期刊
OBESITY REVIEWS
卷 16, 期 11, 页码 1001-1015出版社
WILEY
DOI: 10.1111/obr.12309
关键词
Body mass index; elderly; mortality; nursing home
资金
- Baxter
- Abbott
- Fresenius-Kabi
- Pfizeer
- Nestle
- Sanofi
- Novo Nordisk
- Boehringer Ingelheim
- Merck
- BMS
- Feinstein Institute for Medical Research
- Janssen/JJ
- National Institute of Mental Health (NIMH)
- National Alliance for Research in Schizophrenia and Depression (NARSAD)
- Otsuka
- Takeda
Body mass index (BMI) and mortality in old adults from the general population have been related in a U-shaped or J-shaped curve. However, limited information is available for elderly nursing home populations, particularly about specific cause of death. A systematic PubMed/EMBASE/CINAHL/SCOPUS search until 31 May 2014 without language restrictions was conducted. As no published study reported mortality in standard BMI groups (<18.5, 18.5-24.9, 25-29.9, 30kg/m(2)), the most adjusted hazard ratios (HRs) according to a pre-defined list of covariates were obtained from authors and pooled by random-effect model across each BMI category. Out of 342 hits, 20 studies including 19,538 older nursing home residents with 5,223 deaths during a median of 2 years of follow-up were meta-analysed. Compared with normal weight, all-cause mortality HRs were 1.41 (95% CI=1.26-1.58) for underweight, 0.85 (95% CI=0.73-0.99) for overweight and 0.74 (95% CI=0.57-0.96) for obesity. Underweight was a risk factor for higher mortality caused by infections (HR=1.65 [95% CI=1.13-2.40]). RR results corroborated primary HR results, with additionally lower infection-related mortality in overweight and obese than in normal-weight individuals. Like in the general population, underweight is a risk factor for mortality in old nursing home residents. However, uniquely, not only overweight but also obesity is protective, which has relevant nutritional goal implications in this population/setting.
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