Weight Loss and Mortality Among Free-Living Frail Elders: A Prospective Study

Payette, Hélène; Coulombe, Carole; Boutier, V; Gray‐Donald, Katherine

doi:10.1093/gerona/54.9.m440

Cited by 98 publications

(66 citation statements)

References 31 publications

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“…Weight loss of 4%-5% or more of body weight within 1 year, or 10% or more over 5-10 years or longer, is associated with increased mortality or morbidity or both (Table 1). This association has also been seen in a number of epidemiologic and clinical studies that adjusted for comorbidity, 5,7,13 disability, 5,13 smoking, 5,7 alcohol use 5 or level of physical activity 13 and that excluded deaths within the first few years of weight loss to exclude undiagnosed illness. 7 In frail elderly populations, even small weight loss (e.g., 1 kg, 5 or 3% of body weight 18 ) may be significant.…”

Section: When Is Weight Loss Clinically Important?mentioning

confidence: 66%

“…This association has also been seen in a number of epidemiologic and clinical studies that adjusted for comorbidity, 5,7,13 disability, 5,13 smoking, 5,7 alcohol use 5 or level of physical activity 13 and that excluded deaths within the first few years of weight loss to exclude undiagnosed illness. 7 In frail elderly populations, even small weight loss (e.g., 1 kg, 5 or 3% of body weight 18 ) may be significant. Voluntary weight loss among elderly patients is also associated with increased risk of death 17 and of hip fracture, 19 which highlights the importance of maintaining weight with age.…”

Section: When Is Weight Loss Clinically Important?mentioning

confidence: 66%

“…It is associated with increased mortality, which can range from 9% to as high as 38% within 1 to 2.5 years after weight loss has occurred. 1,3,4 Frail elderly people, 5 people with low baseline body weight, [5][6][7] and elderly patients recently admitted to hospital are particularly susceptible to increased mortality. 8,9 Weight loss is also associated with an increased risk of in-hospital complications, 10,11 a decline in activities of daily living or physical function, 12,13 higher rates of admission to an institution 2,8 and poorer quality of life.…”

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confidence: 99%

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An approach to the management of unintentional weight loss in elderly people

Alibhai

Greenwood²,

Payette³

2005

Canadian Medical Association Journal

227

139

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UNINTENTIONAL WEIGHT LOSS, or the involuntary decline in total body weight over time, is common among elderly people who live at home. Weight loss in elderly people can have a deleterious effect on the ability to function and on quality of life and is associated with an increase in mortality over a 12-month period. A variety of physical, psychological and social conditions, along with age-related changes, can lead to weight loss, but there may be no identifiable cause in up to one-quarter of patients. We review the incidence and prevalence of weight loss in elderly patients, its impact on morbidity and mortality, the common causes of unintentional weight loss and a clinical approach to diagnosis. Screening tools to detect malnutrition are highlighted, and nonpharmacologic and pharmacologic strategies to minimize or reverse weight loss in older adults are discussed.

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Section: When Is Weight Loss Clinically Important?mentioning

confidence: 66%

Section: When Is Weight Loss Clinically Important?mentioning

confidence: 66%

mentioning

confidence: 99%

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An approach to the management of unintentional weight loss in elderly people

Alibhai

Greenwood²,

Payette³

2005

Canadian Medical Association Journal

227

139

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“…(8)(9)(10)(11) Furthermore, weight loss and BMD loss are also correlated. (30) Each of the measures has been shown to be associated with mortality risk, (7,(14)(15)(16) but no previous studies have simultaneously examined their independent effects on mortality risk. By analyzing all of the risk factors together, this study showed for the first time that low baseline BMD, high rate of BMD loss, high rate of weight loss, and weight fluctuation independently and additively contributed to the increased risk of mortality in women.…”

Section: Discussionmentioning

confidence: 99%

Bone Loss, Weight Loss, and Weight Fluctuation Predict Mortality Risk in Elderly Men and Women

