Body Mass Index, Poor Diet Quality, and Health-Related Quality of Life Are Associated With Mortality in Rural Older Adults

Abstract

In an aging population, potentially modifiable factors impacting mortality such as diet quality, body mass index (BMI), and health-related quality of life (HRQOL) are of interest. Surviving members of the Geisinger Rural Aging Study (GRAS) (n = 5,993; aged ?74 years) were contacted in the fall of 2009. Participants in the present study were the 2,995 (1,267 male, 1,728 female; mean age 81.4 ± 4.4 years) who completed dietary and demographic questionnaires and were enrolled in the Geisinger Health Plan over follow-up (mean = 3.1 years). Cox proportional hazards multivariate regression models were used to examine the associations between all-cause mortality and BMI, diet quality, and HRQOL. Compared to GRAS participants with BMIs in the normal range, a BMI < 18.5 was associated with increased mortality (HR 1.85 95%CI 1.09, 3.14, P = 0.02), while a BMI of 25-29.9 was associated with decreased risk of mortality (HR 0.71 95%CI 0.55, 0.91, P =0.007). Poor diet quality increased risk for mortality (HR 1.53 95%CI 1.06, 2.22, P = 0.02). Finally, favorable health-related quality of life was inversely associated with mortality (HR 0.09 95%CI 0.06, 0.13, P < 0.0001). Higher diet quality and HALex scores, and overweight status, were associated with reduced all-cause mortality in a cohort of advanced age. While underweight (BMI < 18.5) increased risk of all-cause mortality, no association was found between obesity and all-cause mortality in this aged cohort.

BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants

“…From a total of 112 173 records identified by the search we included 207 publications 16 17 18 19 20 21 22 23 24 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 …”

“…55 In addition, a large number of additional cohorts were either missed by the search or excluded from the analysis, 56 57 58 59 60 61 62 63 64 65 and at least 53 additional studies have since been published, including >2.3 million deaths and >21.6 million participants. 23 24 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 An updated analysis is therefore warranted.…”

Evolução e associação do IMC entre variáveis sociodemográficas e de condições de vida em idosos do Brasil: 2002/03-2008/09

“…Health problems related to overweight and obesity in Brazil are due in part to the increased income of the population associated to the consumption of foods with inconsistent frequency, low quality and high-energy content, besides the automation of daily activities and the low rates of physical activity practice 27,28 . However, low weight should be a focus of continuous interest of the public health bodies, even showing a decrease in the period investigated, since studies showed that lower quality of life and higher mortality from all causes were associated with this condition of nutritional status [29][30][31] . Some authors argue that variables analyzed on a subjective basis on living conditions can be used to show individuals' real perception of access to food 32,33 and, in association with other information contained in the 2002/03 and 2008/09 POFs, provide a set of information that enriches the understanding of health problems in the Brazilian elderly population.…”

The Association of Dietary Patterns and Weight Change in Rural Older Adults 75 Years and Older

“…In addition, some 5% of our sample reported weight cycling with both loss and gain of 10 pounds during the follow-up period. This discussion is also complicated by recent observations by our team (46) and others (47)(48)(49) that suggest that being overweight or mildly obese may be associated with reduced all-cause mortality among older persons. Relative weight stability may be desirable but it does not reflect changes in body composition like sarcopenia or sarcopenic obesity.…”