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Association Between Anthropometric Measures and Long-Term Survival in Frail Older Women: Observations from the Women's Health Initiative Study.
J Am Geriatr Soc 2016; 64(2):277-84JA

Abstract

OBJECTIVES

To evaluate the association between currently recommended guidelines and commonly used clinical criteria for body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) and all-cause mortality in frail older women.

DESIGN

Longitudinal prospective cohort study.

SETTING

Women's Health Initiative (WHI)-Observational Study.

PARTICIPANTS

A sample of women aged 65-84 with complete data to characterize frailty in the third year of WHI follow-up (N = 11,070).

MEASUREMENTS

Frailty phenotype was determined using the modified Fried criteria. Information on anthropometric measures (BMI, WC, WHR) was collected in clinical examinations. Cox proportional hazards models were used to estimate the effect of BMI, WC, and WHR on mortality adjusted for demographic characteristics and health behaviors.

RESULTS

Over a mean follow-up of 11.5 years, there were 2,911 (26%) deaths in the sample. Women with a BMI from 25.0 to 29.9 kg/m(2) (hazard rate ratio (HR) = 0.80, 95% confidence interval (CI) = 0.73-0.88) and those with a BMI from 30.0 to 34.9 kg/m(2) (HR = 0.79, 95% CI = 0.71-0.88) had lower mortality than those with a BMI from 18.5 to 24.9 kg/m(2) . Women with a WHR greater than 0.8 had higher mortality (HR = 1.16, 95% CI = 1.07-1.26) than those with a WHR of 0.8 or less. No difference in mortality was observed according to WC. Stratifying according to chronic morbidity or smoking status or excluding women with early death and unintentional weight loss did not substantially change these findings.

CONCLUSION

In frail, older women, having a BMI between 25.0 and 34.9 kg/m(2) or a WHR of 0.8 or less was associated with lower mortality. Currently recommended healthy BMI guidelines should be reevaluated for frail older women.

Authors+Show Affiliations

Faculty of Health Science and Social Welfare, University of Haifa, Haifa, Israel.Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.Division of Epidemiology, School of Medicine, University of California at San Diego, San Diego, California.School of Nursing, University of Washington, Seattle, Washington.Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.Faculty of Health Science and Social Welfare, University of Haifa, Haifa, Israel.Faculty of Health Science and Social Welfare, University of Haifa, Haifa, Israel.School of Nursing, University of Washington, Seattle, Washington.Department of General Internal Medicine, MD Anderson Cancer Center, University of Texas, Houston, Texas.School of Medicine, Sticht Center on Aging, Winston-Salem, North Carolina.Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, California.Department of Epidemiology and Prevention, Wake Forest University, Winston-Salem, North Carolina.Department of Epidemiology and Environmental Health, University of Buffalo, Buffalo, New York.Faculty of Health Science and Social Welfare, University of Haifa, Haifa, Israel.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26889837

Citation

Zaslavsky, Oleg, et al. "Association Between Anthropometric Measures and Long-Term Survival in Frail Older Women: Observations From the Women's Health Initiative Study." Journal of the American Geriatrics Society, vol. 64, no. 2, 2016, pp. 277-84.
Zaslavsky O, Rillamas-Sun E, LaCroix AZ, et al. Association Between Anthropometric Measures and Long-Term Survival in Frail Older Women: Observations from the Women's Health Initiative Study. J Am Geriatr Soc. 2016;64(2):277-84.
Zaslavsky, O., Rillamas-Sun, E., LaCroix, A. Z., Woods, N. F., Tinker, L. F., Zisberg, A., ... Zelber-Sagi, S. (2016). Association Between Anthropometric Measures and Long-Term Survival in Frail Older Women: Observations from the Women's Health Initiative Study. Journal of the American Geriatrics Society, 64(2), pp. 277-84. doi:10.1111/jgs.13930.
Zaslavsky O, et al. Association Between Anthropometric Measures and Long-Term Survival in Frail Older Women: Observations From the Women's Health Initiative Study. J Am Geriatr Soc. 2016;64(2):277-84. PubMed PMID: 26889837.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association Between Anthropometric Measures and Long-Term Survival in Frail Older Women: Observations from the Women's Health Initiative Study. AU - Zaslavsky,Oleg, AU - Rillamas-Sun,Eileen, AU - LaCroix,Andrea Z, AU - Woods,Nancy F, AU - Tinker,Lesley F, AU - Zisberg,Anna, AU - Shadmi,Efrat, AU - Cochrane,Barbara, AU - Edward,Beatrice J, AU - Kritchevsky,Stephen, AU - Stefanick,Marcia L, AU - Vitolins,Mara Z, AU - Wactawski-Wende,Jean, AU - Zelber-Sagi,Shira, PY - 2016/2/19/entrez PY - 2016/2/20/pubmed PY - 2016/7/1/medline KW - body mass index KW - frailty KW - mortality KW - obesity KW - women's health SP - 277 EP - 84 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 64 IS - 2 N2 - OBJECTIVES: To evaluate the association between currently recommended guidelines and commonly used clinical criteria for body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) and all-cause mortality in frail older women. DESIGN: Longitudinal prospective cohort study. SETTING: Women's Health Initiative (WHI)-Observational Study. PARTICIPANTS: A sample of women aged 65-84 with complete data to characterize frailty in the third year of WHI follow-up (N = 11,070). MEASUREMENTS: Frailty phenotype was determined using the modified Fried criteria. Information on anthropometric measures (BMI, WC, WHR) was collected in clinical examinations. Cox proportional hazards models were used to estimate the effect of BMI, WC, and WHR on mortality adjusted for demographic characteristics and health behaviors. RESULTS: Over a mean follow-up of 11.5 years, there were 2,911 (26%) deaths in the sample. Women with a BMI from 25.0 to 29.9 kg/m(2) (hazard rate ratio (HR) = 0.80, 95% confidence interval (CI) = 0.73-0.88) and those with a BMI from 30.0 to 34.9 kg/m(2) (HR = 0.79, 95% CI = 0.71-0.88) had lower mortality than those with a BMI from 18.5 to 24.9 kg/m(2) . Women with a WHR greater than 0.8 had higher mortality (HR = 1.16, 95% CI = 1.07-1.26) than those with a WHR of 0.8 or less. No difference in mortality was observed according to WC. Stratifying according to chronic morbidity or smoking status or excluding women with early death and unintentional weight loss did not substantially change these findings. CONCLUSION: In frail, older women, having a BMI between 25.0 and 34.9 kg/m(2) or a WHR of 0.8 or less was associated with lower mortality. Currently recommended healthy BMI guidelines should be reevaluated for frail older women. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/26889837/Association_Between_Anthropometric_Measures_and_Long_Term_Survival_in_Frail_Older_Women:_Observations_from_the_Women's_Health_Initiative_Study_ L2 - https://doi.org/10.1111/jgs.13930 DB - PRIME DP - Unbound Medicine ER -