Inverse relationship between body mass index and mortality in older nursing home residents: a meta-analysis of 19,538 elderly subjects

N Veronese¹, E Cereda², M Solmi³, S A Fowler⁴, E Manzato^{1

5}, S Maggi⁵, P Manu^{6

7

8

9}, E Abe¹⁰, K Hayashi¹⁰, J P Allard^{11

12}, B M Arendt¹¹, A Beck¹³, M Chan¹⁴, Y J P Audrey¹⁴, W-Y Lin^{15

16}, H-S Hsu^{15

16}, C-C Lin^{15

16}, R Diekmann¹⁷, S Kimyagarov¹⁸, M Miller¹⁹, I D Cameron²⁰, K H Pitkälä²¹, J Lee^{22

23}, J Woo^{22

23}, K Nakamura²⁴, D Smiley²⁵, G Umpierrez²⁵, M Rondanelli²⁶, M Sund-Levander²⁷, L Valentini²⁸, K Schindler²⁹, J Törmä³⁰, S Volpato³¹, G Zuliani³¹, M Wong³², K Lok³², J M Kane^{6

7

8

9}, G Sergi¹, C U Correll^{6

7

8

9}

Affiliations

¹ Department of Medicine - DIMED, Geriatrics Section, University of Padova, Padova, Italy.
² Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
³ Department of Neurosciences, University of Padova, Padova, Italy.
⁴ Becker Medical Library, Washington University, St. Louis, MO, USA.
⁵ National Research Council, Institute of Neuroscience, Padova, Italy.
⁶ The Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, New York, USA.
⁷ Hofstra North Shore LIJ School of Medicine, Hempstead, New York, USA.
⁸ The Feinstein Institute for Medical Research, Manhasset, New York, USA.
⁹ Albert Einstein College of Medicine, Bronx, New York, USA.
¹⁰ Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan.
¹¹ Toronto General Hospital, University Health Network, Toronto, Canada.
¹² Department of Medicine, University of Toronto, Toronto, Canada.
¹³ Research Unit for Nutrition (EFFECT), Herlev University Hospital, Herlev, Denmark.
¹⁴ Department of Geriatric Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore.
¹⁵ Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
¹⁶ School of Medicine, China Medical University, Taichung, Taiwan.
¹⁷ Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.
¹⁸ The Gilad Geriatric Center, Ramat-Gan, Israel.
¹⁹ Nutrition and Dietetics, Flinders University, Adelaide, Australia.
²⁰ Walsh Centre for Rehabilitation Research, University of Sydney, Sydney, Australia.
²¹ Unit of Primary Health Care, Department of General Practice, Helsinki University Central Hospital, Helsinki, Finland.
²² The S. H. Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong, China.
²³ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
²⁴ Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
²⁵ Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
²⁶ Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, University of Pavia, Pavia, Italy.
²⁷ Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
²⁸ Section of Dietetics, Department of Agriculture and Food Sciences, University of Applied Sciences, Neubrandenburg, Germany.
²⁹ Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University Vienna, Vienna, Austria.
³⁰ Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
³¹ Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
³² Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.

PMID: 26252230
DOI: 10.1111/obr.12309

Free article

Review

Inverse relationship between body mass index and mortality in older nursing home residents: a meta-analysis of 19,538 elderly subjects

N Veronese et al. Obes Rev. 2015 Nov.

Free article

. 2015 Nov;16(11):1001-15.

doi: 10.1111/obr.12309. Epub 2015 Aug 7.

Authors

Affiliations

¹ Department of Medicine - DIMED, Geriatrics Section, University of Padova, Padova, Italy.
² Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
³ Department of Neurosciences, University of Padova, Padova, Italy.
⁴ Becker Medical Library, Washington University, St. Louis, MO, USA.
⁵ National Research Council, Institute of Neuroscience, Padova, Italy.
⁶ The Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, New York, USA.
⁷ Hofstra North Shore LIJ School of Medicine, Hempstead, New York, USA.
⁸ The Feinstein Institute for Medical Research, Manhasset, New York, USA.
⁹ Albert Einstein College of Medicine, Bronx, New York, USA.
¹⁰ Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan.
¹¹ Toronto General Hospital, University Health Network, Toronto, Canada.
¹² Department of Medicine, University of Toronto, Toronto, Canada.
¹³ Research Unit for Nutrition (EFFECT), Herlev University Hospital, Herlev, Denmark.
¹⁴ Department of Geriatric Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore.
¹⁵ Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
¹⁶ School of Medicine, China Medical University, Taichung, Taiwan.
¹⁷ Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.
¹⁸ The Gilad Geriatric Center, Ramat-Gan, Israel.
¹⁹ Nutrition and Dietetics, Flinders University, Adelaide, Australia.
²⁰ Walsh Centre for Rehabilitation Research, University of Sydney, Sydney, Australia.
²¹ Unit of Primary Health Care, Department of General Practice, Helsinki University Central Hospital, Helsinki, Finland.
²² The S. H. Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong, China.
²³ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
²⁴ Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
²⁵ Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
²⁶ Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, University of Pavia, Pavia, Italy.
²⁷ Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
²⁸ Section of Dietetics, Department of Agriculture and Food Sciences, University of Applied Sciences, Neubrandenburg, Germany.
²⁹ Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University Vienna, Vienna, Austria.
³⁰ Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
³¹ Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
³² Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.

PMID: 26252230
DOI: 10.1111/obr.12309

Abstract

Body mass index (BMI) and mortality in old adults from the general population have been related in a U-shaped or J-shaped curve. However, limited information is available for elderly nursing home populations, particularly about specific cause of death. A systematic PubMed/EMBASE/CINAHL/SCOPUS search until 31 May 2014 without language restrictions was conducted. As no published study reported mortality in standard BMI groups (<18.5, 18.5-24.9, 25-29.9, ≥30 kg/m(2)), the most adjusted hazard ratios (HRs) according to a pre-defined list of covariates were obtained from authors and pooled by random-effect model across each BMI category. Out of 342 hits, 20 studies including 19,538 older nursing home residents with 5,223 deaths during a median of 2 years of follow-up were meta-analysed. Compared with normal weight, all-cause mortality HRs were 1.41 (95% CI = 1.26-1.58) for underweight, 0.85 (95% CI = 0.73-0.99) for overweight and 0.74 (95% CI = 0.57-0.96) for obesity. Underweight was a risk factor for higher mortality caused by infections (HR = 1.65 [95% CI = 1.13-2.40]). RR results corroborated primary HR results, with additionally lower infection-related mortality in overweight and obese than in normal-weight individuals. Like in the general population, underweight is a risk factor for mortality in old nursing home residents. However, uniquely, not only overweight but also obesity is protective, which has relevant nutritional goal implications in this population/setting.

Keywords: Body mass index; elderly; mortality; nursing home.

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Inverse relationship between body mass index and mortality in older nursing home residents: a meta-analysis of 19,538 elderly subjects

Affiliations

Inverse relationship between body mass index and mortality in older nursing home residents: a meta-analysis of 19,538 elderly subjects

Authors

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Abstract

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LinkOut - more resources

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Medical