The impact of body mass index in old age on cause-specific mortality - PubMed (original) (raw)

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

E L de Hollander et al. J Nutr Health Aging. 2012 Jan.

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.

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Figures

Figure 1

Figure 1

Multivariate adjusted hazard ratios for risk of mortality from all-cause mortality (A), cardiovascular disease (B), cancer (C), respiratory disease (D), and other deaths (E) in older adults aged 70-75y by Body Mass Index. In panel A-E solid lines indicate hazard ratios and dashed lines indicate 95% confidence intervals. All models were adjusted for sex, smoking and education level. The baseline BMI associated with the lowest mortality risk was: A 27.1 kg/m2, B 25.6 kg/m2, C 26.6 kg/m2, D not applicable and E 27.4 kg/m2

Figure 2

Figure 2

Sensitivity analyses of multivariate adjusted Cox models: basic model compared to model with physical activity, diet and alcohol use added as extra covariates to the model for all-cause (A) and cardiovascular mortality (B) in older adults aged 70- 75y. All models were adjusted for sex, smoking and education level

Figure 3

Figure 3

Sensitivity analyses of multivariate adjusted Cox models: basic model compared to model with baseline diseases excluded for all-cause (A) and cardiovascular mortality (B) in older adults aged 70-75y. All models were adjusted for sex, smoking and education level

Figure 4

Figure 4

Sensitivity analyses of multivariate adjusted Cox models: basic model compared to model with never-smokers for all-cause (A) and cardiovascular mortality (B) in older adults aged 70-75y. All models were adjusted for sex and education level and the basic model was also adjusted for smoking status

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