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Body mass index, waist circumference, and waist-to-hip ratio as predictors of mortality in nonagenarians: the Vitality 90+ Study.
J Gerontol A Biol Sci Med Sci 2011; 66(11):1244-50JG

Abstract

BACKGROUND

The associations of body mass index (BMI) and abdominal obesity with mortality among very old people are poorly known. The purpose of this study was to investigate the association of BMI, waist circumference (WC), and waist-to-hip ratio with mortality in nonagenarians.

METHODS

This study is part of a prospective population-based study, Vitality 90+, including both community-dwelling and institutionalized persons from Tampere, Finland. Altogether 192 women and 65 men aged 90 years were subjected to anthropometric measurements, a baseline interview, and a 4-year mortality follow-up. Cox proportional hazards models were used in the statistical analyses.

RESULTS

In men, normal weight indicated a three times higher mortality risk (hazard ratio [HR] 3.09, 95% confidence interval [CI] 1.35-7.06) compared with overweight, and WC was inversely associated with mortality (HR 0.96, 95% CI 0.93-1.00) after adjustment for covariates. In women, the univariate waist-to-hip ratio (HR 1.43, 95% CI 1.06-1.92) and BMI-adjusted waist-to-hip ratio (HR 1.45, 95% CI 1.07-1.97) were positively associated with mortality. Also, overweight women whose WC was <86 cm had lower mortality than normal weight women with similar WC (HR 0.34, 95% CI 0.12-0.97).

CONCLUSIONS

In nonagenarian men, low BMI and low WC predict increased mortality. In nonagenarian women, waist-to-hip ratio alone and adjusted for BMI is positively associated with mortality. The potential positive effects of overweight combined with WC warrant more detailed analyses in larger data. In all, future studies are needed to better understand the health and functional consequences of body composition among the oldest old.

Authors+Show Affiliations

School of Health Sciences, University of Tampere, Finland. inna.lisko@uta.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21860016

Citation

Lisko, Inna, et al. "Body Mass Index, Waist Circumference, and Waist-to-hip Ratio as Predictors of Mortality in Nonagenarians: the Vitality 90+ Study." The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, vol. 66, no. 11, 2011, pp. 1244-50.
Lisko I, Tiainen K, Stenholm S, et al. Body mass index, waist circumference, and waist-to-hip ratio as predictors of mortality in nonagenarians: the Vitality 90+ Study. J Gerontol A Biol Sci Med Sci. 2011;66(11):1244-50.
Lisko, I., Tiainen, K., Stenholm, S., Luukkaala, T., Hervonen, A., & Jylhä, M. (2011). Body mass index, waist circumference, and waist-to-hip ratio as predictors of mortality in nonagenarians: the Vitality 90+ Study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 66(11), pp. 1244-50. doi:10.1093/gerona/glr147.
Lisko I, et al. Body Mass Index, Waist Circumference, and Waist-to-hip Ratio as Predictors of Mortality in Nonagenarians: the Vitality 90+ Study. J Gerontol A Biol Sci Med Sci. 2011;66(11):1244-50. PubMed PMID: 21860016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body mass index, waist circumference, and waist-to-hip ratio as predictors of mortality in nonagenarians: the Vitality 90+ Study. AU - Lisko,Inna, AU - Tiainen,Kristina, AU - Stenholm,Sari, AU - Luukkaala,Tiina, AU - Hervonen,Antti, AU - Jylhä,Marja, Y1 - 2011/08/22/ PY - 2011/8/24/entrez PY - 2011/8/24/pubmed PY - 2012/1/19/medline SP - 1244 EP - 50 JF - The journals of gerontology. Series A, Biological sciences and medical sciences JO - J. Gerontol. A Biol. Sci. Med. Sci. VL - 66 IS - 11 N2 - BACKGROUND: The associations of body mass index (BMI) and abdominal obesity with mortality among very old people are poorly known. The purpose of this study was to investigate the association of BMI, waist circumference (WC), and waist-to-hip ratio with mortality in nonagenarians. METHODS: This study is part of a prospective population-based study, Vitality 90+, including both community-dwelling and institutionalized persons from Tampere, Finland. Altogether 192 women and 65 men aged 90 years were subjected to anthropometric measurements, a baseline interview, and a 4-year mortality follow-up. Cox proportional hazards models were used in the statistical analyses. RESULTS: In men, normal weight indicated a three times higher mortality risk (hazard ratio [HR] 3.09, 95% confidence interval [CI] 1.35-7.06) compared with overweight, and WC was inversely associated with mortality (HR 0.96, 95% CI 0.93-1.00) after adjustment for covariates. In women, the univariate waist-to-hip ratio (HR 1.43, 95% CI 1.06-1.92) and BMI-adjusted waist-to-hip ratio (HR 1.45, 95% CI 1.07-1.97) were positively associated with mortality. Also, overweight women whose WC was <86 cm had lower mortality than normal weight women with similar WC (HR 0.34, 95% CI 0.12-0.97). CONCLUSIONS: In nonagenarian men, low BMI and low WC predict increased mortality. In nonagenarian women, waist-to-hip ratio alone and adjusted for BMI is positively associated with mortality. The potential positive effects of overweight combined with WC warrant more detailed analyses in larger data. In all, future studies are needed to better understand the health and functional consequences of body composition among the oldest old. SN - 1758-535X UR - https://www.unboundmedicine.com/medline/citation/21860016/Body_mass_index_waist_circumference_and_waist_to_hip_ratio_as_predictors_of_mortality_in_nonagenarians:_the_Vitality_90+_Study_ L2 - https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/glr147 DB - PRIME DP - Unbound Medicine ER -