzmann MF. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med 2006;355(8):763–778.

    Article  PubMed  CAS  Google Scholar 

  6. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. Jama 2005;293(15):1861–1867.

    Article  PubMed  CAS  Google Scholar 

  7. Flegal KM, Graubard BI, Williamson DF, Gail MH. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA 2007;298(17):2028–2037.

    Article  PubMed  CAS  Google Scholar 

  8. Van’ t Hof MA, Hautvast JG, Schroll M, Vlachonikolis IG. Design, methods and participation. Euronut SENECA investigators. Eur J Clin Nutr 1991;45 Suppl 3:5–22.

    Google Scholar 

  9. De Groot C VSW. Nutrition and the elderly: manual of operations. (Report 11). In: Investigators TE-S, ed. Wageningen, the Netherlands, 1988.

  10. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003;348(26):2599–2608.

    Article  PubMed  Google Scholar 

  11. Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menotti A, van Staveren WA. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. Jama 2004;292(12):1433–1439.

    Article  PubMed  Google Scholar 

  12. Voorrips LE, Ravelli AC, Dongelmans PC, Deurenberg P, Van Staveren WA. A physical activity questionnaire for the elderly. Med Sci Sports Exerc 1991;23(8):974–979.

    PubMed  CAS  Google Scholar 

  13. World Health Organization. International Classification of Diseases, Ninth Revision (ICD-9). Geneva: World Health Organization, 1977.

    Google Scholar 

  14. Kivimaki M, Ferrie JE, Batty GD, Davey Smith G, Elovainio M, Marmot MG, Shipley MJ. Optimal form of operationalizing BMI in relation to all-cause and causespecific mortality: the original Whitehall study. Obesity (Silver Spring) 2008;16(8):1926–1932.

    Article  Google Scholar 

  15. Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, Speizer FE, Hennekens CH. A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 1990;322(13):882–889.

    Article  PubMed  CAS  Google Scholar 

  16. Willett WC, Dietz WH, Colditz GA. Guidelines for healthy weight. N Engl J Med 1999;341(6):427–434.

    Article  PubMed  CAS  Google Scholar 

  17. 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.

  18. van’t Hof MA, Burema J. Assessment of bias in the SENECA study. Eur J Clin Nutr 1996;50Suppl 2:S4–S8.

    Google Scholar 

  19. Sorkin JD, Muller DC, Andres R. 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 1999;150(9):969–977.

    PubMed  CAS  Google Scholar 

  20. Zamboni M, Mazzali G, Zoico E, Harris TB, Meigs JB, Di Francesco V, Fantin F, Bissoli L, Bosello O. Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes (Lond) 2005;29(9):1011–1029.

    Article  CAS  Google Scholar 

  21. Al Snih S, Ottenbacher KJ, Markides KS, Kuo YF, Eschbach K, Goodwin JS. The effect of obesity on disability vs mortality in older Americans. Arch Intern Med 2007;167(8):774–780.

    Article  PubMed  Google Scholar 

  22. Locher JL, Roth DL, Ritchie CS, Cox K, Sawyer P, Bodner EV, Allman RM. Body mass index, weight loss, and mortality in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2007;62(12):1389–1392.

    Article  PubMed  Google Scholar 

  23. Wannamethee SG, Shaper AG, Lennon L, Whincup PH. Decreased muscle mass and increased central adiposity are independently related to mortality in older men. Am J Clin Nutr 2007;86(5):1339–1346.

    PubMed  CAS  Google Scholar 

  24. Baik I, Ascherio A, Rimm EB, Giovannucci E, Spiegelman D, Stampfer MJ, Willett WC. Adiposity and mortality in men. Am J Epidemiol 2000;152(3):264–271.

    Article  PubMed  CAS  Google Scholar 

  25. Breeze E, Clarke R, Shipley MJ, Marmot MG, Fletcher AE. 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 2006;35(1):169–178.

    Article  PubMed  Google Scholar 

  26. Dyer AR, Stamler J, Garside DB, Greenland P. Long-term consequences of body mass index for cardiovascular mortality: the Chicago Heart Association Detection Project in Industry study. Ann Epidemiol 2004;14(2):101–108.

    Article  PubMed  Google Scholar 

  27. Ni Mhurchu C, Rodgers A, Pan WH, Gu DF, Woodward M. Body mass index and cardiovascular disease in the Asia-Pacific Region: an overview of 33 cohorts involving 310 000 participants. Int J Epidemiol 2004;33(4):751–758.

    Article  PubMed  CAS  Google Scholar 

  28. Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, Qizilbash N, Collins R, Peto R. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009;373(9669):1083–1096.

    Article  PubMed  Google Scholar 

  29. Engeland A, Bjorge T, Selmer RM, Tverdal A. Height and body mass index in relation to total mortality. Epidemiology 2003;14(3):293–299.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. National Institute for Public Health and the Environment, Centre for Prevention and Health Services Research, Bilthoven, the Netherlands

    Ellen de Hollander, M. Van Zutphen, R. P. Bogers & W. J. E. Bemelmans

  2. Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands

    Ellen de Hollander, M. Van Zutphen & L. C. P. G. M. De Groot

  3. National Institute for Public Health and the Environment, Centre for Prevention and Health Services Research, PO Box 1, 3720 BA, Bilthoven, The Netherlands

    Ellen de Hollander

Authors
  1. Ellen de Hollander
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Van Zutphen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. P. Bogers
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W. J. E. Bemelmans
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. C. P. G. M. De Groot
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ellen de Hollander.

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Hollander, E., Van Zutphen, M., Bogers, R.P. et al. The impact of body mass index in old age on cause-specific mortality. J Nutr Health Aging 16, 100–106 (2012). https://doi.org/10.1007/s12603-011-0077-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-011-0077-6

Key words

Search

Navigation