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KMID : 0978920050060020225
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Korean Journal of Clinical Geriatrics
2005 Volume.6 No. 2 p.225 ~ p.235
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The Prognostic Effect of Body Mass Index (BMI) on Survival in Community Dwelling High-Risk Male Elders: Is Obesity Protective ?
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Park Joo-Sung
Harker Judith O
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Abstract
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Background: To investigate the relationship of BMI and 2-year mortality in community dwelling at-risk male elders after adjusting for prior weight loss, comorbidity, functional status and functional change at one year.
Methods: Functional status, co-morbidity, cognitive score, depression score and other prognostic factors were obtained by phone interview at baseline and 1 year after baseline. Body weight and height at baseline, 1 year before and 1 year after baseline were obtained by chart review. Missing data from subjects were imputed by EM algorithm. Relationship between BMI and 2-year mortality (relative risk) was analyzed by Cox’s proportional hazards model.
Results: The survey response rate was 88% (2,395 from 2,722), and 1,008 (42%) were identified as high-risk subjects. Of these, 792 (79%) completed baseline interview, and 653 (82%) were available for final analysis. Two-year mortality from 1 year after baseline was 14.1%. The relative risk for mortality of elders age ≥86 years compared to elders ＜71, elders whose BMI ＜20 and those between 20 and 25 compared to those whose BMI was 30 were 3.94 (P＜0.001), 4.11 (P＜0.001), and 1.98 (P＜0.05), respectively.
Conclusion: The relationship between BMI and 2-year mortality was inverse after controlling for weight loss and other known mortality-related factors in community dwelling high-risk male elders. Providers should be cautious in recommending weight loss for high-risk overweight male elders. The possible protective effect of weight gain in lower BMI or normal weight elders with geriatric risk factors deserves further investigation.
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KEYWORD
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Body mass index, Elderly, All-cause mortality, Weight loss, Activities of daily living, Co-morbidity, Depression, Cognitive function
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