Nguyen

Eisman

Nguyen

2007

Journal of Bone and Mineral Research

150

103

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Low baseline BMD, rate of BMD loss, weight loss, and weight fluctuation are significant predictors of all-cause mortality in elderly men and women, independent of each other and of age, incident fracture, and concomitant diseases. Introduction: Although low BMD has been shown to be associated with mortality in women, the effect of BMD is affected by weight and weight change and the contribution of these factors to mortality risk, particularly in men, is not known. This study examined the association between baseline BMD, rate of bone loss, weight loss, and weight fluctuation and all-cause mortality risk in elderly men and women. Materials and Methods: Data from 1059 women and 644 men, Ն60 years of age (as of 1989), of white background who participated in the Dubbo Osteoporosis Epidemiology Study were analyzed. All-cause mortality was recorded annually between 1989 and 2004. BMD at the femoral neck was measured by DXA (GE-LUNAR) at baseline and at approximately every 2 yr afterward. Data on incident osteoporotic fractures and concomitant diseases, including cardiovascular diseases, all types of cancer, and type I/II diabetes mellitus, was also recorded. Results: In the multivariable Cox's proportional hazards model with adjustment for age, incident fractures, and concomitant diseases, the following variables were independent risk factors of all-cause mortality in men: rate of BMD loss of at least 1%/yr, rate of weight loss of at least 1%/yr, and weight fluctuation (defined by the CV) of at least 3%. In women, in addition to the significant factors observed in men, lower baseline BMD was also an independent risk factor of mortality. In both sexes, baseline weight was not an independent and significant predictor of mortality risk. Approximately 36% and 22% of deaths in women and men, respectively, were attributable to the four risk factors. Conclusions: These data suggest that, although low BMD was a risk factor of mortality in women, it was not a risk factor of mortality in men. However, high rates of BMD loss, weight loss, and weight fluctuation were also independent predictors of all-cause mortality in elderly men and women, independent of age, incident fracture, and concomitant diseases.

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“…Change in body weight is an important indicator of health of the patient. A decrease in body weight is related to increased morbidity and often mortality (Payette et al, 1999). In this study we showed that supplementation can improve body weight by 1.4 kg over a 12 week period, an increase higher than Fiatarone Singh et al (2000) reported, largely comparable to other studies performed for 6 weeks (Turic et al, 1998), 8 weeks (Lauque et al, 2000) and 12 weeks (Van der Wielen et al, 1995), but lower than found by Carver & Dobson (1995) (12 weeks).…”

Section: Discussionmentioning

confidence: 99%

Study of the effect of a liquid nutrition supplement on the nutritional status of psycho-geriatric nursing home patients

Wouters-Wesseling¹,

Wouters²,

Kleijer

et al. 2002

Eur J Clin Nutr

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Objectives: To evaluate the acceptance of a multinutrient liquid nutrition supplement in psycho-geriatric nursing home patients and the effect on weight, plasma nutrients and activities of daily life. Design: Double-blind, placebo-controlled 12-week intervention study. Setting: Two nursing homes in Boxtel, The Netherlands. Subjects: Forty-two (body mass index (BMI) < 23 kg=m 2 for men or < 25 kg=m 2 for women) psycho-geriatric nursing home patients aged 60 y or over. Interventions: Provision with a complete micronutrient-enriched liquid nutrition supplement of 125 ml and 0.6 MJ (135 kcal) or placebo twice daily during daytime between main meals. Study parameters were assessed at 0, 6 and 12 weeks. Main Outcome for Measures: Weight, Barthel index of daily activities, several plasma values (albumin, C-reactive protein (CRP), homocysteine, thiamine, thiamine diphosphate (TDF), vitamin B 6 , vitamin B 12 , folic acid, vitamin D), bowel function. Results: The supplement was well accepted. Thirty-five patients completed the intervention period (16 control group; 19 supplement group). Baseline daily nutrient intake was low. A statistically significant improvement was observed for body weight (difference between groups 2.2 kg, P ¼ 0.03), and homocysteine, vitamin B 1 , TDF, vitamin B 6 , vitamin B 12 , folate and vitamin D in the supplement group compared to the placebo group. No significant difference was observed in the Barthel index (mean difference 7 0.3 AE 1.1 for both groups). No difference in occurrence of diarrhoea was observed. Conclusions: The study shows that nutritional supplementation is well accepted and can improve the nutritional status of psycho-geriatric nursing home patients.

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Weight Loss and Mortality Among Free-Living Frail Elders: A Prospective Study

Cited by 98 publications

References 31 publications

An approach to the management of unintentional weight loss in elderly people

An approach to the management of unintentional weight loss in elderly people

Bone Loss, Weight Loss, and Weight Fluctuation Predict Mortality Risk in Elderly Men and Women

Study of the effect of a liquid nutrition supplement on the nutritional status of psycho-geriatric nursing home patients

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