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ABSTRACT: Importance
Body mass index (BMI) shows a U-shaped association with impaired physical functioning among adults; the association is reduced or eliminated with aging.Objective
To examine whether BMI is associated with subsequent disability in activities of daily living (ADL) in Chinese adults age 80 years or older.Design, setting, and participants
Data were obtained on 16 022 adults age 80 years or older who were able to perform ADL independently at baseline from the Chinese Longitudinal Healthy Longevity Study, a community-based prospective cohort study conducted in 23 provinces of China. The study was initiated in 1998, with follow-up and recruitment of new participants in 2000, 2002, 2005, 2008, 2011, and 2014.Main outcomes and measures
Disability in ADL was defined as dependence in eating, toileting, bathing, dressing, indoor activities, and/or continence.Results
Among the 16 022 participants, 45.2% were men and 54.8% were women, with a mean (SD) age of 92.2 (7.2) years and a mean (SD) BMI (calculated as weight in kilograms divided by height in meters squared) of 19.3 (3.8). During 70 606 person-years of follow-up, 8113 participants with disability in ADL were identified. Cox proportional hazards regression models with penalized splines showed that BMI was linearly associated with disability in ADL: each 1-kg/m2 increase in BMI corresponded to a 4.5% decrease in the risk of disability in ADL. In comparison with individuals in the fourth quintile for BMI, the adjusted hazard ratio for disability in ADL was 1.38 (95% CI, 1.29-1.48) in the first quintile, 1.37 (95% CI, 1.28-1.47) in the second quintile, 1.11 (95% CI, 1.04-1.19) in the third quintile, and 0.85 (95% CI, 0.79-0.91) in the fifth quintile (P?Conclusions and relevanceHigher BMI was associated with a lower risk of disability in ADL among Chinese adults age 80 years or older, which suggests that current recommendations for BMI may need to be revisited. More attention should be paid on underweight, rather than overweight or obesity, for the prevention of disability in ADL after age 80 years.
SUBMITTER: Lv YB
PROVIDER: S-EPMC6324469 | biostudies-literature | 2018 Sep
REPOSITORIES: biostudies-literature
Lv Yue-Bin YB Yuan Jin-Qiu JQ Mao Chen C Gao Xiang X Yin Zhao-Xue ZX Kraus Virginia Byers VB Luo Jie-Si JS Chen Hua-Shuai HS Zeng Yi Y Wang Wen-Tao WT Wang Jiao-Nan JN Shi Xiao-Ming XM
JAMA network open 20180907 5
<h4>Importance</h4>Body mass index (BMI) shows a U-shaped association with impaired physical functioning among adults; the association is reduced or eliminated with aging.<h4>Objective</h4>To examine whether BMI is associated with subsequent disability in activities of daily living (ADL) in Chinese adults age 80 years or older.<h4>Design, setting, and participants</h4>Data were obtained on 16 022 adults age 80 years or older who were able to perform ADL independently at baseline from the Chinese ...[more]