Association of Weight at Different Ages and All-Cause Mortality Among Older Adults in the US

Abstract

Objective: Assess the association of BMI and BMI change with mortality. Methods: Using data from the Wisconsin Longitudinal Study (WLS) on participants born mainly in 1939 (n=4922), we investigated the associations between various measures of BMI across the life course (age 54 BMI; age 65 BMI; age 72 BMI; lifetime maximum BMI; BMI change between ages 54 and 65; BMI change between ages 65 and 72) and mortality. We also assessed whether these associations are mediated by late life health. Results: BMI at age 54 was more strongly associated with late life mortality than BMI at older ages. The association between BMI change and mortality varied based on the timing of weight change. Health at age 72, particularly self-rated health, diabetes, and physical functioning, mediated the observed associations. Conclusion: Knowing older people’s weight at midlife and how their weight has changed may be more important in assessing late life mortality risk than their current weight.

Keywords

obesity weight change aging mortality

Get full access to this article

View all access options for this article.

References

Abdullah

Peeters

de Courten

Stoelwinder

(2010). The magnitude of association between overweight and obesity and the risk of diabetes: A meta-analysis of prospective cohort studies. Diabetes Research and Clinical Practice, 89(3), 309–319. https://doi.org/10.1016/j.diabres.2010.04.012

Abdullah

Wolfe

Stoelwinder

J. U.

de Courten

Stevenson

Walls

H. L.

Peeters

(2011). The number of years lived with obesity and the risk of all-cause and cause-specific mortality. International Journal of Epidemiology, 40(4), 985–996. https://doi.org/10.1093/ije/dyr018

Adams

K. F.

Schatzkin

Harris

T. B.

Kipnis

Mouw

Ballard-Barbash

Hollenbeck

Leitzmann

M. F.

(2006). Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. New England Journal of Medicine, 355(8), 763–778. https://doi.org/10.1056/NEJMoa055643

Azur

M. J.

Stuart

E. A.

Frangakis

Leaf

P. J.

(2011). Multiple imputation by chained equations: what is it and how does it work? International Journal of Methods in Psychiatric Research, 20(1), 40–49. https://doi.org/10.1002/mpr.329

Banack

H. R.

Bea

J. W.

Kaufman

J. S.

Stokes

Kroenke

C. H.

Stefanick

M. L.

Beresford

S. A.

Bird

C. E.

Garcia

Wallace

Wild

R. A.

Caan

Wactawski-Wende

(2019). The effects of reverse causality and selective attrition on the relationship between body mass index and mortality in postmenopausal women. American Journal of Epidemiology, 188(10), 1838–1848. https://doi.org/10.1093/aje/kwz160

Berrington de Gonzalez

Hartge

Cerhan

J. R.

Flint

A. J.

Hannan

MacInnis

R. J.

Moore

S. C.

Tobias

G. S.

Anton-Culver

Freeman

L. B.

Beeson

W. L.

Clipp

S. L.

English

D. R.

Folsom

A. R.

Freedman

D. M.

Giles

Hakansson

Henderson

K. D.

Hoffman-Bolton

Thun

M. J.

(2010). Body-Mass Index and mortality among 1.46 Million white adults. New England Journal of Medicine, 363(23), 2211–2219. https://doi.org/10.1056/NEJMoa1000367

Bhaskaran

Dos-Santos-Silva

Leon

D. A.

Douglas

I. J.

Smeeth

(2018). Association of BMI with overall and cause-specific mortality: A population-based cohort study of 3.6 million adults in the UK. The Lancet Diabetes and Endocrinology, 6(12), 944–953. https://doi.org/10.1016/S2213-8587(18)30288-2

Carslake

Smith

G. D.

Gunnell

Davies

Nilsen

T. I. L.

Romundstad

(2018). Confounding by ill health in the observed association between BMI and mortality: Evidence from the HUNT Study using offspring BMI as an instrument. International Journal of Epidemiology, 47(3), 760–770. https://doi.org/10.1093/ije/dyx246

Conner

S. C.

Lodi

Lunetta

K. L.

Casas

J. P.

Lubitz

S. A.

Ellinor

P. T.

Anderson

C. D.

Huang

Coleman

White

W. B.

Benjamin

E. J.

Trinquart

(2019). Refining the association between body mass index and atrial fibrillation: G-formula and restricted mean survival times. Journal of the American Heart Association, 8(16), 1–11. https://doi.org/10.1161/JAHA.119.013011

10.

