Age-dependent relationships between body mass index and mortality: Singapore longitudinal ageing study

Abstract

ObjectivesThe relationship between body mass index (BMI) with mortality risk, in particular the BMI category associated with the lowest all-cause and CVD-and-stroke mortality and the BMI threshold for defining overweight or obesity in older persons is controversial. This study investigated the age-dependent associations of BMI categories with all-cause and cardiovascular disease (CVD) and stroke mortality.MethodProspective cohort study (Singapore Longitudinal Ageing Studies) of older adults aged 55 and above, followed up from 2003 to 2011. Participants were 2605 Chinese with baseline BMI and other variables. Outcome Measurement: Mortality hazard ratios (HR) for all-cause and CVD and stroke mortality.ResultsOverall, BMI showed a U-shaped relationship with all-cause and CVD and stroke mortality, being lowest at Normal Weight-II category (BMI 23.0–24.9 kg/m2). Most evidently among the middle-aged (55–64 years), all-cause mortality risks relative to Normal Weight-II were elevated for underweight (<BMI 18.5; HR = 4.92, p<0.0138), Normal Weight-I (BMI 18.5–22.9; HR = 3.41, p = 0.0149), and Overweight-Obese (BMI>30.0; HR = 4.05,p = 0.0423). Among the old (≥65 years), however, Overweight and Obese categories were not significantly associated with increased all-cause mortality (HR from 0.98 to 1.29), but Overweight-Obese was associated with increased CVD and stroke mortality (HR = 10.0, p = 0.0086).ConclusionBMI showed a U-shaped relationship with mortality. Among older persons aged 65 and above, the overweight-or-obese category of BMI was not associated with excess all-cause mortality.

Weighing the role of skeletal muscle mass and muscle density in cancer patients receiving PD-1/PD-L1 checkpoint inhibitors: a multicenter real-life study

“…Therefore, since in a previous study with a similar population we revealed that a BMI ≥ 25 has a positive predictive and prognostic role during immunotherapy 13 , we used BMI +/− 25 as a landmark to categorize patients while computing the SMI and SMD optimal cut-offs. On the other hand, the median age of our study population was 66 years and 57% of the patients were elderly, and we must recognize that some authors have already speculated about the age-dependent relationship between BMI and mortality overall (non-cancer patients) in both sex 30,31 .…”

“…Recently, an interesting study have tried to shed a light on the complex inter-relations between sex, BMI and sarcopenia, in melanoma patients treated with ICIs (using serum creatinine as a surrogate of muscle mass) 35 . The authors intriguingly found that the best clinical outcome is achieved in overweight/class I obese patients (BMI [25][26][27][28][29][30][31][32][33][34][35], particularly among males, who had higher serum creatinine levels (which stands for a good muscle mass) 35 . BMI and muscle mass seem to have a direct proportionality (the higher is the BMI, the higher the SMI), vice versa their effect on immunotherapy clinical outcomes appears opposite (high BMI has a positive predictive and prognostic role, while sarcopenia has a negative prognostic role), which overlaps in a specific subset of patients (overweight non sarcopenic).…”

Risk of malnutrition is associated with poor physical function in patients undergoing cardiac rehabilitation following heart failure

“…This has been validated by many reports suggesting that low body weight with a BMI <18.5 kg/m 2 may be a risk factor for disease onset or mortality in Asian populations. [23][24][25][26] The primary outcome, ADL as physical function, was assessed using the Barthel index (BI). 27 The BI is often used as an indicator of ADL in clinical practice and consists of an ordinal assessment (0-100 point), with lower scores indicating poor physical function.…”

Aging and Imaging Assessment of Body Composition: From Fat to Facts

“…More recent studies have supported the finding that a high BMI negatively affects healthy life expectancy, and it is also associated with an increased risk for cancer mortality, in particular for colorectal cancer. A difference between men and women exists in the degree that excess body weight increases mortality risk (99)(100)(101)(102)(103)(104)(105)(106).…”