Associations of body size with all-cause and cause-specific mortality in healthy older adults

Prudence R Carr, Katherine L Webb, Johannes T Neumann, Le T P Thao, Lawrence J Beilin, Michael E Ernst, Bernadette Fitzgibbon, Danijela Gasevic, Mark R Nelson, Anne B Newman, Suzanne G Orchard, Alice Owen, Christopher M Reid, Nigel P Stocks, Andrew M Tonkin, Robyn L Woods, John J McNeil

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

In the general population, body mass index (BMI) and waist circumference are recognized risk factors for several chronic diseases and all-cause mortality. However, whether these associations are the same for older adults is less clear. The association of baseline BMI and waist circumference with all-cause and cause-specific mortality was investigated in 18,209 Australian and US participants (mean age: 75.1 ± 4.5 years) from the ASPirin in Reducing Events in the Elderly (ASPREE) study, followed up for a median of 6.9 years (IQR: 5.7, 8.0). There were substantially different relationships observed in men and women. In men, the lowest risk of all-cause and cardiovascular mortality was observed with a BMI in the range 25.0–29.9 kg/m 2 [HR 25-29.9 vs 21–24.9 kg/m 2: 0.85; 95% CI, 0.73–1.00] while the highest risk was in those who were underweight [HR BMI <21 kg/m2 vs BMI 21–24.9 kg/m2: 1.82; 95% CI 1.30–2.55], leading to a clear U-shaped relationship. In women, all-cause mortality was highest in those with the lowest BMI leading to a J-shaped relationship (HR BMI <21 kg/m2 vs BMI 21–24.9 kg/m2: 1.64; 95% CI 1.26–2.14). Waist circumference showed a weaker relationship with all-cause mortality in both men and women. There was little evidence of a relationship between either index of body size and subsequent cancer mortality in men or women, while non-cardiovascular non-cancer mortality was higher in underweight participants. For older men, being overweight was found to be associated with a lower risk of all-cause mortality, while among both men and women, a BMI in the underweight category was associated with a higher risk. Waist circumference alone had little association with all-cause or cause-specific mortality risk. Trial registration ASPREE https://ClinicalTrials.gov number NCT01038583.

Original languageEnglish
Article number3799
Pages (from-to)3799
JournalScientific Reports
Volume13
Issue number1
DOIs
Publication statusPublished - 7 Mar 2023

Keywords / Materials (for Non-textual outputs)

  • Aged
  • Female
  • Humans
  • Male
  • Aspirin
  • Australia/epidemiology
  • Body Size
  • Cause of Death
  • Thinness
  • Waist Circumference

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