 |
|
The Effect of Obesity on Disability vs Mortality in Older Americans
Soham Al Snih, MD, PhD;
Kenneth J. Ottenbacher, PhD, OTR;
Kyriakos S. Markides, PhD;
Yong-Fang Kuo, PhD;
Karl Eschbach, PhD;
James S. Goodwin, MD
Arch Intern Med. 2007;167(8):774-780.
Background The association between obesity and mortality is reduced or eliminated in older subjects. In addition to mortality, disability is an important health outcome. The objectives of this study were to examine the association between body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, and subsequent disability and mortality among older Americans, as well as to estimate the effect of BMI on life expectancy and disability-free life expectancy among older Americans.
Methods We studied 8359 non-Hispanic white Americans, 1931 African Americans, and 2435 Mexican Americans 65 years or older who were not disabled at baseline from 5 sites of the Established Populations for Epidemiologic Studies of the Elderly. Measures included BMI, medical conditions, activities of daily living, and demographic information. Cox proportional hazards regression analysis was used to estimate the hazard ratios (HRs) for subsequent disability and mortality during 7 years of follow-up. Total life expectancy and disability-free life expectancy were estimated using the interpolation of Markov chain approach.
Results The lowest HR (1.02; 95% confidence interval [CI], 0.94-1.10) for disability was at a BMI of 25 to less than 30. Subjects with BMIs of lower than 18.5 or 30 or higher at baseline were significantly more likely to experience disability during the follow-up period. In contrast, the lowest HRs for mortality were seen among subjects with BMIs of 25 to less than 30 (HR, 0.78; 95% CI, 0.72-0.85) and 30 to less than 35 (HR, 0.80; 95% CI, 0.72-0.90), with subjects with BMIs of lower than 25 or 35 or higher experiencing higher hazards for mortality. Disability-free life expectancy is greatest among subjects with a BMI of 25 to less than 30.
Conclusion Assessments of the effect of obesity on the health of older Americans should account for mortality and incidence of disability.
Author Affiliations: Sealy Center on Aging (Dr Al Snih), Division of Rehabilitation Sciences, School of Allied Health Sciences (Drs Al Snih and Ottenbacher), Department of Preventive Medicine and Community Health (Dr Markides), and Division of Geriatrics, Department of Internal Medicine (Drs Kuo, Eschbach, and Goodwin), University of Texas Medical Branch, Galveston.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED LETTERS
How Can Obesity Be Healthy?
Divina N. Dyer
Arch Intern Med. 2007;167(22):2527-2528.
EXTRACT
| FULL TEXT
The Effect of Obesity on Disability vs Mortality in Older American: The Potential Implication of Testosterone
Claude Schulman
Arch Intern Med. 2007;167(22):2528.
EXTRACT
| FULL TEXT
RELATED ARTICLES
Obesity, Disability, and Mortality: A Puzzling Link
Luigi Ferrucci and Dawn Alley
Arch Intern Med. 2007;167(8):750-751.
EXTRACT
| FULL TEXT
Obesity and Workers' Compensation: Results From the Duke Health and Safety Surveillance System
Truls Østbye, John M. Dement, and Katrina M. Krause
Arch Intern Med. 2007;167(8):766-773.
ABSTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Secular Trends in Body Weight in Older Men Born Between 1877 and 1941: The Baltimore Longitudinal Study of Aging
Stenholm et al.
J Gerontol A Biol Sci Med Sci 2009;0:glp178v1-glp178.
ABSTRACT
| FULL TEXT
Mexican Americans and Frailty: Findings From the Hispanic Established Populations Epidemiologic Studies of the Elderly
Ottenbacher et al.
AJPH 2009;99:673-679.
ABSTRACT
| FULL TEXT
Correlates of Improvement in Walking Ability in Older Persons in the United States
Feinglass et al.
AJPH 2009;99:533-539.
ABSTRACT
| FULL TEXT
A Research Agenda: The Changing Relationship Between Body Weight and Health in Aging
Alley et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2008;63:1257-1259.
FULL TEXT
A Framework for the Concurrent Consideration of Occupational Hazards and Obesity
Schulte et al.
ANN OCCUP HYG 2008;52:555-566.
ABSTRACT
| FULL TEXT
Effect of Weight Loss and Exercise Therapy on Bone Metabolism and Mass in Obese Older Adults: A One-Year Randomized Controlled Trial
Villareal et al.
J. Clin. Endocrinol. Metab. 2008;93:2181-2187.
ABSTRACT
| FULL TEXT
The Effect of Obesity on Disability vs Mortality in Older American: The Potential Implication of Testosterone
Schulman
Arch Intern Med 2007;167:2528-2528.
FULL TEXT
How Can Obesity Be Healthy?
Dyer
Arch Intern Med 2007;167:2527-2528.
FULL TEXT
The Association Between Weight Gain Up to Midlife, 30-Year Mortality, and Quality of Life in Older Men
Strandberg et al.
Arch Intern Med 2007;167:2260-2261.
FULL TEXT
Is Disability Obesity's Price of Longevity?
Gregg and Guralnik
JAMA 2007;298:2066-2067.
FULL TEXT
Obesity, Disability, and Mortality: A Puzzling Link
Ferrucci and Alley
Arch Intern Med 2007;167:750-751.
FULL TEXT
|
