Inverse relationship between body mass index and mortality in older nursing home residents: a meta-analysis of 19,538 elderly subjects
2015 (English)In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, no 11, 1001-1015 p.Article in journal (Refereed) Published
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/m2), 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.
Place, publisher, year, edition, pages
Wiley-Blackwell, 2015. Vol. 16, no 11, 1001-1015 p.
Body mass index;elderly;mortality;nursing home
Public Health, Global Health, Social Medicine and Epidemiology
IdentifiersURN: urn:nbn:se:liu:diva-121461DOI: 10.1111/obr.12309ISI: 000363424300007PubMedID: 26252230OAI: oai:DiVA.org:liu-121461DiVA: diva2:855374
Funding agencies: Baxter; Abbott; Fresenius-Kabi; Pfizeer; Nestle; Sanofi; Novo Nordisk; Boehringer Ingelheim; Merck; BMS; Feinstein Institute for Medical Research; Janssen/JJ; National Institute of Mental Health (NIMH); National Alliance for Research in Schizophrenia and 2015-09-212015-09-212016-05-04Bibliographically approved