Key result
BMI loss >10% in older adults is linked to ~69% higher all-cause mortality versus stable BMI.
Why the study?
The associations of weight change with all-cause and cause-specific mortality stratified by age remained unclear.
Does weight change affect all-cause and cause-specific mortality in adults aged ≥45 years?
Cohort (n=746,991)
Does weight change affect all-cause and cause-specific mortality in adults aged ≥45 years?
Effect estimate: HR 1.69 (95% CI 1.54-1.86)
Absolute Event Rate: 130.1% vs 77.6%
Weight loss and excessive weight gain are associated with increased mortality in older adults, whereas only excessive weight loss increases mortality risk in middle-aged adults.
BACKGROUND: The associations of weight change with all-cause and cause-specific mortality stratified by age remains unclear. We evaluated the age-stratified (< 65 vs ≥ 65 years) associations of weight change with all-cause and cause-specific mortality in a large sample of Chinese adults. METHODS: Our cohort study included 746,991 adults aged at least 45 years from the Shenzhen Healthcare Big Data Cohort in China. BMI change were categorized as change within 5% (stable), decrease by 5% to 10%, decrease by > 10%, increase by 5% to 10%, and increase by > 10%. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, non-communicable disease, cardiovascular disease (CVD), and cancer mortality according to BMI change, with adjustment for potential confounders. RESULTS: During a median follow-up of 2.2 years (2,330,180 person-years), there were 10,197 deaths. A notable interaction emerged between weight change and age. For participants ≥ 65 years, compared with stable BMI, more than a 10% decrease in BMI was associated with higher risk of all-cause mortality (HR: 1.69, 95% CI: 1.54-1.86), non-communicable disease mortality (HR: 1.67, 95% CI: 1.52-1.84), CVD mortality (HR: 1.55, 95% CI: 1.34-1.80), and cancer mortality (HR: 1.59, 95% CI: 1.33-1.92). Similar patterns of results for 5% to 10% decrease in BMI were observed. More than a 10% increase in BMI was associated with increased risk of all-cause mortality (HR: 1.13, 95% CI: 1.04-1.24), non-communicable disease mortality (HR: 1.14, 95% CI: 1.04-1.25), and CVD mortality (HR: 1.27, 95% CI: 1.12-1.44). For participants < 65 years, only more than a 10% decrease in BMI was associated with higher risk of all-cause mortality (HR: 1.41, 95% CI: 1.12-1.77), non-communicable disease mortality (HR: 1.43, 95% CI: 1.13-1.81), and cancer mortality (HR: 1.79, 95% CI: 1.29-2.47). CONCLUSIONS: Weight loss and excessive weight gain were associated with increased risks of mortality among older adults, while only excessive weight loss was associated with increased risks of mortality among middle-aged adults.
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Huang et al. (2024) conducted a cohort in Community-dwelling adults (n=746,991). Decrease in BMI >10% vs. Stable BMI (change within 5%) was evaluated on All-cause mortality (≥65 years) (HR 1.69, 95% CI 1.54-1.86). Among adults aged 65 years and older, a decrease in BMI of more than 10% was associated with a 69% higher risk of all-cause mortality (HR 1.69) compared to maintaining a stable BMI.
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