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Weight change, body composition, and risk of mobility disability and mortality in older adults: a population-based cohort study.

ABSTRACT: OBJECTIVES:To examine associations between weight change, body composition, risk of mobility disability, and mortality in older adults. DESIGN:Prospective, longitudinal, population-based cohort. SETTING:The Health, Aging, and Body Composition Study. PARTICIPANTS:Women (n = 1,044) and men (n = 931) aged 70 to 79. MEASUREMENTS:Weight and lean and fat mass from dual-energy X-ray absorptiometry measured annually over 5 years. Weight was defined as stable (n = 664, reference), loss (n = 662), gain (n = 321), or cycling (gain and loss, n = 328) using change of 5% from year to year or from Year 1 to 6. Mobility disability (two consecutive reports of difficulty walking one-quarter mile or climbing 10 steps) and mortality were determined for 8 years after the weight change period. Associations were analyzed using Cox proportional hazards regression adjusted for covariates. RESULTS:During follow-up, 313 women and 375 men developed mobility disability, and 322 women and 378 men died. There was no risk of mobility disability or mortality with weight gain. Weight loss (hazard ratio (HR) = 1.88, 95% confidence interval (CI) = 1.40-2.53) and weight cycling (HR = 1.59, 95% CI = 1.11-2.29) were associated with mobility disability in women, and weight loss was associated with mobility disability in men (HR = 1.30, 95% CI = 1.01-1.69). Weight loss and weight cycling were associated with mortality risk in women (weight loss: HR = 1.47, 95% CI = 1.07-2.01; weight cycling: HR = 1.62, 95% CI = 1.15-2.30) and in men (weight loss: HR = 1.41, 95% CI = 1.09-1.83; weight cycling: HR = 1.50, 95% CI = 1.08-2.08). Adjustment for lean and fat mass and change in lean and fat mass from Year 1 to 6 attenuated the relationships between weight loss and mobility disability in men and between weight loss and mortality in men and women. CONCLUSION:Weight cycling and weight loss predict impending mobility disability and mortality in old age, underscoring the prognostic importance of weight history.

SUBMITTER: Murphy RA

PROVIDER: S-EPMC4134405 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

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Weight change, body composition, and risk of mobility disability and mortality in older adults: a population-based cohort study.

Murphy Rachel A RA Patel Kushang V KV Kritchevsky Stephen B SB Houston Denise K DK Newman Anne B AB Koster Annemarie A Simonsick Eleanor M EM Tylvasky Frances A FA Cawthon Peggy M PM Harris Tamara B TB

Journal of the American Geriatrics Society 20140715 8

<h4>Objectives</h4>To examine associations between weight change, body composition, risk of mobility disability, and mortality in older adults.<h4>Design</h4>Prospective, longitudinal, population-based cohort.<h4>Setting</h4>The Health, Aging, and Body Composition Study.<h4>Participants</h4>Women (n = 1,044) and men (n = 931) aged 70 to 79.<h4>Measurements</h4>Weight and lean and fat mass from dual-energy X-ray absorptiometry measured annually over 5 years. Weight was defined as stable (n = 664, ...[more]

PMID: 25039391

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Project description:ObjectiveTo investigate the association between weight change in older adults and mortality in a multiethnic population.MethodsWe performed a prospective analysis using data on weight change between the baseline (1993-1996) and the 10-year follow-up (2003-2007) surveys in relation to subsequent mortality among 63 040 participants in the Multiethnic Cohort Study in Hawaii and California. The participants were African American, Native Hawaiian, Japanese American, Latino and white, aged 45-75 years at baseline, and did not report heart disease or cancer at either survey.ResultsDuring an average of 7.3 years of follow-up after the 10-year survey, 6623 deaths were identified. Compared with individuals whose weight remained stable (±2.5 kg), those who lost weight and those with the highest weight gain (>10 kg) were at increased risk of all-cause mortality, with the risks greater for the weight loss (hazard ratios (HR): 2.86; 95% confidence interval (95% CI): 2.62-3.11 for >10 kg) than the weight-gain group (HR: 1.25; 95% CI: 1.11-1.41 for >10 kg), thus resulting in a reverse J-shaped curve. Japanese Americans and Latinos had stronger associations of weight loss >10 kg with mortality than did African Americans, Native Hawaiians and whites. The increase in risk with weight gain >10 kg was greater for older (⩾55 years at baseline) than younger individuals, whereas the increase in mortality associated with weight loss was greater for the normal weight (<25 kg m-2 at baseline) participants and never smokers, compared with overweight/obese persons and current smokers, respectively.ConclusionsOur findings confirm the association between weight change and a higher mortality in a healthy, multiethnic population, with higher risks for weight loss than weight gain. On the basis of these observations, public health recommendation should focus on the prevention of weight loss, as well as weight stability within the non-obese range, for middle-aged and older adults.

Dataset Information

Weight change, body composition, and risk of mobility disability and mortality in older adults: a population-based cohort study.

Publications

Weight change, body composition, and risk of mobility disability and mortality in older adults: a population-based cohort study.

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