Abstract
Objective: To examine the relationship between body mass index (BMI) at age 70, weight change between age 70 and 75, and 15 y mortality.
Design: Cohort study of 70-y-olds.
Setting: Geriatric Medicine Department, Göteborg University, Sweden.
Subjects: A total of 2628 (1225 males and 1403 females) 70-y-olds examined in 1971–1981 in Gothenburg, Sweden.
Results: The relative risks (RRs) for 15 y mortality were highest in the lowest BMI quintiles of males 1.20 (95% CI 0.96–1.51) and females 1.49 (95% CI 1.14–1.96). In non-smoking males, no significant differences were observed across the quintiles for 5, 10 and 15 y mortality. In non-smoking females, the highest RR (1.58, 95% CI 1.15–2.16) for 15 y mortality was in the lowest quintile. After exclusion of first 5 y death, no excess risks were found in males for following 5 and 10 y mortality across the quintiles. In females, a U-shaped relation was observed after such exclusions. BMI ranges with lowest 15 y mortality were 27–29 and 25–27 kg/m2 in non-smoking males and females, respectively. A weight loss of≥10% between age 70 and 75 meant a significantly higher risk for subsequent 5 and 10 y mortality in both sexes relative to individuals with ‘stable’ weights.
Conclusion: Low BMI and weight loss are risk factors for mortality in the elderly and smoking habits did not significantly modify that relationship. The BMI ranges with lowest risks for 15 y mortality are relatively higher in elderly. Exclusion of early deaths from the analysis modified the weight–mortality relationship in elderly males but not in females.
Sponsorship: See Acknowledgements.
European Journal of Clinical Nutrition (2001) 55, 482–492
This is a preview of subscription content, access via your institution
Relevant articles
Open Access articles citing this article.
-
Sarcopenic obesity and associations with mortality in older women and men – a prospective observational study
BMC Geriatrics Open Access 09 June 2020
-
Effect of monosodium l-glutamate (umami substance) on cognitive function in people with dementia
European Journal of Clinical Nutrition Open Access 22 October 2018
-
Lower body mass index and mortality in older adults starting dialysis
Scientific Reports Open Access 27 August 2018
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Get just this article for as long as you need it
$39.95
Prices may be subject to local taxes which are calculated during checkout
References
Allison DB, Gallagher D, Heo M, Pi-Sunyer EX & Heymsfield SB (1997) Body mass index and all-cause mortality among people age 70 and over: the Lonitudinal Study of Aging Int. J. Obes. Relat. Metab. Disord. 21 424–431
Allison DB, Faith MS, Heo M, Townsend-Butterworth D & Williamson DF (1999) Meta-analysis of the effect of excluding early deaths on the estimated relationship between body mass index and mortality Obes. Res. 7 342–354
Andres R (1999) Beautiful hypothesis and ugly facts: the BMI–mortality association Obes. Res. 7 417–419
Andres R, Elahi D, Tobin JD, Muller DC & Brant L (1985) Impact of age on weight goals Ann. Intern. Med. 103 1030–1033
Andres R, Muller DC & Sorkin JD (1993) Long-term effects of change in body weight on all-cause mortality: a review. Ann. Intern. Med. 119 737–743
Baik I, Ascherio A, Rimm EB, Giovannucci E, Spiegelman D, Stampfer MJ & Willett WC (2000) Adiposity and mortality in men Am. J. Epidemiol. 152 264–271
Baumgartner RN, Heymsfield SB & Roche AF (1994) Human body composition and the epidemiology of chronic disease Obes. Res. 3 73–95
Berg S (1980) Psychological functioning in 70- and 75-year-old people. A study in an industrialized city Acta Psych. Scand. 62(Suppl 288) S1–S47
Borkan GA, Hults DE, Gerzof SG & Robbins AH (1985) Comparison of body composition in middle-aged and elderly males using computed tomography Am. J. Anthropol. 66 289–295
Calle EE, Thun MJ, Petrelli JM, Rodriguez C & Heath CW Jr (1999) Body mass index and mortality in a prospective cohort of US adults New Engl. J. Med. 341 1097–1105
