Body mass index categories and anxiety symptoms among adults aged ≥ 50 years from low and middle income countries

Background Body weight may be a risk factor for anxiety; however, there is a scarcity of studies on this association in older adults especially from low and middle income countries (LMICs). Therefore, we investigated the association between body mass index (BMI) and anxiety symptoms among adults aged >= 50 years from 6 LMICs. Methods Cross-sectional, community-based, nationally representative data from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) were analyzed. The BMI was based on measured weight and height and was categorized as: < 18.5 kg/m(2) (underweight), 18.5-24.9 kg/m(2) (normal weight), 25.0-29.9 kg/m(2) (overweight), 30.0-34.9 kg/m(2) (obesity class I), 35.0-39.9 kg/m(2) (obesity class II), and >= 40 kg/m(2) (obesity class III). Anxiety symptoms referred to severe/extreme problems with worry or anxiety in the past 30 days. Multivariable logistic regression analysis was conducted. Results Data on 34,129 individuals aged >= 50 years (mean age 62.4 years, SD 16.0 years; 52.1% female) were analyzed. Overall, compared to normal weight, only underweight was significantly associated with anxiety symptoms (odds ratio, OR = 1.56; 95% confidence interval, CI = 1.26-1.95). Obesity class III (vs. normal weight) was associated with significantly increased odds for anxiety symptoms (OR = 4.15; 95%CI = 1.49-11.59) only among males. Conclusion In this large representative sample of older adults from LMICs, underweight was associated with anxiety symptoms in males and females. Class III obesity was associated with anxiety symptoms only in males. Future studies to shed light on the reason why severe obesity was associated with anxiety symptoms only among males in LMICs are needed.

Automated summary

This study investigated the association between body weight and anxiety symptoms in older adults from low and middle income countries. The results showed that underweight and class III obesity were significantly associated with anxiety symptoms, with class III obesity only affecting males. Further research is needed to understand the reason behind this association.