Marcio M Nishida1, Mika Okura2, Mihoko Ogita3, Tomoki Aoyama2, Tadao Tsuboyama4, Hidenori Arai5. 1. Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto, Japan; National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan. 2. Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto, Japan. 3. Division of Geriatric Nursing, Shiga University of Medical Science, Otsu City, Shiga, Japan. 4. Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto, Japan; School of Health Sciences, Bukkyo University, Kyoto City, Kyoto, Japan. 5. National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan. Electronic address: harai@ncgg.go.jp.
Abstract
OBJECTIVE: Previous studies in older populations have shown a cardioprotective effect for obesity, an observation known as the obesity paradox. However, whether a decrease or increase in body weight over a certain period affects disability and mortality in older adults remains unknown. Hence, we examined whether the percent body weight change can predict the risk of mortality and disability in older Japanese adults. DESIGN: We performed a longitudinal prospective cohort study. SETTING AND PARTICIPANTS: We investigated 1229 community-dwelling older adults (aged ≥65 years) living in Japan. METHODS: Participants were divided into 3 groups (weight loss, stable weight, and weight gain) based on percentage body weight change (using 1 standard deviation from the mean as cutoff points) between 2011 and 2013. Death and disability incidences were monitored between April 2013 and March 2016. Disability was defined as the need for new long-term care insurance (LTCI). RESULTS: The rates of death and new LTCI requests over the 3-year follow-up were 2.4% and 4.7%, respectively. The weight loss group (reduction >4.8%) had a 5.0% death rate and an 11.1% new LTCI rate, which were significantly higher than those in the stable weight (1.6% and 3.8%, respectively) and weight gain (ie, gain >3.1%) groups (3.9% and 4.7%, respectively). Cox regression analysis confirmed a higher risk for death [hazard ratio (HR) = 3.10, 95% confidence interval (CI) = 1.31-7.31] and new LTCI requests (HR = 3.03, 95% CI = 1.69-5.43) only in the weight loss group. The body mass index did not significantly influence the risk of death or disability. CONCLUSIONS/IMPLICATIONS: Weight loss over 2 years but not body mass index was associated with a higher death and disability risk during the subsequent 3-year follow-up period among older participants. Weight change surveillance can improve the quality of health care by early identifying frailty and death risk population.
OBJECTIVE: Previous studies in older populations have shown a cardioprotective effect for obesity, an observation known as the obesity paradox. However, whether a decrease or increase in body weight over a certain period affects disability and mortality in older adults remains unknown. Hence, we examined whether the percent body weight change can predict the risk of mortality and disability in older Japanese adults. DESIGN: We performed a longitudinal prospective cohort study. SETTING AND PARTICIPANTS: We investigated 1229 community-dwelling older adults (aged ≥65 years) living in Japan. METHODS:Participants were divided into 3 groups (weight loss, stable weight, and weight gain) based on percentage body weight change (using 1 standard deviation from the mean as cutoff points) between 2011 and 2013. Death and disability incidences were monitored between April 2013 and March 2016. Disability was defined as the need for new long-term care insurance (LTCI). RESULTS: The rates of death and new LTCI requests over the 3-year follow-up were 2.4% and 4.7%, respectively. The weight loss group (reduction >4.8%) had a 5.0% death rate and an 11.1% new LTCI rate, which were significantly higher than those in the stable weight (1.6% and 3.8%, respectively) and weight gain (ie, gain >3.1%) groups (3.9% and 4.7%, respectively). Cox regression analysis confirmed a higher risk for death [hazard ratio (HR) = 3.10, 95% confidence interval (CI) = 1.31-7.31] and new LTCI requests (HR = 3.03, 95% CI = 1.69-5.43) only in the weight loss group. The body mass index did not significantly influence the risk of death or disability. CONCLUSIONS/IMPLICATIONS: Weight loss over 2 years but not body mass index was associated with a higher death and disability risk during the subsequent 3-year follow-up period among older participants. Weight change surveillance can improve the quality of health care by early identifying frailty and death risk population.
Authors: Hiroshi Murayama; Jersey Liang; Benjamin A Shaw; Anda Botoseneanu; Erika Kobayashi; Taro Fukaya; Shoji Shinkai Journal: J Gerontol A Biol Sci Med Sci Date: 2021-10-13 Impact factor: 6.053