High Body Mass Index Does Not Predict Mortality in Older People: Analysis of the Longitudinal Study of Aging

  1. David C. Grabowski PhD1,
  2. John E. Ellis MD2

Article first published online: 21 DEC 2001

DOI: 10.1046/j.1532-5415.2001.49189.x

Issue

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 49, Issue 7, pages 968–979, July 2001

Additional Information

How to Cite

Grabowski, D. C. and Ellis, J. E. (2001), High Body Mass Index Does Not Predict Mortality in Older People: Analysis of the Longitudinal Study of Aging. Journal of the American Geriatrics Society, 49: 968–979. doi: 10.1046/j.1532-5415.2001.49189.x

Author Information

  1. 1

    Department of Health Care Organization and Policy, The University of Alabama at Birmingham, Birmingham, Alabama; and

  2. 2

    Department of Anesthesia and Critical Care and Robert Wood Johnson Clinical Scholars Program, The University of Chicago, Chicago, Illinois.

  1. Address reprint requests to David C. Grabowski, PhD, RPHB 330, 1530 3rd Ave South, Birmingham, AL 35294–0022.

Publication History

  1. Issue published online: 21 DEC 2001
  2. Article first published online: 21 DEC 2001

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Keywords:

  • body mass index (BMI);
  • obesity;
  • mortality;
  • older individuals;
  • Cox proportional hazard regression

OBJECTIVE: To determine the excess mortality associated with obesity (defined by body mass index (BMI)) in older people, with and without adjustment for other risk factors associated with mortality and for demographic factors.

DESIGN: Retrospective cohort analysis of the Longitudinal Study of Aging (LSOA).

SETTING: Nationally representative sample of community-dwelling older people.

PARTICIPANTS: Seven thousand five hundred and twenty-seven participants age 70 and older in 1984.

MEASUREMENTS: We used Cox regression to calculate proportional hazards ratios for mortality over 96 months. We tested the hypothesis that increased BMI (top 15%) increased mortality rates in older people.

RESULTS: Death occurred in 38% of the cohort: 54% of the thin (lowest 10% of the population, BMI <19.4 kg/m2), 33% of the obese (highest 15%, BMI> 28.5 kg/m2), and 37% of the remaining participants (normal) died. Adjustment for demographic factors, health services utilization, and functional status still demonstrated reduced mortality in obese older people (hazard ratio 0.86, 95% confidence interval (CI) = 0.77–0.97) compared with normal. After adjustment, thin older people remained more likely to die (hazard ratio 1.46, 95% CI = 1.30–1.64) than normal older people. Sensitivity analyses for income, mortality during the first two years of follow-up, and medical comorbidities did not substantively alter the conclusions.

CONCLUSION: Obesity may be protective compared with thinness or normal weight in older community-dwelling Americans.

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