Our results showed increased mortality risks for elderly people with an increased WC-even across BMI categories- and for those who were classified as 'underweight' using BMI. The results provide a solid basis for re-evaluation of WC cut-points in ageing populations.

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This study examined the physical activity (PA) levels of people with specific disabilities, using health care registration data. Data of 321,656 adults (83%) from the Dutch Public Health Monitor 2012 were used to assess adherence to the World Health Organization (WHO) PA guidelines (%) and the time (min/week) spent on moderate-to-vigorous-intensity and vigorous-intensity PA. Specific physical and sensory (i.e. vision and hearing) disabilities were identified by means of two health claims registries that include reimbursement of functional aids and long-term care. Generalized estimated equations were used to determine the association of PA with disabilities, adjusted for confounders (model 1) and additionally for self-reported activity limitations (model 2). Adults with disabilities had lower levels of WHO PA guidelines adherence (range: −49.8% to −11.9%, p < 0.01) and of moderate-to-vigorous-intensity PA (range: −691 to −200 min/week, p < 0.01) than adults without physical and sensory disabilities. Adults with physical disabilities had the lowest levels. The difference in levels of vigorous-intensity PA between adults with and without physical and sensory disabilities ranged from −12 to 8 min/week Only adults receiving long-term care due to physical disabilities had significantly lower vigorous-intensity PA levels (−12 min/week, p < 0.01). After adjustment for self-reported activity limitations, the difference in PA levels between adults with and without physical and sensory disabilities attenuated, especially among those with physical disabilities, but PA levels were still lower for adults with physical disabilities (−34.5% to −9.8% and −466 to −172 min/week, p < 0.01, respectively). Regardless of self-reported activity limitations, adults with objectively measured disabilities, especially those with physical disabilities, had lower PA levels compared to adults without physical and sensory disabilities.

In this study, BMI was associated with all-cause mortality risk in older people. This risk was mostly driven by an increased cardiovascular mortality risk, as no association was found for mortality risk from cancer or respiratory disease. Our results indicate that the WHO cut-off point of 25 kg/m² for overweight might be too low in old age, but more studies are needed to define specific cut-off points.

Overweight is associated with a reduced health-related quality of life (QOL), but less is known about the impact of long-term body mass index (BMI, calculated as weight (kg)/height (m)(2)) patterns on QOL in adults. In the Dutch Doetinchem Cohort Study (1989-2009) that included 1,677 men and 1,731 women aged 20-66 years, 6 BMI patterns were defined by using 4 measurements over a 15-year period: 1) persistent healthy weight (18.5-24.9, reference pattern); 2) persistent overweight (25.0-29.9); 3) persistent obesity (≥30.0); 4) developing overweight; 5) developing obesity; and 6) switching between BMI categories. For each BMI pattern, adjusted QOL (measured on a 0-100 scale) was estimated at the end of this period. The lowest QOL was observed for persistent obesity of all BMI patterns. It was 5.0 points (P = 0.02) lower for 1 mental dimension in men and 6.2-11.6 points (P < 0.05) lower for 5 (mainly physical) dimensions in women. Developing overweight or obesity scored 1.8-6.3 points (P < 0.05) lower on 2-5 (mainly physical) dimensions. Persistent overweight hardly differed from a persistent healthy weight. In women, switching between BMI categories resulted in a lower QOL on the mental dimensions. Studying long-term BMI patterns over a 15-year period showed that persistent obesity, developing overweight, and developing obesity resulted in a lower QOL-particularly on the physical dimensions-compared with a persistent healthy weight.

Weight gain and weight loss were associated with unfavourable changes in HRQL compared with a stable weight. For weight gain, this was most pronounced on the physical scales and for weight loss, although less consistent, on the mental scales.

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