Body mass index, dementia, and mortality in the elderly |
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Authors: | J A Luchsinger B Patel M X Tang N Schupf R Mayeux |
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Institution: | Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY 10032, USA. jal94@columbia.edu |
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Abstract: | Objectives: To explore the association between body mass index and mortality in the elderly taking the diagnosis of dementia into account.Design: Cohort study.Setting: cohort study of aging in Medicare recipients in New York City.Participants: 1,452 elderly individuals 65 years and older of both genders.Measurements: We used proportional hazards regression for longitudinal multivariate analyses relating body mass index (BMI) and weight
change to all-cause mortality.Results: 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.Conclusion: The presence of dementia does not explain the association between low BMI and higher mortality in the elderly. However,
dementia may explain the association between weight loss and higher mortality. |
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Keywords: | Mortality dementia body mass index weight change |
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