Higher BMI May Be Better For Older Adults

AlphaCog

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Higher BMI May Be Better for Older Adults
https://www.medpagetoday.com/endocrinology/generalendocrinology/44843
The association between all-cause mortality and BMI created a U-shaped curve with a broad base (P-nonlinearity <0.001). The "nadir of the curve for BMI and mortality was between 24.0 and 30.9, with the lowest risk being between 27.0 and 27.9 (HR 0.90, 95% CI 0.88-0.92)," wrote Caryl A. Nowson, PhD, of Deakin University in Melbourne, Australia, and her co-authors, in the American Journal of Clinical Nutrition.

They said that mortality risk did not increase with excess weight in this population until BMI was ≥33 (HR 1.08 for BMI of 33.0-33.9, 95% CI 1.00-1.15).

Risk of mortality was highest at a BMI lower than 23, the authors said. Using a BMI of 23.0 to 23.9 as the reference, there was a 12% greater risk of mortality for those with a BMI in the range of 21.0-21.9 (HR 1.12, 95% CI 1.10-1.13) and a 19% greater risk for those with a BMI in the range of 20.0-20.9 (HR 1.19, 95% CI 1.17-1.22), the authors said.

Which body mass index (BMI) is better in the elderly for functional status? - PubMed - NCBI
Abstract

BMI is commonly used indicator of malnutrition and 18.5-24.9 kg/m(2) is generally regarded optimal. However, there is an ongoing debate on ideal range for elderly. BMI cut-off values vary also between ethnic groups. We aimed to investigate relationships between BMI, functional status and malnutrition in elderly living in a nursing home in Turkey. BMIs of 254 residents were calculated. Chronic diseases and currently used drugs were noted. Functional status was evaluated with Katz-activities-of-daily-living (ADL) and Lawton-instrumental-activities-of-daily-living (IADL). Nutritional assessment was performed by Mini-Nutritional-Assessment (MNA) test. Mean age was 75.2 ± 8.2 years. Subjects were classified into 4 groups as BMI <18.5, 18.5-24.9, 25-29.9, and ≥ 30.0 kg/m(2). ADL scores and IADL scores were higher in higher BMI groups. There were no differences in terms of age-number of chronic diseases. Even in BMI ≥ 35 kg/m(2) residents, ADL was significantly higher than 25-34.9 kg/m(2) residents. BMI was significantly correlated with ADL and IADL scores. In Groups 3 and 4, there were 22.2% and 9.1% residents without normal nutrition, respectively. Better functional status was associated with higher BMI values even in BMIs ≥ 30 kg/m(2). In elderly, relative high rates of undernutrition may be present in BMIs regarded as overweight or obese.

Body Mass Index, Dementia, and Mortality in the Elderly
There were 479 deaths during 9,974 person-years of follow-up. There were 210 cases of prevalent dementia at baseline, and 209 cases of incident dementia during follow-up. Among 1,372 persons with BMI information, the lowest quartile of BMI was associated with a higher mortality risk compared to the second quartile (HR = 1.5; 95% CI: 1.1,2.0) after adjustment for age, gender, education, ethnic group, smoking, cancer, and dementia. When persons with dementia were excluded, both the lowest (HR = 1.9; 95% CI =1.3,2.6) and highest (HR = 1.6; 95% CI : 1.1,2.3) quartiles of BMI were related to higher mortality. Weight loss was related to a higher mortality risk (HR = 1.5; 95% CI: 1.2,1.9) but this association was attenuated when persons with short follow-up or persons with dementia were excluded.
 
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They say it is not good to lose weight too quickly and this thread posted by @ecstatichamster bolsters this advice….


“Compared with participants whose BMI were stable, individuals who had a decrease in BMI were at increased risk of all-cause mortality,

Every 5% decrease in BMI was associated with a 27% increase in the risk of all-cause mortality (HR = 1.27, 95% CI: 1.22–1.31, p < 0.001). The results from subgroups showed similar trends.

Conclusions: A decrease in BMI more than 5% shows a significantly increased risk of all-cause mortality among older individuals; but no significant association between increase in BMI and all-cause mortality.”

 
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