Body mass index trajectories and all-cause mortality in older Chinese adults: Hong Kong's Elderly Health Service Cohort.

IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Man Ki Kwok, Siu Yin Lee, Gabriel M Leung, C Mary Schooling
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引用次数: 0

Abstract

Background: Weight loss at older ages appears to be associated with higher mortality in Western and some East Asian countries, despite differences in the prevalence of obesity; whether it is relevant to China is unknown. We examined the association of body mass index (BMI) trajectories with all-cause mortality in older Chinese adults by sex and baseline age (65-69 years, 70+ years).

Methods: 54 160 participants aged 65 or above from Hong Kong's Elderly Health Service Cohort with at least five BMI measurements were included. We identified distinct BMI trajectories using group-based trajectory modelling. We assessed the associations of BMI trajectories with mortality risk using a Cox model stratified by sex and age.

Results: Compared with 'normal weight, stable', the 'low-normal weight, decreasing' had higher mortality risk in both sexes and age groups (eg, HR 1.43, 95% CI 1.24 to 1.66 in men aged 65-69 years). The 'overweight, stable' and 'obese, stable' had lower mortality risk, especially in men at older ages. However, the proportion in the 'low-normal weight, decreasing' was greater at 70+ years than at 65-69 years, while the proportion in the 'overweight, stable' and 'obese, stable' was lower in the older group.

Conclusions: Decreasing BMI is a likely symptom of ill health in older adults. Inconsistency between the risks and the proportion in each BMI trajectory group by age suggests the observed associations could be driven by changes in weight and preferential recruitment of survivors. Maintaining a healthy weight remains relevant at older ages.

中国老年人的体重指数轨迹和全因死亡率:香港长者健康服务队列。
背景:在西方和一些东亚国家,尽管肥胖患病率存在差异,但老年人体重减轻似乎与较高的死亡率有关;是否与中国有关不得而知。我们按性别和基线年龄(65-69岁,70岁以上)研究了中国老年人体重指数(BMI)轨迹与全因死亡率的关系。方法:54 160名来自香港老年健康服务队列的65岁或以上的参与者,至少有5项BMI测量。我们使用基于群体的轨迹建模确定了不同的BMI轨迹。我们使用按性别和年龄分层的Cox模型评估BMI轨迹与死亡风险的关联。结果:与“正常体重,稳定”相比,“低正常体重,下降”在男女和年龄组中都有更高的死亡风险(例如,65-69岁男性的HR为1.43,95% CI为1.24至1.66)。“超重,稳定”和“肥胖,稳定”的人死亡风险较低,尤其是在老年男性中。然而,在70岁以上的人群中,“低正常体重,正在减少”的比例比65-69岁的人群要大,而在老年人群中,“超重,稳定”和“肥胖,稳定”的比例要低。结论:BMI下降可能是老年人健康状况不佳的症状。风险和各年龄BMI轨迹组中比例的不一致表明,观察到的关联可能是由体重变化和幸存者的优先招募驱动的。在老年人中保持健康的体重仍然很重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Epidemiology and Community Health
Journal of Epidemiology and Community Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
11.10
自引率
0.00%
发文量
100
审稿时长
3-6 weeks
期刊介绍: The Journal of Epidemiology and Community Health is a leading international journal devoted to publication of original research and reviews covering applied, methodological and theoretical issues with emphasis on studies using multidisciplinary or integrative approaches. The journal aims to improve epidemiological knowledge and ultimately health worldwide.
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