Body mass index and nine-year mortality in disabled and nondisabled older U.S. individuals.

To investigate the relationship between body mass index (BMI) and 9-year mortality in older (> or = 65) Americans with and without disability.Cohort study.The unique disability-focused National Long Term Care Survey (NLTCS) data that assessed the health and well-being of older individuals in 1994 were analyzed.Four thousand seven hundred ninety-one individuals in the 1994 survey.BMI (kg/m2) was calculated from self- or proxy reports of height and weight. The analysis was adjusted for 1-year change in BMI and demographic and health-related factors, as well as reports by proxies, and death occurring during the first 2 years after the interview.The relative risk of death as a function of BMI formed a nonsymmetric U-shaped pattern, with larger risks associated with lower BMI (< 22.0) and minimal risks for BMI of 25.0 to 34.9. (BMI 22.0-24.9 was the reference.) Adjustments for demographic and health-related factors had little effect on this pattern. Nondisabled individuals exhibited a similar U-shaped pattern but with lower risks associated with lower BMI. For disabled individuals, the mortality-risk pattern was higher for lower BMI (< 22.0) and flat for higher BMI, thus exhibiting an inverse J shape. BMI patterns were age sensitive, with disability status affecting sensitivity.Overweight or mild (grade 1) obesity was not a risk factor for 9-year mortality in older Americans participating in the 1994 NLTCS. A flatter BMI pattern of the relative risk of death for disabled than for nondisabled individuals suggests that optimal body weight can be sensitive to age and health and well-being.

Duke Scholars

Author Alexander Kulminski Social Science Research Institute

Author Konstantin Arbeev Social Science Research Institute

Author Irina Kulminskaya  

Author Svetlana Ukraintseva Social Science Research Institute

Author Kenneth C. Land Sociology

Author Igor Akushevich Social Science Research Institute

Author Anatoli I. Yashin Social Science Research Institute