Abstract
Lower body mass index (BMI) has consistently been associated with mortality in elderly in the general and chronic disease populations. Remarkably, in older incident dialysis patients no association of BMI with mortality was found. We performed an in-depth analysis and explored possible time-stratified effects of BMI. 908 incident dialysis patients aged ≥65 years of the NECOSAD study were included, and divided into tertiles by baseline BMI (<23.1 (lower), 23.1–26.0 (reference), ≥26.0 (higher) kg/m2). Because the hazards changed significantly during follow-up, the effect of BMI was modeled for the short-term (<1 year) and longer-term (≥1 year after dialysis initiation). During follow-up (median 3.8 years) 567 deaths occurred. Lower BMI was associated with higher short-term mortality risk (adjusted-HR 1.63 [1.14–2.32] P = 0.007), and lower longer-term mortality risk (adjusted-HR 0.81 [0.63–1.04] P = 0.1). Patients with lower BMI who died during the first year had significantly more comorbidity, and worse self-reported physical functioning compared with those who survived the first year. Thus, lower BMI is associated with increased 1-year mortality, but conditional on surviving the first year, lower BMI yielded a similar or lower mortality risk compared with the reference. Those patients with lower BMI, who had limited comorbidity and better physical functioning, had better survival.
Highlights
Lower body mass index (BMI) has consistently been associated with mortality in elderly in the general and chronic disease populations
The deleterious effect of low BMI on survival has been documented in chronic disease populations, including heart failure, chronic obstructive pulmonary disease, peripheral vascular disease, and rheumatoid arthritis[10,11,12,13,14]
Of 2,051 patients included in NECOSAD, 925 were aged ≥65 years, and in 908 patients weight and height were available at baseline
Summary
Lower body mass index (BMI) has consistently been associated with mortality in elderly in the general and chronic disease populations. A previous study failed to observe an association of BMI with long-term mortality risk in elderly (≥65 years) patients starting dialysis[15]. This finding is striking, as it is inconsistent with the aforementioned effects of low BMI, both in the general older adult population and in chronic disease populations. We conducted an in-depth exploratory analysis of the association of BMI with mortality risk in older incident dialysis patients to investigate whether the effect of baseline-measured BMI on mortality risk might change during follow-up time
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: 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.