Undernutrition as a major risk factor for death among older Brazilian adults in the community-dwelling setting: SABE survey

Objective: To investigate the independent association between undernutrition and death in older adults in a community-dwelling setting. Methods: This retrospective study was based on the Health, Well-being and Ageing survey conducted in 2000 that included 1170 older adults (>= 60 y) from Sao Paulo, Brazil. Death occurrences were considered through March, 2007. The variables analyzed were undernutrition (Mini-Nutritional Assessment), gender, income, muscle strength, hip fracture, smoking habits, cancer, depression, diabetes, coronary heart disease, chronic lung disease, cerebral vascular disease, and hypertension. A hierarchical multivariate analysis by logistic regression was performed according to age groups (60-74 and >= 75 y). Results: Undernutrition frequency was higher in adults >= 75 y old (2.6% versus 2.4%). The frequency of death in undernourished subjects was higher in the 60- to 74-y-old group (7.6%) than in those >= 75 y old (3.9%). Undernutrition was the strongest independent risk factor for death (P < 0.05) in the 60- to 74-y-old group (odds ratio 6.05, 95% confidence interval 5.76-6.35) and in the >= 75-y-old group (odds ratio 2.76, 95% confidence interval 2.51-3.04). All other variables were also associated with death, except for hip fracture and cerebral vascular disease, in the two age groups and hypertension in the 60- to 74-y-old group; however, the effect of these variables was less. Conclusion: Undernutrition represented the strongest risk factor for death in Brazilian community-dwelling older adults 60 to 74 y old and showed a stronger association than for adults >= 75 y old. (C) 2011 Elsevier Inc. All rights reserved.