The relationship between body mass index prior to old age and disability in old age

Abstract

OBJECTIVES: To analyse the relationship between body mass index (BMI) in middle-age and disability status in old-age using data from the Melbourne Collaborative Cohort Study (MCCS). METHODS: A total of 41 514 participants enroled in the MCCS between 1990-1994. Height and weight were measured at baseline and disability, defined as limitations to self-care activities of daily living (ADLs) and self-care plus mobility activities, was identified at follow-up (2003-2007). In all, 6300 participants were o65 years at baseline, X70 years at follow-up and not missing BMI at baseline or ADLs at follow-up. The association between BMI in six categories (30)(31)(32)(33)(34)(35); 35 þ ) and disability status was analysed using logistic regression. Models were stratified by sex, and sequentially adjusted for age, education, country of birth, then smoking, alcohol, fruit and vegetable intake, and physical activity. RESULTS: Adjusted odds ratios for composite self-care ADL and mobility limitations compared with BMI 18.5-22.5 kg m À 2 were 1.73 (95%CI 1.14-2.64) for BMI 30-35 kg m À 2 and 3.46 (1.78-6.73) for BMI 35 þ kg m À 2 in males. In females, adjusted odds ratios were 1.29 (1.00-1.68) for BMI 22.5-25 kg m À 2 , 1.74 (1.35-2.24) for BMI 25-27.5 kg m À 2 , 2.58 (1.98-3.36) for BMI 27.5-30 kg m À 2 , 2.74 (2.10-3.58) for BMI 30-35 kg m À 2 and 4.21 (3.12-5.88) for BMI 35 þ kg m À 2 . CONCLUSION: A graded relationship was observed between BMI and disability in males and females, across the continuum of BMI. These results highlight the importance of a healthy body weight at middle age in order to reduce the risk of disability in old age.

Gender‐dependent association of body mass index and waist circumference with disability in the chinese oldest old

“…In males, our results were consistent with other studies (2-4, 7, 21-23), which found associations of obesity, higher BMI or higher WC with increased risk of ADL limitation. There are several possible explanations for this association.…”

Predicting the risk of physical disability in old age using modifiable mid-life risk factors

“…For example, a recent review and meta-analysis on the association between BMI and dementia showed a positive association between abnormal BMI and dementia when BMI was measured in mid-life, not in late-life 31. Our finding of a threefold increase in the probability of disability associated with obesity is similar to the association found by Backholer et al 8 in a cohort of 6300 Australians aged under 65 at baseline and followed up over 14 years. Backholer et al reported an OR for ADL disability of 2.74 (95% CI 2.10 to 3.58) for women with class 1 obesity (BMI 30–35 kg/m 2 ) and OR of 4.21 (95% CI 3.12 to 5.88) for women with obesity class 2 and above (BMI ≥35 kg/m 2 ).…”

Obesity in the elderly: an emerging health issue

“…6 In a large study sample of subjects, a significant relation between BMI assessed at midlife and disability in old age was observed even after taking into account several covariates. 5 After a 26-year follow-up, overweight and obese midlife men showed, respectively, 2.06 and 5.41 higher risk to become frail in old ages. Weight gain from midlife to old age was higher in subjects who became prefrail or frail in older ages.…”