The Association of Weight Loss, Weight Status, and Abdominal Obesity with All-Cause Mortality in Older Adults

Tagrid Abdullah Alharbi, Joanne Ryan, Rosanne Freak-Poli, Danijela Gasevic, Jacqueline Scali, Karen Ritchie, Marie Laure Ancelin, Alice J. Owen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)
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Abstract

Objectives: The objectives of this study were to examine whether weight loss, weight status (based on body mass index [BMI] categories), and abdominal obesity (based on waist circumference [WC]) were associated with a 17-year mortality risk in community-dwelling older adults. Methods: Participants were 2,017 community-dwelling adults aged 65 years or above in the longitudinal Enquete de Sante Psychologique-Risques, Incidence et Traitement study. Self-reported weight loss was collected at baseline during face-to-face interviews. Bodyweight (kg), height (m), and WC (cm) were independently measured at the baseline. BMI was categorized as follows: underweight (BMI 18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/ m2), and obese (≥30 kg/m2). Abdominal obesity was defined by a WC of ≥102 cm in men and ≥88 cm in women. Adjusted Cox proportional hazards models were used to examine associations of weight loss, weight status, and abdominal obesity with all-cause mortality. Results: Over 17 years of follow-up (median 15.5 years), 812 participants died. Abdominal obesity compared to nonabdominal obesity was associated with a 49% increased mortality risk (95% confidence interval (CI): 1.22-1.83). However, being overweight (but not obese) was associated with a 20% decreased risk (95% CI: 0.66-0.97) compared to a normal BMI. Gender did not affect these associations. In the whole cohort, self-reported weight loss at baseline was not associated with an increased mortality risk after adjusting for health and lifestyle factors. However, in men, a baseline self-reported recent weight loss of >3 kg was associated with a 52% increase in mortality risk (95% CI: 1.05-2.18) in a fully adjusted model. Conclusion: In community-dwelling adults aged ≥65 years, abdominal obesity was strongly associated with increased mortality risk. Being overweight appeared, however, to be protective against mortality. Modest self-reported weight loss was not associated with all-cause mortality in community-dwelling older adults after adjusting for health and lifestyle factors. However, men reporting recent weight loss of more than 3 kg may be at increased risk. The findings of this study support the use of WC, rather than BMI, as a predictor of mortality risk in older adults.

Original languageEnglish
Pages (from-to)1366-1374
Number of pages9
JournalGerontology
Volume68
Issue number12
DOIs
Publication statusPublished - 1 Dec 2022

Bibliographical note

Funding Information:
The ESPRIT project is financed by the regional government of Languedoc-Roussillon, the Agence Nationale de la Recherche Project 07 LVIE 004, and an unconditional grant from Novartis. The funders had no role in the design and conduct of the study and in data collection, management, analysis, or interpretation of the data and were not involved with the writing, preparation, review, or approval of the article. Joanne Ryan is funded by a fellowship (APP1135727 from the National Health & Medical Research Council (NHMRC), Australia. Rosanne Freak-Poli is funded by an Australian Heart Foundation post-doctoral fellowship (101927).

Publisher Copyright:
© 2022 The Author(s).

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