TY - JOUR
T1 - Associations of Body Mass Index and Waist Circumference with 3-Year All-Cause Mortality Among the Oldest Old
T2 - Evidence from a Chinese Community-Based Prospective Cohort Study
AU - Lv, Yue Bin
AU - Liu, Simin
AU - Yin, Zhao Xue
AU - Gao, Xiang
AU - Kraus, Virginia Byers
AU - Mao, Chen
AU - Yuan, Jin Qiu
AU - Zhang, Juan
AU - Luo, Jie Si
AU - Chen, Hua Shuai
AU - Zeng, Yi
AU - Shi, Xiao Ming
N1 - Funding Information:
This work was supported by National Natural Sciences Foundation of China [grant number 71233001, 71490732 to Y.Z. and 81573247 to X.M.S.], the U.S. National Institute of Aging [grant number 2P01AG031719 to Y.Z.], and a Claude D. Pepper Older Americans Independence Centers grant [grant number 5P30AG028716 from NIA to V.B.K.]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine
PY - 2018/8
Y1 - 2018/8
N2 - Objective: Current international and national guidelines for body mass index (BMI) and waist circumference (WC) have been recommended to all adults. However, whether recommendations applied to the oldest old (aged 80+) is poorly known. The study objective was to investigate the relation of BMI and WC with 3-year all-cause mortality among the oldest old. Design, Setting, and Participants: A total of 4361 Chinese oldest old (mean age 91.8) participated in this community-based prospective cohort study. Measurements: BMI and WC were measured at baseline in 2011 and were used as continuous variables and as categorized variables by recommendations or by tertiles. Adjusted, sex-stratified Cox models with penalized splines and Cox models were constructed to explore the association. Results: Greater BMI and WC were linearly associated with lower mortality risk in both genders. The mortality risk was the lowest in overweight or obese participants (BMI ≥ 24.0) and was lower in participants with abdominal obesity. Compared to the upper tertile, those in the middle and lower tertile of BMI had a higher risk of mortality for men [hazard ratio (HR): 1.23 (1.02-1.48) and 1.53 (1.28-1.82)] and for women [HR: 1.21 (1.03-1.41) and 1.35 (1.15-1.58)]; it was also found in participants in the middle and lower tertile of WC for men [HR: 1.21 (1.01-1.46) and 1.41 (1.18-1.69)] and for women [HR: 1.35 (1.15-1.58) and 1.55 (1.32-1.81)] (all the P values for trend <.001). These findings were robust in further sensitivity analyses or when using propensity score matching, in subgroup analyses, or in octogenarians, nonagenarians, and centenarians. Conclusions: In Chinese oldest old, both higher BMI and higher WC predict better survival in both genders. The finding suggests optimal BMI and WC may be sensitive to age, thus, the current recommendations for the oldest old may need to be revisited.
AB - Objective: Current international and national guidelines for body mass index (BMI) and waist circumference (WC) have been recommended to all adults. However, whether recommendations applied to the oldest old (aged 80+) is poorly known. The study objective was to investigate the relation of BMI and WC with 3-year all-cause mortality among the oldest old. Design, Setting, and Participants: A total of 4361 Chinese oldest old (mean age 91.8) participated in this community-based prospective cohort study. Measurements: BMI and WC were measured at baseline in 2011 and were used as continuous variables and as categorized variables by recommendations or by tertiles. Adjusted, sex-stratified Cox models with penalized splines and Cox models were constructed to explore the association. Results: Greater BMI and WC were linearly associated with lower mortality risk in both genders. The mortality risk was the lowest in overweight or obese participants (BMI ≥ 24.0) and was lower in participants with abdominal obesity. Compared to the upper tertile, those in the middle and lower tertile of BMI had a higher risk of mortality for men [hazard ratio (HR): 1.23 (1.02-1.48) and 1.53 (1.28-1.82)] and for women [HR: 1.21 (1.03-1.41) and 1.35 (1.15-1.58)]; it was also found in participants in the middle and lower tertile of WC for men [HR: 1.21 (1.01-1.46) and 1.41 (1.18-1.69)] and for women [HR: 1.35 (1.15-1.58) and 1.55 (1.32-1.81)] (all the P values for trend <.001). These findings were robust in further sensitivity analyses or when using propensity score matching, in subgroup analyses, or in octogenarians, nonagenarians, and centenarians. Conclusions: In Chinese oldest old, both higher BMI and higher WC predict better survival in both genders. The finding suggests optimal BMI and WC may be sensitive to age, thus, the current recommendations for the oldest old may need to be revisited.
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U2 - 10.1016/j.jamda.2018.03.015
DO - 10.1016/j.jamda.2018.03.015
M3 - Article
C2 - 29807748
AN - SCOPUS:85047401342
SN - 1525-8610
VL - 19
SP - 672-678.e4
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 8
ER -