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Introduction: Existing evidence evaluating the impact of change in body mass index (BMI) on the risk of all-cause and cardiovascular disease (CVD)-related mortality in older people is limited and inconsistent. This population-based cohort study evaluated the association of changes in BMI over time with all-cause and CVD-related mortality in older adults. Methods: We recruited 55,351 adults aged over 65 years between 2006 and 2011 from Taipei Elderly Health Examination Program who underwent repeated annual health examinations at 3.2-year intervals and were followed up for mortality over 5.5 years. Cox proportional hazard and Fine-Gray sub-distribution hazard models with death from non-CVD causes as the competing risk were used to determine the impact of changes in BMI status on the risk of all-cause or CVD-related mortality, respectively. Results: Over 227,967 person-years of follow-up, 4,054 participants died, including 940 (23.2%) CVD-related deaths. After adjusting for other covariates, >10% decrease in BMI was significantly associated with a higher risk of all-cause (adjusted hazard ratio [AHR] = 1.93; 95% confidence interval [CI]: 1.74–2.13) and CVD-related mortality (AHR = 1.96; 95% CI: 1.60–2.40), compared with stable BMI. Sensitivity analysis showed that a >10% decrease in BMI was significantly associated with a high risk of all-cause and CVD-related mortality in participants with normal weight, underweight, overweight, or obesity at baseline. Conclusion: Older adults with >10% decrease in BMI are at high risk of all-cause and CVD-related mortality. Our findings suggest that older individuals experiencing a substantial reduction in BMI should undergo a thorough evaluation to minimize the risks associated with mortality.

1.
Partridge
L
,
Deelen
J
,
Slagboom
PE
.
Facing up to the global challenges of ageing
.
Nature
.
2018
;
561
(
7721
):
45
56
.
2.
Taiwan NDCo
.
Elderly population in taiwan
. https://www.ndc.gov.tw/en/Content_List.aspx?n=85E9B2CDF4406753 (accessed January 16, 2024).
3.
Rodrigues
A
,
Pereira
PC
,
Vicente
AF
,
A Brito
J
,
Bernardo
MA
,
F Mesquit
M
.
Food intake, body mass index and body fat mass in elderly
.
Asian J Clin Nutr
.
2012
;
4
(
3
):
107
15
.
4.
Lin
YK
,
Wang
CC
,
Yen
YF
,
Chen
LJ
,
Ku
PW
,
Chen
CC
, et al
.
Association of body mass index with all-cause mortality in the elderly population of Taiwan: a prospective cohort study
.
Nutr Metab Cardiovasc Dis
.
2021
;
31
(
1
):
110
8
.
5.
Flicker
L
,
McCaul
KA
,
Hankey
GJ
,
Jamrozik
K
,
Brown
WJ
,
Byles
JE
, et al
.
Body mass index and survival in men and women aged 70 to 75
.
J Am Geriatr Soc
.
2010
;
58
(
2
):
234
41
.
6.
Singh
PN
,
Haddad
E
,
Tonstad
S
,
Fraser
GE
.
Does excess body fat maintained after the seventh decade decrease life expectancy
.
J Am Geriatr Soc
.
2011
;
59
(
6
):
1003
11
.
7.
Gaddey
HL
,
Holder
KK
.
Unintentional weight loss in older adults
.
Am Fam Physician
.
2021
;
104
(
1
):
34
40
.
8.
Park
S
,
Pi
S
,
Hwang
J
,
Kang
JH
,
Kwon
JW
.
Effects of initial body mass index and weight change on all-cause mortality: a 10-year cohort study in korea
.
Asia Pac J Public Health
.
2018
;
30
(
3
):
217
26
.
9.
Dahl
AK
,
Fauth
EB
,
Ernsth-Bravell
M
,
Hassing
LB
,
Ram
N
,
Gerstof
D
.
Body mass index, change in body mass index, and survival in old and very old persons
.
