Association of Body Mass Index with All-Cause and Cardiovascular Disease Mortality in the Elderly

Abstract

ObjectivesTo evaluate the associations of body mass index (BMI) with all-cause, cardiovascular disease (CVD), and expanded CVD mortality in the elderly.DesignObservational cohort study.SettingAnnual physical examination program for the elderly from 2006 to 2010.ParticipantsWe included 77,541 Taipei residents aged ≥65 years (39,365 men and 38,176 women).MeasurementsBMI was categorized as underweight (BMI<18.5), normal weight (18.5≤BMI<25), overweight (25≤BMI<30), grade 1 obesity (30≤BMI<35), or grade 2–3 obesity (BMI≥35). Mortality was ascertained by national death files.ResultsUnderweight (hazard ratios [HRs] of all-cause, CVD, and expanded CVD mortality: 1.92, 1.74, and 1.77, respectively), grade 2–3 obesity (HRs: 1.59, 2.36, and 2.22, respectively), older age, male sex, smoking, and high fasting blood sugar were significant predictors of mortality. Meanwhile, being married/cohabitating, higher education, alcohol consumption, more regular exercise, and high total cholesterol were inversely associated with mortality. Multivariate stratified subgroup analyses verified smokers (HRs of all-cause, CVD, and expanded CVD mortality: 3.25, 10.71, and 7.86, respectively, for grade 2–3 obesity), the high triglyceride group (HRs: 5.82, 10.99, and 14.22, respectively for underweight), and patients with 3–4 factors related to metabolic syndrome (HRs: 4.86, 12.72, and 11.42, respectively, for underweight) were associated with mortality.ConclusionThe associations of BMI with all-cause, CVD, expanded CVD mortality in the elderly are represented by U-shaped curves, suggesting unilateral promotions or interventions in weight reduction in the elderly may be inappropriate. Heterogeneous effects of grades 1 and 2–3 obesity on mortality were observed and should be treated as different levels of obesity.

Association of estimated glomerular filtration rate with all-cause and cardiovascular mortality: the role of malnutrition-inflammation-cachexia syndrome

“…This programme provides health examinations that are performed according to an identical protocol and medical services with no formal referral requirement. Older citizens participate on a voluntary basis, are encouraged to undergo health examination annually, and are free to choose any hospital contracted with the Taipei City Government . All participants provide written informed consent authorizing the Taipei City Government Institution to process health examination data and release data for research purposes.…”

High Serum Uric Acid Levels Are Associated with All‐Cause and Cardiovascular, but Not Cancer, Mortality in Elderly Adults

“…Each year approximately 40,000 to 46,000 people participate in this program, with approximately 13% to 16% participation rate in the community . The cohort data have been described in detail in previous studies . Participants voluntarily participated in a routine physical examination program and were encouraged to participate in the program yearly.…”

Baseline body mass index among children and adults undergoing allogeneic hematopoietic cell transplantation: clinical characteristics and outcomes

“…The prevalence of overweight and obesity has increased substantially since the 1960s, resulting in a broad range of health problems and economic consequences (2-5). An estimated 1.4 billion adults (ages 20 and older) worldwide are overweight or obese, with an additional 170 million overweight or obese children and adolescents, one quarter of whom are under the age of five (6, 7).…”