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Body Mass Index, Change in Body Mass Index, and Survival in Old and Very Old Persons
Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
Department of Family, Consumer, and Human Development, Utah State University, Logan, Utah.
Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.ORCID iD: 0000-0003-4149-9787
University of Gothenburg.
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2013 (English)In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 61, no 4, 512-518 p.Article in journal (Refereed) Published
Abstract [en]

Background: Current recommendations from the World Health Organization (WHO) are that individuals should seek to maintain a body mass index (BMI) between 18.5-25 kg/m2, independent of age. However, there is an ongoing discussion whether the WHO recommendations apply to old (70 ≥ 80 years) and very old persons (80+ years). In the present study we examine how BMI status and change in BMI are associated with mortality among old and very old individuals.

Design: Pooled data from three multidisciplinary prospective population-based studies OCTO-twin, GENDER, and NONA.

Setting: Sweden.

Participants: 882 individuals aged 70 to 95 years.

Measurements: Body Mass Index was calculated from measured height and weight as kg/m2. Information about survival status and time of death was obtained from Swedish Civil Registration System

Results: Mortality hazard was 20% lower for the overweight group relative to the normal/underweight group (RR = 0.80, p < .05), and the mortality hazard for the obese group did not differ significantly from the normal/underweight group (RR = 0.93, > .10), independent of age, education, and multimorbidity. Furthermore, mortality hazard was 141% higher for the BMI loss group relative to the BMI stable group (RR = 1.65, p < .05); and 178% higher for the BMI gain group relative to BMI stable group (RR = 1.53, p < .05).  However, the BMI change differences were moderated by age, i.e. the higher mortality risks associated with both loss in BMI and BMI gain were less severe in very old age.

Conclusion: Old persons who were overweight had a decreased mortality risk compared to old persons having a BMI below 25, even after controlling for weight change and multimorbidity. Compared to persons who had a stable BMI those who increased or decreased in BMI had a higher mortality risk, particularly among people aged 70 to 80. This study lends further support for the opinion that the WHO guidelines are overly restrictive in old age.

Place, publisher, year, edition, pages
2013. Vol. 61, no 4, 512-518 p.
Keyword [en]
aging, aged, body mass index, survival, mortality, obesity, overweight, underweight
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hj:diva-19739DOI: 10.1111/jgs.12158Local ID: HHJÅldrandeISOAI: oai:DiVA.org:hj-19739DiVA: diva2:564009
Available from: 2012-11-01 Created: 2012-11-01 Last updated: 2016-09-07Bibliographically approved

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