학술논문
Inverse relationship between body mass index and mortality in older nursing home residents: a meta-analysis of 19,538 elderly subjects
Document Type
Author
Veronese, N.; Cereda, E.; Solmi, M; Fowler, S.A.; Manzato, E; Maggi, S; Manu, P; Abe, E; Hayashi, K; Allard, J.P.; Arendt, B.M.; Beck, A; Chan, M; Audrey, Y.J.P.; Lin, W-Y; Hsu, H-S; Lin, C-C; Diekmann, R; Kimyagarov, S; Miller, M; Cameron, I.D.; Pitkälä, K.H.; Lee, J; Woo, J; Nakamura, K; Smiley, D; Umpierrez, G; Rondanelli, M; Sund-Levander, Märtha; Valentini, L; Schindler, K; Törmä, J; Volpato, S; Zuliani, G; Wong, M; Lok, K; Kane, J.M.; Sergi, G; Correll, C.U.
Source
Obesity Reviews. 16(11):1001-1015
Subject
Language
English
ISSN
1467-7881
1467-789X
1467-789X
Abstract
Body mass index (BMI) and mortality in old adults from the general population have been related in a U-shaped or J-shaped curve. However, limited information is available for elderly nursing home populations, particularly about specific cause of death. A systematic PubMed/EMBASE/CINAHL/SCOPUS search until 31 May 2014 without language restrictions was conducted. As no published study reported mortality in standard BMI groups (<18.5, 18.5–24.9, 25–29.9, ≥30 kg/m2), the most adjusted hazard ratios (HRs) according to a pre-defined list of covariates were obtained from authors and pooled by random-effect model across each BMI category. Out of 342 hits, 20 studies including 19,538 older nursing home residents with 5,223 deaths during a median of 2 years of follow-up were meta-analysed. Compared with normal weight, all-cause mortality HRs were 1.41 (95% CI = 1.26–1.58) for underweight, 0.85 (95% CI = 0.73–0.99) for overweight and 0.74 (95% CI = 0.57–0.96) for obesity. Underweight was a risk factor for higher mortality caused by infections (HR = 1.65 [95% CI = 1.13–2.40]). RR results corroborated primary HR results, with additionally lower infection-related mortality in overweight and obese than in normal-weight individuals. Like in the general population, underweight is a risk factor for mortality in old nursing home residents. However, uniquely, not only overweight but also obesity is protective, which has relevant nutritional goal implications in this population/setting.