Dixon

J. B.

Egger

G. J.

Finkelstein

E. A.

Kral

J. G.

Lambert

G. W.

(2015). “Obesity paradox” misunderstands the biology of optimal weight throughout the life cycle. International Journal of Obesity, 39(1), 82–84. https://doi.org/10.1038/ijo.2014.59

11.

Flegal

Carroll

Kuczmarski

Johnson

(1998). Overweight and obesity in the United States: Prevalence and trends, 1960-1994. International Journal of Obesity, 22(1), 39–47.

12.

Flegal

K. M.

Graubard

B. I.

Williamson

D. F.

Cooper

R. S.

(2011). Reverse causation and illness-related weight loss in observational studies of body weight and mortality. American Journal of Epidemiology, 173(1), 1–9. https://doi.org/10.1093/aje/kwq341

13.

Flegal

K. M

Graubard

B. I.

Williamson

D. F.

Gail

M. H.

(2005). Excess deaths assocaited with underweight, overweight, and obesity. JAMA, 293(15), 1861–1867. https://doi.org/10.1001/jama.293.15.1861

14.

Flicker

McCaul

K. A.

Hankey

G. J.

Jamrozik

Brown

W. J.

Byles

J. E.

Almeida

O. P.

(2010). Body mass index and survival in men and women aged 70 to 75. Journal of the American Geriatrics Society, 58(2), 234–241. https://doi.org/10.1111/j.1532-5415.2009.02677.x

15.

Ghaem Maralani

Tai

B. C.

Wong

T. Y.

Tai

E. S.

Wang

J. J.

Mitchell

(2014). The prognostic role of body mass index on mortality amongst the middle-aged and elderly: A competing risk analysis. Diabetes Research and Clinical Practice, 103(1), 42–50. https://doi.org/10.1016/j.diabres.2013.11.025

16.

Glymour

M. M.

Weuve

Berkman

L. F.

Kawachi

Robins

J. M.

(2005). When is baseline adjustment useful in analyses of change? An example with education and cognitive change. American Journal of Epidemiology, 162(3), 267–278. https://doi.org/10.1093/aje/kwi187

17.

Hales

Carroll

Fryar

Ogden

(2020). Prevalence of obesity and severe obesity among Adults: United States, 2017-2018. NCHS Data Brief, 360(360), 1–8. http://www.ncbi.nlm.nih.gov/pubmed/26633046

18.

Hauser

R. M.

Roan

C. L.

(2006). The class of 1957 in their mid-60s: A first look. In Center for Demography and Ecology (No. 2006–03).

19.

Herd

Carr

Roan

(2014). Cohort Profile: Wisconsin longitudinal study (WLS). International Journal of Epidemiology, 43(1), 34–41. https://doi.org/10.1093/ije/dys194

20.

Hernán

M. A.

Taubman

S. L.

(2008). Does obesity shorten life? The importance of well-defined interventions to answer causal questions. International Journal of Obesity, 32(1), S8–S14. https://doi.org/10.1038/ijo.2008.82

21.

Holme

Tonstad

(2015). Survival in elderly men in relation to midlife and current BMI. Age and Ageing, 44(3), 434–439. https://doi.org/10.1093/ageing/afu202

22.

F. B.

(2008). Obesity epidemiology. Oxford University Press.

23.

Idler

E. L.

Benyamini

(1997). Self-rated health and mortality: A review of twenty-seven community studies, 38(1), 21–37. Published by : American Sociologic.

