Abstract
Objective
Current international and national guidelines for body mass index (BMI) and waist
circumference (WC) have been recommended to all adults. However, whether recommendations
applied to the oldest old (aged 80+) is poorly known. The study objective was to investigate
the relation of BMI and WC with 3-year all-cause mortality among the oldest old.
Design, Setting, and Participants
A total of 4361 Chinese oldest old (mean age 91.8) participated in this community-based
prospective cohort study.
Measurements
BMI and WC were measured at baseline in 2011 and were used as continuous variables
and as categorized variables by recommendations or by tertiles. Adjusted, sex-stratified
Cox models with penalized splines and Cox models were constructed to explore the association.
Results
Greater BMI and WC were linearly associated with lower mortality risk in both genders.
The mortality risk was the lowest in overweight or obese participants (BMI ≥ 24.0)
and was lower in participants with abdominal obesity. Compared to the upper tertile,
those in the middle and lower tertile of BMI had a higher risk of mortality for men
[hazard ratio (HR): 1.23 (1.02-1.48) and 1.53 (1.28-1.82)] and for women [HR: 1.21
(1.03-1.41) and 1.35 (1.15-1.58)]; it was also found in participants in the middle
and lower tertile of WC for men [HR: 1.21 (1.01-1.46) and 1.41 (1.18-1.69)] and for
women [HR: 1.35 (1.15-1.58) and 1.55 (1.32-1.81)] (all the P values for trend <.001). These findings were robust in further sensitivity analyses
or when using propensity score matching, in subgroup analyses, or in octogenarians,
nonagenarians, and centenarians.
Conclusions
In Chinese oldest old, both higher BMI and higher WC predict better survival in both
genders. The finding suggests optimal BMI and WC may be sensitive to age, thus, the
current recommendations for the oldest old may need to be revisited.
Keywords
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Article info
Publication history
Published online: May 25, 2018
Footnotes
This work was supported by National Natural Sciences Foundation of China [grant number 71233001, 71490732 to Y.Z. and 81573247 to X.M.S.], the U.S. National Institute of Aging [grant number 2P01AG031719 to Y.Z.], and a Claude D. Pepper Older Americans Independence Centers grant [grant number 5P30AG028716 from NIA to V.B.K.]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Informed consent was obtained from all participants and/or their relatives, and the study was approved by the Ethics Committee of Peking University.
The authors declare no conflicts of interest.
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© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
