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Inverse relationship between body mass index and mortality in older nursing home residents: a meta-analysis of 19,538 elderly subjects

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


  • N Veronese
  • E Cereda
  • M Solmi
  • S A Fowler
  • E Manzato
  • S Maggi
  • P Manu
  • E Abe
  • K Hayashi
  • J P Allard
  • B M Arendt
  • A Beck
  • M Chan
  • Y J P Audrey
  • W-Y Lin
  • H-S Hsu
  • C-C Lin
  • Rabea Diekmann
  • S Kimyagarov
  • M Miller
  • I D Cameron
  • K H Pitkälä
  • J Lee
  • J Woo
  • Kyosuke Nakamura
  • D Smiley
  • G Umpierrez
  • M Rondanelli
  • M Sund-Levander
  • L Valentini
  • K Schindler
  • J Törmä
  • S Volpato
  • G Zuliani
  • M Wong
  • K Lok
  • J M Kane
  • G Sergi
  • C U Correll
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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/m(2)), 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.

TidsskriftObesity reviews : an official journal of the International Association for the Study of Obesity
Udgave nummer11
Sider (fra-til)1001-15
Antal sider15
StatusUdgivet - nov. 2015

ID: 46197761