Body mass index and all‐cause mortality in older adults: A scoping review of observational studies. (21st April 2020)

• Record Type: Journal Article
• Authors: Javed, Ayesha A.; Aljied, Rumaisa; Allison, David J.; Anderson, Laura N.; Ma, Jinhui; Raina, Parminder
• Is Part Of: Obesity reviews. Volume 21:Number 8(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-04-21
• Subjects: aging -- body mass index -- mortality -- obesity; Obesity -- Periodicals; 616.398005
• DOI: 10.1111/obr.13035
• Languages: English
• ISSNs: 1467-7881

Abstract

Summary: In older age, body composition changes as fat mass increases and redistributes. Therefore, the current body mass index (BMI) classification may not accurately reflect risk in older adults (65+). This study aimed to review the evidence on the association between BMI and all‐cause mortality in older adults and specifically, the findings regarding overweight and obese BMI. A systematic search of the OVID MEDLINE and Embase databases was conducted between 2013 and September 2018. Observational studies examining the association between BMI and all‐cause mortality within a community‐dwelling population aged 65+ were included. Seventy‐one articles were included. Studies operationalized BMI categorically (n = 60), continuously (n = 8) or as a numerical change/group transition (n = 7). Reduced risk of mortality was observed for the overweight BMI class compared with the normal BMI class (hazard ratios [HR] ranged 0.41‐0.96) and for class 1 or 2 obesity in some studies. Among studies examining BMI change, increases in BMI demonstrated lower mortality risks compared with decreases in BMI (HR: 0.83‐0.95). Overweight BMI classification or a higher BMI value may be protective with regard to all‐cause mortality, relative to normal BMI, in older adults. These findings demonstrate the potential need for age‐specific BMI cut‐points in older adults.