An Evidence-Based Assessment of Federal Guidelines for Overweight and Obesity as They Apply to Elderly Persons

Heiat, Asefeh; Vaccarino, Viola; Krumholz, Harlan M.

doi:10.1001/archinte.161.9.1194

Cited by 383 publications

(299 citation statements)

References 45 publications

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“…The cut-off point of a BMI greater than 27 identified light overweight. This cut-off point was reported on a recent review to be a significant prognostic factor for all-cause and cardiovascular mortality among 65 -74 y old persons (Heiat et al, 2001). For energy and protein intake we considered subjects at risk of poor nutrition if their intake was lower than French recommended dietary allowances for elderly persons (Martin, 2001), that is lower than 1 g per kg of body weight per day for protein intake and intake lower or equal than 30 kcal per kg of body weight per day for energy intake.…”

Section: Discussionmentioning

confidence: 90%

Nutritional status of healthy elderly persons living in Dordogne, France, and relation with mortality and cognitive or functional decline

et al. 2002

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OBJECTIVE: Description of the nutritional status of healthy elderly people and investigation of its longitudinal relationship with mortality and cognitive or functional decline. DESIGN: Longitudinal study. SETTING: In Dordogne, France. SUBJECTS: A total of 169 French elderly community dwellers aged 68 y and older from in the PAQUID (Personnes Agées QUID) study were included. Dietary intake was assessed by a 3 day food record and a dietary history. Self-reported weight and height were used to calculate the body mass index (BMI, kg=m 2 ). Mortality, activities of daily living (ADL), instrumental activities of daily living (IADL) and the Mini Mental State Examination (MMSE) were measured at 5 y follow-up. RESULTS: Nutritional intake and BMI vary according to age and sex. Men generally have a higher nutritional intake than women. Intake decreases with age especially in men. Among the 169 subjects, 22 died. When analyzed by logistic regression, there was no relation between markers of risk of poor nutrition and mortality but a BMI greater or equal 27 at baseline was associated with a increased risk of 5 y mortality (OR ¼ 6.27, 95% CI 1.29 -30.37) adjusted for sex and age. With regard to cognitive decline, subjects with a BMI greater or equal than 23 kg=m 2 had 3.6 times lower chance of presenting a decline in the subsequent 5 y adjusted by age and sex (OR ¼ 0.28, 95%, CI 0.09 -0.90). BMI ranging between 23 and 27 was associated with a significantly decreased risk of IADL disability (OR ¼ 0.31, 95% CI 0.10 -0.93) in multivariate analyses. CONCLUSION: In apparently healthy elderly people a BMI ranging between 23 and 27 is associated with lower risks of functional and cognitive declines in the subsequent 5 y.

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Section: Discussionmentioning

confidence: 90%

Nutritional status of healthy elderly persons living in Dordogne, France, and relation with mortality and cognitive or functional decline

et al. 2002

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“…We conducted secondary analyses categorizing BMI into four categories according to the National Heart Lung and Blood Institute (NHLBI) guidelines: underweight (< 18.5 kg/m 2 ), normal (18.5 − 24.9 kg/m 2 ), overweight (25.0 − 29.9 kg/m 2 ), and obese (≥ 30.0 kg/m 2 ) 12 . However, this classification has been reported to be of poor predictive value in the elderly 13 , and we did not use it for the main analyses.…”

Section: Body Mass Index and Waist Circumferencementioning

confidence: 99%

Body mass index, dementia, and mortality in the elderly

Luchsinger

Patel²,

Tang

et al. 2008

The Journal of nutrition, health and aging

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Objectives-To explore the association between body mass index and mortality in the elderly taking the diagnosis of dementia into account. Design-Cohort study.Setting-cohort study of aging in Medicare recipients in New York City.Participants-1,452 elderly individuals 65 years and older of both genders.Measurements-We used proportional hazards regression for longitudinal multivariate analyses relating body mass index (BMI) and weight change to all-cause mortality.Results-There were 479 deaths during 9,974 person-years of follow-up. There were 210 cases of prevalent dementia at baseline, and 209 cases of incident dementia during follow-up. Among 1,372 persons with BMI information, the lowest quartile of BMI was associated with a higher mortality risk compared to the second quartile (HR = 1.5; 95% CI: 1.1,2.0) after adjustment for age, gender, education, ethnic group, smoking, cancer, and dementia. When persons with dementia were excluded, both the lowest (HR = 1.9; 95% CI =1.3,2.6) and highest (HR = 1.6; 95% CI : 1.1,2.3) quartiles of BMI were related to higher mortality. Weight loss was related to a higher mortality risk (HR = 1.5; 95% CI: 1.2,1.9) but this association was attenuated when persons with short follow-up or persons with dementia were excluded. Conclusion-The presence of dementia does not explain the association between low BMI and higher mortality in the elderly. However, dementia may explain the association between weight loss and higher mortality.

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“…Guidelines for optimal weight in older individuals are limited by uncertainty about the ideal BMI (53). The excess health risk associated with a higher BMI declines with increasing age.…”

Section: Clinical Targeting Of Higher Risk Obesitymentioning

confidence: 99%

Targeting abdominal obesity in cardiology: Can we be effective?

Poirier

2008

Canadian Journal of Cardiology

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An Evidence-Based Assessment of Federal Guidelines for Overweight and Obesity as They Apply to Elderly Persons

Cited by 383 publications

References 45 publications

Nutritional status of healthy elderly persons living in Dordogne, France, and relation with mortality and cognitive or functional decline

Nutritional status of healthy elderly persons living in Dordogne, France, and relation with mortality and cognitive or functional decline

Body mass index, dementia, and mortality in the elderly

Targeting abdominal obesity in cardiology: Can we be effective?

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