The Impact of Obesity on Active Life Expectancy in Older American Men and Women

Reynolds, Sandra L.; Saito, Yasuhiko; Crimmins, Eileen M.

doi:10.1093/geront/45.4.438

Cited by 164 publications

(141 citation statements)

References 38 publications

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“…In the general population, the negative association of obesity with life expectancy is greater at a young age and less pronounced at age 70 years (28,29). We found a similar continuous age-dependent association between obesity and mortality among dialysis patients.…”

Section: Discussionsupporting

confidence: 71%

Obesity and Mortality Risk among Younger Dialysis Patients

Hoogeveen

Halbesma²,

Rothman

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Many studies show that obesity in dialysis patients is not strongly associated with mortality but not whether this modest association is constant over age. This study investigated the extent to which the relation of body mass index (BMI) and mortality differs between younger and older dialysis patients.Design, setting, participants, & measurements Adult dialysis patients were prospectively followed from their first dialysis treatment for 7 years or until death or transplantation. Patients were stratified by age (,65 or $65 years) and baseline BMI (,20, 20-24 [reference], 25-29, and $30 kg/m 2 ).Results The study sample included 984 patients younger than 65 years and 765 patients 65 years or older; cumulative survival proportions at end of follow-up were 50% and 16%. Age-standardized mortality rate was 1.7 times higher in obese younger patients than those with normal BMI, corresponding to an excess rate of 5.2 deaths/100 patient-years. Mortality rates were almost equal between obese older patients and those with normal BMI. Excess rates of younger and older patients with low compared with normal BMI were 8.7 and 1.1 deaths/100 patient-years. After adjustment for age, sex, smoking, comorbidity, and treatment modality, hazard ratios by increasing BMI were 2.00, 1, 0.95, and 1.57 for younger patients and 1.07, 1, 0.88, and 0.91 for older patients, implying that obesity is a 1.7-fold (95% confidence interval, 1.1-to 2.9-fold) stronger risk factor in younger than older patients.Conclusions In contrast to older dialysis patients, younger patients with low or very high BMI had a substantially elevated risk for death.

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Section: Discussionsupporting

confidence: 71%

Obesity and Mortality Risk among Younger Dialysis Patients

Hoogeveen

Halbesma²,

Rothman

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…15,16,[45][46][47][48][49][50] Therefore, it is imperative for studies of lifetime costs to account for differential life expectancy between normal weight and heavier adults.…”

Section: Differential Life Expectancy By Bmimentioning

confidence: 99%

Lifetime Direct Medical Costs of Childhood Obesity

2014

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BACKGROUND AND OBJECTIVES: An estimate of the lifetime medical costs of an obese child provides a benchmark of the potential per capita savings that could accrue from successful childhood obesity prevention efforts. We reviewed the literature to identify the best current estimate of the incremental lifetime per capita medical cost of an obese child in the United States today relative to a normal weight child. METHODS: We searched PubMed and Web of Science for US-based studies published within the 15 years preceding May 2013 from which lifetime medical cost estimates can be extracted or imputed. Two reviewers independently screened search results and extracted data from eligible articles. All estimates were inflated to 2012 dollars and discounted to reflect costs from the perspective of a 10-year-old child today. RESULTS: We identified 6 studies. The incremental lifetime direct medical cost from the perspective of a 10-year-old obese child relative to a 10-year-old normal weight child ranges from $12 660 to $19 630 when weight gain through adulthood among normal weight children is accounted for and from $16 310 to $39 080 when this adjustment is not made. CONCLUSIONS: We recommend use of an estimate of $19 000 as the incremental lifetime medical cost of an obese child relative to a normal weight child who maintains normal weight throughout adulthood. The alternative estimate, which considers the reality of eventual weight gain among normal weight youth, is $12 660. Additional research is needed to include estimates of indirect costs of childhood obesity.

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“…High weight increases the mechanical stress on joints, particularly knee and back, increasing back pain and osteoarthritis and limiting mobility (17,18). If disability is increased but not mortality, numbers of obese survivors expand morbidity, increasing life years lived with disability, care dependence, and health-care costs (19,20).…”

mentioning

confidence: 99%

Smoking Kills, Obesity Disables: A Multistate Approach of the US Health and Retirement Survey

Reuser

Bonneux

Willekens

2009

Obesity

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Increasing BMI causes concerns about the consequences for health care. Decreasing cardiovascular mortality has lowered obesity‐related mortality, extending duration of disability. We hypothesized increased duration of disability among overweight and obese individuals. We estimated age‐, risk‐, and state‐dependent probabilities of activities of daily living (ADL) disability and death and calculated multistate life tables, resulting in the comprehensive measure of life years with and without ADL disability. We used prospective data of 16,176 white adults of the Health and Retirement Survey (HRS). Exposures were self‐reported BMI and for comparison smoking status and levels of education. Outcomes were years to live with and without ADL disability at age 55. The reference categories were high normal weight (BMI: 23–24.9), nonsmoking and high education. Mild obesity (BMI: 30–34.9) did not change total life expectancy (LE) but exchanged disabled for disability‐free years. Mild obesity decreased disability‐free LE with 2.7 (95% confidence limits 1.2; 3.2) year but increased LE with disability with 2.0 (0.6; 3.4) years among men. Among women, BMI of 30 to 34.9 decreased disability‐free LE with 3.6 (2.1; 5.1) year but increased LE with disability with 3.2 (1.6;4.8) years. Overweight (BMI: 25–29.9) increases LE with disability for women only, by 2.1 (0.8; 3.3) years). Smoking compressed disability by high mortality. Smoking decreased LE with 7.2 years, and LE with disability with 1.3 (0.5; 2.5) years (men) and 1.4 (0.3; 2.6) years (women). A lower education decreased disability‐free life, but not duration of ADL disability. In the aging baby boom, higher BMI will further increase care dependence.

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The Impact of Obesity on Active Life Expectancy in Older American Men and Women

Cited by 164 publications

References 38 publications

Obesity and Mortality Risk among Younger Dialysis Patients

Obesity and Mortality Risk among Younger Dialysis Patients

Lifetime Direct Medical Costs of Childhood Obesity

Smoking Kills, Obesity Disables: A Multistate Approach of the US Health and Retirement Survey

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