J Am Geriatr Soc
.
2013
;
61
(
4
):
512
8
.
10.
Graf
CE
,
Herrmann
FR
,
Spoerri
A
,
Makhlouf
AM
,
Sørensen
TIA
,
Ho
S
, et al
.
Impact of body composition changes on risk of all-cause mortality in older adults
.
Clin Nutr
.
2016
;
35
(
6
):
1499
505
.
11.
Lu
TH
,
Lee
MC
,
Chou
MC
.
Accuracy of cause-of-death coding in Taiwan: types of miscoding and effects on mortality statistics
.
Int J Epidemiol
.
2000
;
29
(
2
):
336
43
.
12.
Chen
LJ
,
Hamer
M
,
Lai
YJ
,
Huang
BH
,
Ku
PW
,
Stamatakis
E
.
Can physical activity eliminate the mortality risk associated with poor sleep? A 15-year follow-up of 341,248 MJ Cohort participants
.
J Sport Health Sci
.
2022
;
11
(
5
):
596
604
.
13.
Pan
WH
,
Lee
MS
,
Chuang
SY
,
Lin
YC
,
Fu
ML
.
Obesity pandemic, correlated factors and guidelines to define, screen and manage obesity in Taiwan
.
Obes Rev
.
2008
;
9
(
Suppl 1
):
22
31
.
14.
Fine
JP
,
Gray
RJ
.
A proportional hazards model for the subdistribution of a competing risk
.
J Am Stat Assoc
.
1999
;
94
(
446
):
496
509
.
15.
León-Muñoz
LM
,
Guallar-Castillón
P
,
López García
E
,
Banegas
JR
,
Gutiérrez-Fisac
JL
,
Rodríguez-Artalejo
F
.
Relationship of BMI, waist circumference, and weight change with use of health services by older adults
.
Obes Res
.
2005
;
13
(
8
):
1398
404
.
16.
Bosch
X
,
Monclús
E
,
Escoda
O
,
Guerra-García
M
,
Moreno
P
,
Guasch
N
, et al
.
Unintentional weight loss: clinical characteristics and outcomes in a prospective cohort of 2677 patients
.
PLoS One
.
2017
;
12
(
4
):
e0175125
.
17.
Locher
JL
,
Roth
DL
,
Ritchie
CS
,
Cox
K
,
Sawyer
P
,
Bodner
EV
, et al
.
Body mass index, weight loss, and mortality in community-dwelling older adults
.
J Gerontol A Biol Sci Med Sci
.
2007
;
62
(
12
):
1389
92
.
18.
Santos
VRD
,
Christofaro
DGD
,
Gomes
IC
,
Júnior
IFF
,
Gobbo
LA
.
Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over
.
Rev Bras Ortop
.
2018
;
53
(
3
):
300
5
.
19.
Lloyd
JT
,
Alley
DE
,
Hawkes
WG
,
Hochberg
MC
,
Waldstein
SR
,
Orwig
DL
.
Body mass index is positively associated with bone mineral density in US older adults
.
Arch Osteoporos
.
2014
;
9
:
175
.
20.
Bouillanne
O
,
Dupont-Belmont
C
,
Hay
P
,
Hamon-Vilcot
B
,
Cynober
L
,
Aussel
C
.
Fat mass protects hospitalized elderly persons against morbidity and mortality
.
Am J Clin Nutr
.
2009
;
90
(
3
):
505
10
.
21.
Agarwal
E
,
Miller
M
,
Yaxley
A
,
Isenring
E
.
Malnutrition in the elderly: a narrative review
.
Maturitas
.
2013
;
76
(
4
):
296
302
.
22.
Harrington
M
,
Gibson
S
,
Cottrell
RC
.
A review and meta-analysis of the effect of weight loss on all-cause mortality risk
.
Nutr Res Rev
.
2009
;
22
(
1
):
93
108
.
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