Self-Reported Early and Later Life Weight and the Risk of All-Cause Mortality in Older Adults - 10/12/24

Doi : 10.1007/s12603-023-1907-1 
T.A. Alharbi 1, J. Ryan 1, R. Freak-Poli 1, D. Gasevic 1, 2, J. McNeil 1, R.L. Woods 1, C. Britt 1, M.R. Nelson 1, 3, Alice J. Owen 1
1 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd., Level 4, 3004, Melbourne, VIC, Australia 
2 Usher Institute, University of Edinburgh, Teviot Place, EH8 9AG, Edinburgh, UK 
3 Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, Australia 

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Abstract

Objectives

The extent to which body weight in early adulthood is associated with late-life mortality risk is unclear. This study aimed to determine the association between body mass index (BMI) in early adulthood (at 18 years of age) and older age (70 years and over), and the risk of mortality in later life.

Design

Secondary analysis of the ASPREE Longitudinal Study of Older Persons (ALSOP).

Setting, Participants

Data were from 14,853 relatively healthy community-dwelling Australians aged ≥70 years when enrolled in the study.

Measurements

Self-reported weight atage ≥70 years and recalled weight at age 18 years were collected at ALSOP study baseline. Height was measured with a stadiometer and was used for calculation of BMI at both timepoints. BMI at each timepoint was defined as: underweight, normal weight, overweight and obese. Individuals were categorised into one of five ‘lifetime’ BMI groups: normal weight (BMI between 18.5 and 24.9 at both times), overweight (25.0–29.9 at either or both times), obesity to non-obese (≥30.0 at age 18 and <30.0≥70 years), non-obese to obesity (<30.0 at age 18 and ≥30.0 at age≥70 years), and early and later life obesity (≥30.0 at both times).

Results

During a median 4.7 years follow-up, 715 deaths occurred. Obesity at 18 years, but not in older age (p=0.44), was significantly associated with the risk of mortality in later life, even after accounting for current health status (HR: 2.35, 95% CI: 1.53–3.58, p<0.001). Compared with participants with normal BMI at both time points, being obese at both time points was associated with increased mortality risk (HR=1.99, 95% CI: 1.04–3.81, p=0.03), and the risk was even greater for individuals who were obese at 18 years but were no longer obese in older age (HR=2.92, 95% CI: 1.65–5.16, p<0.001), in fully adjusted models. Participants who were normal weight at 18 years and were obese in later life, did not have an increased mortality risk (p=0.78).

Conclusions

Obesity in early adulthood, and obesity in both early and later life, were associated with increased mortality risk in later life. This highlights the importance of preventing obesity in early adulthood and maintaining a normal weight over an adult lifespan.

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Key words : Body mass index, obesity, mortality, older adults, later life


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Vol 27 - N° 4

P. 301-308 - avril 2023 Retour au numéro
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