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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
Univ Padua, Geriatr Sect, Dept Med DIMED, Padua, Italy..
Fdn IRCCS Policlin San Matteo, Nutr & Dietet Serv, Pavia, Italy..
Univ Padua, Dept Neurosci, Padua, Italy..
Washington Univ, Becker Med Lib, St Louis, MO USA..
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2015 (English)In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, no 11, 1001-1015 p.Article, review/survey (Refereed) PublishedText
Abstract [en]

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, 30kg/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.

Place, publisher, year, edition, pages
2015. Vol. 16, no 11, 1001-1015 p.
Keyword [en]
Body mass index, elderly, mortality, nursing home
National Category
Endocrinology and Diabetes
URN: urn:nbn:se:uu:diva-269131DOI: 10.1111/obr.12309ISI: 000363424300007PubMedID: 26252230OAI: oai:DiVA.org:uu-269131DiVA: diva2:882356
Available from: 2015-12-14 Created: 2015-12-14 Last updated: 2015-12-14Bibliographically approved

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