American Journal of Epidemiology Advance Access originally published online on April 26, 2006
American Journal of Epidemiology 2006 163(10):938-949; doi:10.1093/aje/kwj114
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Original Contribution |
Association of Body Mass Index and Weight Change with All-Cause Mortality in the Elderly
1 Department of Neurology, School of Medicine, University of California, Irvine, CA
2 Institute for Brain Aging and Dementia, University of California, Irvine, CA
3 Department of Neurobiology and Behavior, School of Biological Sciences, University of California, Irvine, CA
4 Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
Correspondence to Dr. María M. Corrada, Hewitt Hall, Room 1513, Department of Neurology, School of Medicine, University of California, Irvine, CA 92697-1400 (e-mail: mcorrada{at}uci.edu).
The authors explored the relation of body mass index (BMI; weight (kg)/height (m)2) and weight change to all-cause mortality in the elderly, using data from a large, population-based California cohort study, the Leisure World Cohort Study. They estimated relative risks of mortality associated with self-reported BMI at study entry, BMI at age 21 years, and weight change between age 21 and study entry. Participants were categorized as underweight (BMI <18.5), normal weight (BMI 18.5–24.9), overweight (BMI 25–29.9), or obese (BMI 
30). Of 13,451 participants aged 73 years (on average) at study entry (1981–1985), 11,203 died during 23 years of follow-up (1981–2004). Relative to normal weight, being underweight (relative risk (RR) = 1.51, 95% confidence interval (CI): 1.38, 1.65) or obese (RR = 1.25, 95% CI: 1.13, 1.38) at study entry was associated with increased mortality. People who were either overweight or obese at age 21 also had increased mortality (RR = 1.17, 95% CI: 1.09, 1.25). Participants who lost weight between age 21 and study entry had increased mortality regardless of their BMI category at age 21. Obesity was significantly associated with increased mortality only among persons under age 75 years and among never or past smokers. This study highlights the influence on older-age mortality risk of being overweight or obese in young adulthood and underweight or obese in later life.
aged; body mass index; body weight changes; longevity; mortality; risk factors
Abbreviations: BMI, body mass index; CI, confidence interval; RR, relative risk
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