Campbell AJ, Spears GFS, Brown JS, Busby WJ & Borrie MJ (1990) Anthropometric measurements as predictors of mortality in a community population aged 70 y and over Age Ageing 19 131–135
Cornoni-Huntley JC, Harris TB, Everett DF, Albanes D, Micozzi MS, Miles TP & Feldman JJ (1991) An overview of body weight of older persons, including the impact on mortality: the National Health and Nutrition Examination Survey I-Epidemiologic Follow-up Study J. Clin. Epidemiol. 44 743–753
de Groot CPGM, van Staveren WA & Hautvast JGAJ (1991) EURONUT-SENECA Eur. J. Clin. Nutr. 45 (Suppl 3), S1–S196
Diehr P, Bild DE, Harris TB, Duxbury A, Siscovick D & Rossi M (1998) Body mass index and mortality in nonsmoking older adults: the Cardiovascular Health Study Am. J. Public Health 88 623–629
Eriksson B, Mellström D & Svanborg A (1987) Medical–social intervention in a 70-year-old Swedish population. A general presentation of methodological experience Compr. Gerontol. C. 1 49–56
Fischer J & Johnson MA (1990) Low body weight and weight loss in the aged J. Am. Diet. Assoc. 90 1697–1706
Folsom AR, Kaye SA, Sellers TA, Hong CP, Cerhan JR, Potter JD & Prineas RJ (1993) Body fat distribution and 5-year risk of death in older women J.A.M.A. 269 483–487
Garrison RJ, Feinleib M, Castelli WP & McNamara MP (1983) Cigarette smoking as a confounder of the relationship between relative weight and long-term mortality. The Framingham Heart Study. J.A.M.A. 249 2199–2203
Greenland S (1995) Dose response and trend analysis in epidemiology: alternatives to categorical analysis Epidemiology 6 356–365
Harris T, Cook EF, Garison R, Higgins M, Kannel W & Goldman L (1988) Body mass index and mortality among non smoking older persons: the Framingham Heart study J.A.M.A. 259 1520–1524
Ho SC, Woo J & Sham A (1994) Risk factor change in older persons, a perspective from Hong Kong: weight change and mortality J. Gerontol. Med. Sec. 49 269–272
Kushner RF (1993) Body weight and mortality Nutr. Rev. 51 127–136
Landi F, Zuccala G, Gambassi G, Incalzi RA, Manigrasso L, Pagano F, Carbonin P & Bernabei R (1999) Body mass index and mortality among older people living in the community J. Am. Geriatr. Soc. 47 1072–1076
Landi F, Onder G, Gambassi G, Pedone C, Carbonin P & Bernabei R (2000) Body mass index and mortality among hospitalized patients Arch. Intern. Med. 160 2641–2644
Lee I-M & Paffenbarger RS Jr (1992) Change in body weight and longevity J.A.M.A. 268 2045–2049
Linsted KD & Singh PN (1997) Body mass and 26-year risk of mortality among women who never smoked: findings from the Adventist Mortality Study Am. J. Epidemiol. 146 1–11
Lissner L, Odell PM, D'Agostino RB, Stokes J III, Kreger BE, Belanger AJ & Brownell KD (1991) Variability of body weight and health outcomes in the Framingham population New Engl. J. Med. 324 1839–1844
Losonczy KG, Harris TB, Cornoni-Huntley J, Simonsick EM, Wallace RB, Cook NR, Ostfeld AM & Blazer DG (1995) Does weight loss from middle age to old age explain the inverse weight mortality relation in old age Am. J. Epidemiol. 141 312–321
Manson JE, Stampfer MJ, Hennekens CH & Willett WC (1987) Body weight and longevity. A reassesment. J.A.M.A. 257 353–358
Mattila K, Haavisto M & Rajala S (1986) Body mass index and mortality in the elderly Br. Med. J. 292 867–868
Michels KB, Greenland S & Rosner BA (1998) Does body mass index adequately capture the relation of body composition and body size to health outcomes Am. J. Epidemiol. 147 167–172
Nilsson LV (1983) Prevalence of mental disorders in a 70-year-old urban sample. A cohort comparison. J. Clin. Exp. Gerontol. 5 101–120
Pálsson SP (2000) Population studies on depression in the elderly. Prevalence, incidence and relation to cognitive function and dementia Doctoral thesis Göteborg University, Sweden
Pamuk ER, Williamson DF, Serdula MK, Madan J & Byers TE (1993) Weight loss and subsequent death in a cohort of US adults Ann. Intern. Med. 119 744–748
Persson G (1981) Prevalence of mental disorders in a 70-year-old urban population Acta Psychiat. Scand. 62 119–139
