Year-end Sale % OFF 
Abstract
ImportanceBody mass index (BMI) shows a U-shaped association with impaired physical functioning among adults; the association is reduced or eliminated with aging.ObjectiveTo examine whether BMI is associated with subsequent disability in activities of daily living (ADL) in Chinese adults age 80 years or older.Design, Setting, and ParticipantsData were obtained on 16 022 adults age 80 years or older who were able to perform ADL independently at baseline from the Chinese Longitudinal Healthy Longevity Study, a community-based prospective cohort study conducted in 23 provinces of China. The study was initiated in 1998, with follow-up and recruitment of new participants in 2000, 2002, 2005, 2008, 2011, and 2014.Main Outcomes and MeasuresDisability in ADL was defined as dependence in eating, toileting, bathing, dressing, indoor activities, and/or continence.ResultsAmong the 16 022 participants, 45.2% were men and 54.8% were women, with a mean (SD) age of 92.2 (7.2) years and a mean (SD) BMI (calculated as weight in kilograms divided by height in meters squared) of 19.3 (3.8). During 70 606 person-years of follow-up, 8113 participants with disability in ADL were identified. Cox proportional hazards regression models with penalized splines showed that BMI was linearly associated with disability in ADL: each 1-kg/m2 increase in BMI corresponded to a 4.5% decrease in the risk of disability in ADL. In comparison with individuals in the fourth quintile for BMI, the adjusted hazard ratio for disability in ADL was 1.38 (95% CI, 1.29-1.48) in the first quintile, 1.37 (95% CI, 1.28-1.47) in the second quintile, 1.11 (95% CI, 1.04-1.19) in the third quintile, and 0.85 (95% CI, 0.79-0.91) in the fifth quintile (P < .001 for trend). When BMI was categorized by Chinese guidelines, the underweight group (BMI <18.5) showed significantly increased risk of disability in ADL (hazard ratio, 1.34; 95% CI, 1.28-1.41) and the overweight or obese group (BMI ≥24.0) showed significantly decreased risk of disability in ADL (hazard ratio, 0.84; 95% CI, 0.78-0.91) compared with the normal weight group (BMI 18.5 to <24.0) (P < .001 for trend).Conclusions and RelevanceHigher BMI was associated with a lower risk of disability in ADL among Chinese adults age 80 years or older, which suggests that current recommendations for BMI may need to be revisited. More attention should be paid on underweight, rather than overweight or obesity, for the prevention of disability in ADL after age 80 years.
Highlights
A marked increase has been documented in the prevalence worldwide, including China, of individuals with overweight and obesity, usually assessed by body mass index (BMI; calculated as weight in kilograms divided by height in meters squared).[1,2] Individuals with overweight and obesity constitute a major public health problem owing to the increased risk of hypertension, dyslipidemia, coronary heart disease, stroke, type 2 diabetes, musculoskeletal disorders, and some kinds of cancer.[3]
Cox proportional hazards regression models with penalized splines showed that BMI was linearly associated with disability in activities of daily living (ADL): each 1-kg/m2 increase in BMI corresponded to a 4.5% decrease in the risk of disability in ADL
When BMI was categorized by Chinese guidelines, the underweight group (BMI
Summary
A marked increase has been documented in the prevalence worldwide, including China, of individuals with overweight and obesity, usually assessed by body mass index (BMI; calculated as weight in kilograms divided by height in meters squared).[1,2] Individuals with overweight and obesity constitute a major public health problem owing to the increased risk of hypertension, dyslipidemia, coronary heart disease, stroke, type 2 diabetes, musculoskeletal disorders, and some kinds of cancer.[3]. A consistent and puzzling finding is the reduction or elimination of this association with increasing age.[4] Previous research and discussions have focused on the association of increased BMI with morbidity and mortality for older adults, but associations of BMI with many important measures of health, such as disability in activities of daily living (ADL), have not been fully examined. Disability in ADL is considered the most serious form of disability measure[5]; it is defined as difficulty undertaking activities in any areas of daily life due to a health issue or a physical problem.[6] At some point, a person with disability in ADL may be unable to live independently and may require assistance from family or institutionalization. Independent of how disability in ADL was measured, many studies have addressed the association between BMI and disability in ADL at older ages: both longitudinal[7,8,9] and cross-sectional[10,11,12,13] studies have consistently found that obesity was an independent risk factor for disability in ADL in older adults
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
