Journal
GERONTOLOGY
Volume 68, Issue 12, Pages 1366-1374Publisher
KARGER
DOI: 10.1159/000522040
Keywords
Weight loss; Obesity; Abdominal obesity; Mortality
Categories
Funding
- regional government of Languedoc-Roussillon [07 LVIE 004]
- Agence Nationale de la Recherche [APP1135727]
- Novartis [101927]
- National Health & Medical Research Council (NHMRC), Australia
- Australian Heart Foundation post-doctoral fellowship
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This study examined the association between weight loss, weight status, abdominal obesity, and 17-year mortality risk in community-dwelling older adults. Abdominal obesity was strongly associated with increased mortality risk, while being overweight appeared to be protective against mortality. Modest self-reported weight loss was not associated with all-cause mortality, but men reporting recent weight loss of more than 3 kg may be at increased risk. The findings support the use of waist circumference as a predictor of mortality risk in older adults.
Objectives: The objectives of this study were to examine whether weight loss, weight status (based on body mass index [BMI] categories), and abdominal obesity (based on waist circumference [WC]) were associated with a 17-year mortality risk in community-dwelling older adults. Methods: Participants were 2,017 community-dwelling adults aged 65 years or above in the longitudinal Enquete de Sante Psychologique-Risques, Incidence et Traitement study. Self-reported weight loss was collected at baseline during face-to-face interviews. Bodyweight (kg), height (m), and WC (cm) were independently measured at the baseline. BMI was categorized as follows: underweight (BMI <18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (>= 30 kg/m(2)). Abdominal obesity was defined by a WC of >= 102 cm in men and >= 88 cm in women. Adjusted Cox proportional hazards models were used to examine associations of weight loss, weight status, and abdominal obesity with all-cause mortality. Results: Over 17 years of follow-up (median 15.5 years), 812 participants died. Abdominal obesity compared to nonabdominal obesity was associated with a 49% increased mortality risk (95% confidence interval (CI): 1.22-1.83). However, being overweight (but not obese) was associated with a 20% decreased risk (95% CI: 0.66-0.97) compared to a normal BMI. Gender did not affect these associations. In the whole cohort, self-reported weight loss at baseline was not associated with an increased mortality risk after adjusting for health and lifestyle factors. However, in men, a baseline self-reported recent weight loss of >3 kg was associated with a 52% increase in mortality risk (95% CI: 1.05-2.18) in a fully adjusted model. Conclusion: In community-dwelling adults aged >= 65 years, abdominal obesity was strongly associated with increased mortality risk. Being overweight appeared, however, to be protective against mortality. Modest self-reported weight loss was not associated with all-cause mortality in community-dwelling older adults after adjusting for health and lifestyle factors. However, men reporting recent weight loss of more than 3 kg may be at increased risk. The findings of this study support the use of WC, rather than BMI, as a predictor of mortality risk in older adults.
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