Association of Body Compartment Shrinkage with Subsequent Health Care Utilization in Older Men. (17th December 2021)

• Record Type: Journal Article
• Authors: Schousboe, John; Langsetmo, Lisa; Kats, Allyson; Taylor, Brent; Ensrud, Kristine
• Is Part Of: Innovation in aging. Volume 5(2021)Supplement 1
• Page Start: 610
• Page End: 610
• Publication Date: 2021-12-17
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igab046.2336
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: Both height loss and weight loss among the very old are associated with adverse health outcomes including fractures and mortality. However, it is not clear whether the associations between weight loss and health outcomes are attributable to specific compartmental (fat vs. fat-free) loss or whether they are attributable to overall shrinkage. Our objective was to estimate the associations of compartmental loss and height loss with subsequent total health care costs, acute hospitalizations, and skilled nursing facility (SNF) stays over a three-year follow-up period, adjusted for each other and important covariates (age, race, multimorbidity, IADL impairment, depressive symptoms, walk speed). Our analytic cohort was 1505 older men (mean [SD] age 79.3 [5.2] years) who attended the 3rd Osteoporotic Fractures in Men (MrOS) study visit (V3) and who were enrolled in Medicare Fee for Service (FFS). Annualized changes in fat-free and fat mass (measured with dual-energy x-ray absorptiometry) and height were assessed over a mean (SD) 6.8 (0.3) years prior to V3. Total health care costs, acute hospital stays, and SNF stays were ascertained during 3 years after V3 using linked Medicare FFS claims files. Fat-free mass loss (per SD) was associated with total health care costs (cost ratio 1.10, 95% CI 1.01, 1.19), but not with acute hospital or SNF stays. Fat mass loss and height loss were not associated with health care utilization outcomes after multivariable adjustment. Loss of fat-free mass is modestly associated with higher total health care costs after accounting for age, race, multimorbidity, and IADL impairment.