Yue-Bin Lv1, Simin Liu2, Zhao-Xue Yin3, Xiang Gao4, Virginia Byers Kraus5, Chen Mao6, Jin-Qiu Yuan7, Juan Zhang8, Jie-Si Luo3, Hua-Shuai Chen9, Yi Zeng10, Xiao-Ming Shi11. 1. National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China. 2. Department of Epidemiology, Brown University, Providence, RI. 3. Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China. 4. Department of Nutritional Sciences, Pennsylvania State University, Philadelphia, PA. 5. Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC. 6. Division of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China. 7. Division of Epidemiology, JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China. 8. School of Public Health, Peking Union Medical College/ Chinese Academy of Medical Sciences, Beijing, China. 9. Center for the study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC. 10. Center for the study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC; Center for Study of Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, Peking University, Beijing, China. 11. National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: shixm@chinacdc.cn.
Abstract
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.
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 obeseparticipants (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.
Authors: Hanne Nybo; Hans Chr Petersen; David Gaist; Bernard Jeune; Kjeld Andersen; Matt McGue; James W Vaupel; Kaare Christensen Journal: J Am Geriatr Soc Date: 2003-10 Impact factor: 5.562
Authors: Tabita M Valentijn; Wael Galal; Elke K M Tjeertes; Sanne E Hoeks; Hence J Verhagen; Robert Jan Stolker Journal: Surgeon Date: 2013-03-09 Impact factor: 2.392
Authors: Anna K Dahl; Elizabeth B Fauth; Marie Ernsth-Bravell; Linda B Hassing; Nilam Ram; Denis Gerstof Journal: J Am Geriatr Soc Date: 2013-03-01 Impact factor: 5.562
Authors: Martin Lajous; Anne Bijon; Guy Fagherazzi; Marie-Christine Boutron-Ruault; Beverley Balkau; Françoise Clavel-Chapelon; Miguel A Hernán Journal: Epidemiology Date: 2014-01 Impact factor: 4.822
Authors: Gang Tian; Jingliang Shuai; Rui Li; Tong Zhou; Yan Shi; Gang Cheng; Yan Yan Journal: Front Aging Neurosci Date: 2022-08-22 Impact factor: 5.702