24.

Janssen

Mark

A. E.

(2007). Elevated body mass index and mortality risk in the elderly. Obesity Reviews, 8(1), 41–59. https://doi.org/10.1111/j.1467-789X.2006.00248.x

25.

Javed

A. A.

Aljied

Allison

D. J.

Anderson

L. N.

Raina

(2020). Body mass index and all-cause mortality in older adults: A scoping review of observational studies. Obesity Reviews, March. https://doi.org/10.1111/obr.13035

26.

Jylhä

(2009). What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science & Medicine, 69(3), 307–316. https://doi.org/10.1016/j.socscimed.2009.05.013

27.

Karampela

Chrysanthopoulou

Christodoulatos

G. S.

Dalamaga

(2020). Is There an obesity paradox in critical illness? Epidemiologic and metabolic considerations. Current Obesity Reports. https://doi.org/10.1007/s13679-020-00394-x

28.

Karlson

K. B.

Holm

Breen

(2012). Comparing regression coefficients between same-sample nested models using logit and probit: A new method. Sociological Methodology, 42(1), 286–313. https://doi.org/10.1177/0081175012444861

29.

Kushner

R. F.

Batsis

J. A.

Butsch

W. S.

Davis

Golden

Halperin

Kidambi

Machineni

Novick

Port

Rubino

D. M.

Saunders

K. H.

Shapiro Manning

Soleymani

Kahan

(2020). Weight history in clinical practice: The state of the science and future directions. Obesity, 28(1), 9–17. https://doi.org/10.1002/oby.22642

30.

Lee

J. M.

Pilli

Gebremariam

Keirns

C. C.

Davis

M. M.

Vijan

Freed

G. L.

Herman

W. H.

Gurney

J. G.

(2010). Getting heavier, younger: Trajectories of obesity over the life course. International Journal of Obesity, 34(4), 614–623. https://doi.org/10.1038/ijo.2009.235

31.

Mehta

N. K.

Abrams

L. R.

Myrskylä

(2020). US life expectancy stalls due to cardiovascular disease, not drug deaths. Proceedings of the National Academy of Sciences of the United States of America, 117(13), 6998–7000. https://doi.org/10.1073/pnas.1920391117

32.

Murayama

Liang

Bennett

J. M.

Shaw

B. A.

Botoseneanu

Kobayashi

Fukaya

Shinkai

(2015). Trajectories of body mass index and their associations with mortality among older Japanese: Do they differ from those of Western populations? American Journal of Epidemiology, 182(7), 597–605. https://doi.org/10.1093/aje/kwv107

33.

Nilsson

P. M.

Nilsson

J. Å.

Hedblad

Berglund

Lindgärde

(2002). The enigma of increased non-cancer mortality after weight loss in healthy men who are overweight or obese. Journal of Internal Medicine, 252(1), 70–78. https://doi.org/10.1046/j.1365-2796.2002.01010.x

34.

Preston

S. H.

Mehta

N. K.

Stokes

(2013). Modeling obesity histories in cohort analyses of health and mortality. Epidemiology, 24(1), 158–166. https://doi.org/10.1097/EDE.0b013e3182770217

35.

Preston

S. H.

Stokes

(2014). Obesity paradox: Conditioning on disease enhances biases in estimating the mortality risks of obesity. Epidemiology, 25(3), 454–461. https://doi.org/10.1097/EDE.0000000000000075

36.

Prosper

M.-H.

(2009). Obesity as a predictor of self-rated health. American Journal of Health Behavior, 33(3), 319–329. https://doi.org/10.5993/AJHB.33.3.10

37.

Reither

E. N.

Hauser

R. M.

Yang

(2009). Do birth cohorts matter? Age-period-cohort analyses of the obesity epidemic in the United States. Social Science & Medicine, 69(10), 1439–1448. https://doi.org/10.1016/j.socscimed.2009.08.040

38.

