Dataset Information

Weight change in older adults and mortality: the Multiethnic Cohort Study.

ABSTRACT: OBJECTIVE:To investigate the association between weight change in older adults and mortality in a multiethnic population. METHODS:We 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. RESULTS:During 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. CONCLUSIONS:Our 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.

SUBMITTER: Park SY

PROVIDER: S-EPMC5803382 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Weight change in older adults and mortality: the Multiethnic Cohort Study.

Park S-Y SY Wilkens L R LR Maskarinec G G Haiman C A CA Kolonel L N LN Marchand L L LL

International journal of obesity (2005) 20170814 2

<h4>Objective</h4>To investigate the association between weight change in older adults and mortality in a multiethnic population.<h4>Methods</h4>We 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 ...[more]

PMID: 28885999

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Project description:ImportanceVitamin D (VitD) deficiency is associated with brain structural abnormalities, cognitive decline, and incident dementia.ObjectiveTo assess associations between VitD status and trajectories of change in subdomains of cognitive function in a cohort of ethnically diverse older adults.Design, setting, and participantsLongitudinal multiethnic cohort study of 382 participants in an outpatient clinic enrolled between February 2002 and August 2010 with baseline assessment and yearly follow-up visits. Serum 25-hydroxyvitamin D (25-OHD) was measured, with VitD status defined as the following: deficient, less than 12 ng/mL (to convert to nanomoles per liter, multiply by 2.496); insufficient, 12 to less than 20 ng/mL; adequate, 20 to less than 50 ng/mL; or high, 50 ng/mL or higher. Subdomains of cognitive function were assessed using the Spanish and English Neuropsychological Assessment Scales. Associations were evaluated between 25-OHD levels (as continuous and categorical [deficient, insufficient, or adequate]) and trajectories of cognitive decline.Main outcomes and measuresSerum 25-OHD levels, cognitive function, and associations between 25-OHD levels and trajectories of cognitive decline.ResultsParticipants (N = 382 at baseline) had a mean (SD) age of 75.5 (7.0) years; 61.8% were women; and 41.4% were white, 29.6% African American, 25.1% Hispanic, and 3.9% other race/ethnicity. Diagnosis at enrollment included 17.5% with dementia, 32.7% with mild cognitive impairment, and 49.5% cognitively normal. The mean (SD) 25-OHD level was 19.2 (11.7) ng/mL, with 26.2% of participants being VitD deficient and 35.1% insufficient. The mean (SD) 25-OHD levels were significantly lower for African American and Hispanic participants compared with white participants (17.9 [15.8] and 17.2 [8.4] vs 21.7 [10.0] ng/mL, respectively; P < .001 for both). The mean (SD) 25-OHD levels were similarly lower in the dementia group compared with the mild cognitive impairment and cognitively normal groups (16.2 [9.4] vs 20.0 [10.3] and 19.7 [13.1] ng/mL, respectively; P = .006). The mean (SD) follow-up was 4.8 (2.5) years. Rates of decline in episodic memory and executive function among VitD-deficient (episodic memory: β = -0.04 [SE = 0.02], P = .049; executive function: β = -0.05 [SE = 0.02], P = .01) and VitD-insufficient (episodic memory: β = -0.06 [SE = 0.02], P < .001; executive function: β = -0.04 [SE = 0.02], P = .008) participants were greater than those with adequate status after controlling for age, sex, education, ethnicity, body mass index, season of blood draw, vascular risk, and apolipoprotein E4 genotype. Vitamin D status was not significantly associated with decline in semantic memory or visuospatial ability. Exclusion of participants with dementia did not substantially affect the associations between VitD status and rates of cognitive decline.Conclusions and relevanceLow VitD status was associated with accelerated decline in cognitive function domains in ethnically diverse older adults, including African American and Hispanic individuals who exhibited a high prevalence of VitD insufficiency or deficiency. It remains to be determined whether VitD supplementation slows cognitive decline.

Dataset Information

Weight change in older adults and mortality: the Multiethnic Cohort Study.

Publications

Weight change in older adults and mortality: the Multiethnic Cohort Study.

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