Body mass index, weight change and mortality in the elderly. A 15 y longitudinal population study of 70 y olds

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 Access

through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal

Receive 12 print issues and online access $259.00 per year only $21.58 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices

may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support

SIMILAR CONTENT BEING VIEWED BY OTHERS BODY COMPOSITION AND MORTALITY FROM MIDDLE TO OLD AGE: A PROSPECTIVE COHORT STUDY FROM THE UK BIOBANK Article 22 April 2023 AGE-APPROPRIATE BMI

CUT-POINTS FOR CARDIOMETABOLIC HEALTH RISK: A CROSS-SECTIONAL ANALYSIS OF THE CANADIAN LONGITUDINAL STUDY ON AGING Article 29 January 2022 METABOLIC OBESITY PHENOTYPES AND ALL-CAUSE

MORTALITY AMONG THE CHINESE OLDEST-OLD POPULATION: A PROSPECTIVE COHORT STUDY Article 26 June 2024 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 Article  CAS  Google Scholar  * 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 Article  CAS  Google Scholar  * Andres R (1999) Beautiful hypothesis and ugly facts: the BMI–mortality association _Obes. Res._ 7 417–419 Article  CAS  Google Scholar

  * Andres R, Elahi D, Tobin JD, Muller DC & Brant L (1985) Impact of age on weight goals _Ann. Intern. Med._ 103 1030–1033 Article  CAS  Google Scholar  * 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 Article  CAS  Google Scholar  * 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 Article  CAS  Google Scholar  * Baumgartner RN, Heymsfield SB

& Roche AF (1994) Human body composition and the epidemiology of chronic disease _Obes. Res._ 3 73–95 Article  Google Scholar  * 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 Google Scholar  * 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 Article  CAS  Google Scholar  * 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 Article  CAS  Google Scholar  * 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 Article  CAS  Google Scholar  *

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 Article  CAS  Google Scholar  * de Groot CPGM, van Staveren WA &

Hautvast JGAJ (1991) EURONUT-SENECA _Eur. J. Clin. Nutr._ 45 (Suppl 3), S1–S196 Google Scholar  * 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 Article  CAS  Google Scholar  * 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 CAS  PubMed  Google Scholar  * Fischer J

& Johnson MA (1990) Low body weight and weight loss in the aged _J. Am. Diet. Assoc._ 90 1697–1706 PubMed  Google Scholar  * 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 Article  CAS  Google Scholar  * 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 Article  CAS 

Google Scholar  * Greenland S (1995) Dose response and trend analysis in epidemiology: alternatives to categorical analysis _Epidemiology_ 6 356–365 Article  CAS  Google Scholar  * 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 Article 

CAS  Google Scholar  * 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

Article  Google Scholar  * Kushner RF (1993) Body weight and mortality _Nutr. Rev._ 51 127–136 Article  CAS  Google Scholar  * 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 Article  CAS  Google Scholar  *

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 Article  CAS  Google

Scholar  * Lee I-M & Paffenbarger RS Jr (1992) Change in body weight and longevity _J.A.M.A._ 268 2045–2049 Article  Google Scholar  * 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 Article  Google Scholar  * 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 Article  CAS  Google Scholar  * 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 Article  CAS  Google Scholar  * Manson JE, Stampfer MJ, Hennekens CH & Willett WC (1987)

Body weight and longevity. A reassesment. _J.A.M.A._ 257 353–358 Article  CAS  Google Scholar  * Mattila K, Haavisto M & Rajala S (1986) Body mass index and mortality in the elderly _Br.

Med. J._ 292 867–868 Article  CAS  Google Scholar  * 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 Article  CAS  Google Scholar  * Nilsson LV (1983) Prevalence of mental disorders in a 70-year-old urban sample. A cohort comparison. _J.

Clin. Exp. Gerontol._ 5 101–120 Google Scholar  * Pálsson SP (2000) Population studies on depression in the elderly. Prevalence, incidence and relation to cognitive function and dementia

_Doctoral thesis_ Göteborg University, Sweden Google Scholar  * 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 Article  CAS  Google Scholar  * Persson G (1981) Prevalence of mental disorders in a 70-year-old urban population _Acta Psychiat. Scand._ 62 119–139 Article 

Google Scholar  * 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 Article  CAS  Google Scholar  * 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 Article  Google Scholar  * 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 Article  CAS  Google Scholar  * 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 Google Scholar  * 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 CAS  PubMed  Google Scholar  * 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 CAS  PubMed  Google Scholar  *

Sjöström L (1992) Mortality of severely obese subjects _Am. J. Clin. Nutr._ 55(SUPPL 2) S516–523 Article  Google Scholar  * 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 Google Scholar  * Steen B & Djurfeldt H (1993) The gerontological

and geriatric population studies in Gothenburg. Sweden. _Z. Gerontol._ 26 163–169 PubMed  Google Scholar  * 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 Google Scholar  * Stevens J (1998) Studies of the

impact of age on optimal body weight _J. Nutr. Biochem._ 9 501–510 Article  CAS  Google Scholar  * 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 Article  CAS  Google Scholar  * Takala JK, Mattila KJ & Ryynänen O (1994) Overweight, underweight and

mortality among the aged _Scand. J. Prim. Health Care_ 12 244–248 Article  CAS  Google Scholar  * Tayback M, Kumanyika S & Chee E (1990) Body weight as a risk factor in the elderly

_Arch. Intern. Med._ 150 1065–1072 Article  CAS  Google Scholar  * Willett WC (1997) Weight loss in the elderly: cause or effect of poor health _Am. J. Clin. Nutr._ 66 737–738 Article  CAS 

Google Scholar  Download references 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 Author notes * DK Dey and B Steen: _Guarantors:_ DK Dey and B Steen. * DK Dey, E Rothenberg, V Sundh, I Bosaeus and B Steen: _Contributors:_ DKD did the data analysis and

was primarily responsible for writing the manuscript. ER contributed in the study concept and critical reading of the paper. VS did the statistical analysis. IB contributed ideas for

analysis and editing the paper. BS, was overall study coordinator, provided guidance in the study design, supervised analysis and contributed in editing the manuscript. AUTHORS AND

AFFILIATIONS * Department of Geriatric Medicine, Göteborg University, Göteborg, Sweden DK Dey, E Rothenberg, V Sundh & B Steen * Department of Clinical Nutrition, Göteborg University,

Göteborg, Sweden E Rothenberg & I Bosaeus Authors * DK Dey View author publications You can also search for this author inPubMed Google Scholar * E Rothenberg View author publications

You can also search for this author inPubMed Google Scholar * V Sundh View author publications You can also search for this author inPubMed Google Scholar * I Bosaeus View author

publications You can also search for this author inPubMed Google Scholar * B Steen View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR

Correspondence to DK Dey. RIGHTS AND PERMISSIONS Reprints 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 Download citation * Received: 20

November 2000 * Revised: 06 February 2001 * Accepted: 06 February 2001 * Published: 22 June 2001 * Issue Date: 01 June 2001 * DOI: https://doi.org/10.1038/sj.ejcn.1601208 SHARE THIS ARTICLE

Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided

by the Springer Nature SharedIt content-sharing initiative KEYWORDS * BMI * weight change * mortality * elderly