Reither

E. N.

Masters

R. K.

Yang

Y. C.

Powers

D. A.

Zheng

Land

K. C.

(2015). Should age-period-cohort studies return to the methodologies of the 1970s? Social Science & Medicine, 128(1), 356–365. https://doi.org/10.1016/j.socscimed.2015.01.011

39.

Schaap

L. A.

Quirke

Wijnhoven

H. A. H.

Visser

(2018). Changes in body mass index and mid-upper arm circumference in relation to all-cause mortality in older adults. Clinical Nutrition, 37(6), 2252–2259. https://doi.org/10.1016/j.clnu.2017.11.004

40.

Siegel

P. M.

(1971). Prestige in the American occupational structure. University of Chicago.

41.

StataCorp . (2019). Stata statistical software: Release 16. StataCorp LLC.

42.

Stokes

(2014). Using maximum weight to redefine body mass index categories in studies of the mortality risks of obesity. Population Health Metrics, 12(1), 6. https://doi.org/10.1186/1478-7954-12-6

43.

Stokes

(2016). Validating a summary measure of weight history for modeling the health consequences of obesity. Annals of Epidemiology, 26(12), 821–826.e2. https://doi.org/10.1016/j.annepidem.2016.10.005

44.

Stokes

Preston

S. H.

(2017). Deaths attributable to diabetes in the United States: Comparison of data sources and estimation approaches. Plos One, 12(1), 1–12. https://doi.org/10.1371/journal.pone.0170219

45.

Stokes

A. C.

Xie

Lundberg

D. J.

Hempstead

Zajacova

Zimmer

Glei

D. A.

Meara

Preston

S. H.

(2020). Increases in BMI and chronic pain for US adults in midlife, 1992 to 2016. SSM - Population Health, 12(1), 100644. https://doi.org/10.1016/j.ssmph.2020.100644

46.

Von Bonsdorff

M. B.

Törmäkangas

Rantanen

Salonen

M. K.

Osmond

Kajantie

Eriksson

J. G.

(2015). Early life body mass trajectories and mortality in older age: Findings from the Helsinki Birth Cohort Study. Annals of Medicine, 47(1), 34–39. https://doi.org/10.3109/07853890.2014.963664

47.

Wade

K. H.

Carslake

Tynelius

Smith

G. D.

Martin

R. M.

(2019). Variation of all-cause and cause-specific mortality with body mass index in one million Swedish parent-son pairs: An instrumental variable analysis. Plos Medicine, 16(8), 1–15. https://doi.org/10.1371/journal.pmed.1002868

48.

Willett

Dietz

Colditz

(1999). Guidelines for healthy weight. New England Journal of Medicine, 341(1), 427–434. https://doi.org/10.1056/NEJM199908053410607

49.

Xie

Lundberg

D. J.

Collins

J. M.

Johnston

S. S.

Waggoner

J. R.

Hsiao

C. W.

Preston

S. H.

Manson

J. E.

Stokes

A. C.

(2020). Association of weight loss between early adulthood and midlife with all-cause mortality risk in the US. JAMA Network Open, 3(8), 1–11. https://doi.org/10.1001/jamanetworkopen.2020.13448

50.

Cupples

L. A.

Stokes

Liu

C.-T.

(2018). Association of obesity with mortality over 24 years of weight history. JAMA Network Open, 1(7), Article e184587. https://doi.org/10.1001/jamanetworkopen.2018.4587

51.

Ley

S. H.

Manson

J. A. E.

Willett

Satija

F. B.

Stokes

(2017). Weight history and all-cause and cause-specific mortality in three prospective cohort studies. Annals of Internal Medicine, 166(9), 613–620. https://doi.org/10.7326/M16-1390

52.

Zheng

Tumin

Qian

(2013). Obesity and mortality risk: New findings from body mass index trajectories. American Journal of Epidemiology, 178(11), 1591–1599. https://doi.org/10.1093/aje/kwt179

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.30 MB