Rinder L, Roupe S, Steen B & Svanborg A (1975) Seventy-year-old people in Gothenburg. A population study in an industrialized Swedish city. I. General presentation of the study Acta Med. Scand. 198 397–407
Rumpell C, Harris TB & Madans J (1993) Modification of the relationship between the Quetelet index and mortality by weight-loss history among older women Ann. Epidemiol. 3 343–350
Rundgren Å, Eklund S & Jonson R (1984) Bone mineral content in 70-and 75-year-old men and women: an analysis of some anthropometric background factors Age Ageing 13 6–13
Seidell JC & Visscher TLS (2000) Body weight and weight change and their health implications for the elderly Eur. J. Clin. Nutr. 54 (Suppl 3), S33–S39
Seidell JC, Oosterlee A, Deurenberg P, Hautvast JGAJ & Ruijs JHJ (1988) Abdominal fat depots measured with computed tomography: effects of degree of obesity, sex and age Eur. J. Clin. Nutr. 42 805–815
Seidell JC, Andres R, Sorkin JD & Muller DC (1994) The sagittal waist diameter and mortality in men: the Baltimore Longitudinal Study on Aging Int. J. Obes. Relat. Metab. Disord. 18 61–67
Sjöström L (1992) Mortality of severely obese subjects Am. J. Clin. Nutr. 55(Suppl 2) S516–523
Sonn U & Åsberg KH (1991) Assessment of activities of daily living in the elderly. A study of a population of 76-year-olds in Gothenburg, Sweden. Scand. J. Rehab. Med. 23 193–202
Steen B & Djurfeldt H (1993) The gerontological and geriatric population studies in Gothenburg. Sweden. Z. Gerontol. 26 163–169
Steen B, Lundgren BK & Isaksson B (1985) Body composition at age 70, 75, 79 and 81. A longitudinal population study. In Nutrition, Immunity and Illness in the Elderly, ed. RK Chandra 49–52 New York: Pergamon Press
Stevens J (1998) Studies of the impact of age on optimal body weight J. Nutr. Biochem. 9 501–510
Stevens J, Cai J, Pamuk ER, Williamson DF, Thun MJ & Wood JL (1998) The effect of age on the association between body mass index and mortality New Engl. J. Med. 338 1–7
Takala JK, Mattila KJ & Ryynänen O (1994) Overweight, underweight and mortality among the aged Scand. J. Prim. Health Care 12 244–248
Tayback M, Kumanyika S & Chee E (1990) Body weight as a risk factor in the elderly Arch. Intern. Med. 150 1065–1072
Willett WC (1997) Weight loss in the elderly: cause or effect of poor health Am. J. Clin. Nutr. 66 737–738
Acknowledgements
The authors want to thank Anders Odén, PhD, for statistical discussions and advice. The gerontological and geriatric population studies in Gothenburg (H70) were supported by grants from: the Swedish Ministry of Health and Social Affairs, Commission for Social Research, the Swedish Council for Planning and Coordination of Research, the Gothenburg Medical Services Administration, the Wilhelm and Martina Lundgren Foundation, the Swedish Medical Research Council, the Dr. Félix Neubergh Foundation, the Gothenburg Administration of Social Services, the Swedish Social Research Council, the Hjalmar Svensson Foundation, the Elsa and Eivind K: son Sylvan Foundation, Gun and Bertil Stohnes Foundation.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dey, D., Rothenberg, E., Sundh, V. et al. Body mass index, weight change and mortality in the elderly. A 15 y longitudinal population study of 70 y olds. Eur J Clin Nutr 55, 482–492 (2001). https://doi.org/10.1038/sj.ejcn.1601208
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ejcn.1601208
Keywords
- BMI
- weight change
- mortality
- elderly
This article is cited by
-
Modified geriatric nutrition risk index as a prognostic predictor of esophageal cancer
Esophagus (2021)
-
Primary Care Prognostic (PCP) Index of 11-Year Mortality Risk: Development and Validation of a Brief Prognostic Tool
Journal of General Internal Medicine (2021)
-
Sarcopenic obesity and associations with mortality in older women and men – a prospective observational study
BMC Geriatrics (2020)
-
Effect of monosodium l-glutamate (umami substance) on cognitive function in people with dementia
European Journal of Clinical Nutrition (2019)
-
Weight change is associated with increased all-cause mortality and non-cardiac mortality among patients with type 2 diabetes mellitus
Endocrine (2019)