Christophe E Graf1, François R Herrmann1, Adrian Spoerri2, Anne-Marie Makhlouf3, Thorkild I A Sørensen4, Sylvain Ho2, Véronique L Karsegard3, Laurence Genton5. 1. Division of Geriatrics, Dept. Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. 2. Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. 3. Clinical Nutrition, Geneva University Hospitals, Geneva, Switzerland. 4. Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Section on Metabolic Genetics, Faculty of Medical and Health Sciences, University of Copenhagen, Denmark; MRC Integrative Epidemiology Unit, Bristol University, Bristol, UK. 5. Clinical Nutrition, Geneva University Hospitals, Geneva, Switzerland. Electronic address: laurence.genton@hcuge.ch.
Abstract
PURPOSE: This study evaluates the relationship between body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI) changes and mortality in persons ≥65 years. METHODS: Adults ≥65 years with at least two body composition measurements (BCM) between 1990 and 2011 were included. We excluded persons who died within one month of the second BCM and who had two single BCM in a one-month timeframe. Mortality data was retrieved until December 2012. For each person, we calculated the regression slopes for BMI, FMI and FFMI changes. Significant positive slopes were categorized as "gain", negative slopes as "loss" and the others as "maintenance". The impact of body composition changes was evaluated by Cox regression models while adjusting for sex, age, co-morbidities and body composition at the last measurement. RESULTS: We included 791 persons with 3049 BCM. After adjustment for sex, and age and co-morbidities, a loss of FFMI, but not of FMI or BMI, increased the risk of mortality (HR 2.02, 95%CI 1.28-3.19). The prediction of mortality with FFMI loss remained significant when further adjusting for FMI loss and the last available body composition (HR 1.68, 95%CI 1.04-2.70). CONCLUSIONS: FFMI loss is related to increased mortality in older persons.
PURPOSE: This study evaluates the relationship between body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI) changes and mortality in persons ≥65 years. METHODS: Adults ≥65 years with at least two body composition measurements (BCM) between 1990 and 2011 were included. We excluded persons who died within one month of the second BCM and who had two single BCM in a one-month timeframe. Mortality data was retrieved until December 2012. For each person, we calculated the regression slopes for BMI, FMI and FFMI changes. Significant positive slopes were categorized as "gain", negative slopes as "loss" and the others as "maintenance". The impact of body composition changes was evaluated by Cox regression models while adjusting for sex, age, co-morbidities and body composition at the last measurement. RESULTS: We included 791 persons with 3049 BCM. After adjustment for sex, and age and co-morbidities, a loss of FFMI, but not of FMI or BMI, increased the risk of mortality (HR 2.02, 95%CI 1.28-3.19). The prediction of mortality with FFMI loss remained significant when further adjusting for FMI loss and the last available body composition (HR 1.68, 95%CI 1.04-2.70). CONCLUSIONS: FFMI loss is related to increased mortality in older persons.
Authors: Carla M Prado; Sarah A Purcell; Carolyn Alish; Suzette L Pereira; Nicolaas E Deutz; Daren K Heyland; Bret H Goodpaster; Kelly A Tappenden; Steven B Heymsfield Journal: Ann Med Date: 2018-09-12 Impact factor: 4.709
Authors: Camilla S Morgen; Lars Ängquist; Merete Appleyard; Peter Schnohr; Gorm B Jensen; Thorkild I A Sørensen Journal: PLoS One Date: 2019-08-15 Impact factor: 3.240
Authors: Helene Kirkegaard; Mette Bliddal; Henrik Støvring; Kathleen M Rasmussen; Erica P Gunderson; Lars Køber; Thorkild I A Sørensen; Ellen A Nøhr Journal: PLoS Med Date: 2021-04-02 Impact factor: 11.069