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

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; R. Diekmann; S. Kimyagarov; M. Miller; I. D. Cameron; K. H. Pitkälä; J. Lee; J. Woo; K. 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

doi:10.1111/obr.12309

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

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, R. Diekmann, S. Kimyagarov, M. MillerI. D. Cameron, K. H. Pitkälä, J. Lee, J. Woo, K. 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

IRCCS Fondazione Policlinico San Matteo

Research output: Contribution to journal › Article › peer-review

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 (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.

Original language	English
Pages (from-to)	1001-1015
Number of pages	15
Journal	Obesity Reviews
Volume	16
Issue number	11
DOIs	https://doi.org/10.1111/obr.12309
Publication status	Published - Nov 1 2015

Keywords

Body mass index
Elderly
Mortality
Nursing home

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health
Endocrinology, Diabetes and Metabolism

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10.1111/obr.12309

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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., ... Correll, C. U. (2015). Inverse relationship between body mass index and mortality in older nursing home residents: A meta-analysis of 19,538 elderly subjects. Obesity Reviews, 16(11), 1001-1015. https://doi.org/10.1111/obr.12309

Inverse relationship between body mass index and mortality in older nursing home residents : A meta-analysis of 19,538 elderly subjects. / 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, M.; Valentini, L.; Schindler, K.; Törmä, J.; Volpato, S.; Zuliani, G.; Wong, M.; Lok, K.; Kane, J. M.; Sergi, G.; Correll, C. U.

In: Obesity Reviews, Vol. 16, No. 11, 01.11.2015, p. 1001-1015.

Research output: Contribution to journal › Article › peer-review

Veronese, N, Cereda, E, Solmi, M, Fowler, SA, Manzato, E, Maggi, S, Manu, P, Abe, E, Hayashi, K, Allard, JP, Arendt, BM, Beck, A, Chan, M, Audrey, YJP, Lin, WY, Hsu, HS, Lin, CC, Diekmann, R, Kimyagarov, S, Miller, M, Cameron, ID, Pitkälä, KH, Lee, J, Woo, J, Nakamura, K, Smiley, D, Umpierrez, G, Rondanelli, M, Sund-Levander, M, Valentini, L, Schindler, K, Törmä, J, Volpato, S, Zuliani, G, Wong, M, Lok, K, Kane, JM, Sergi, G & Correll, CU 2015, 'Inverse relationship between body mass index and mortality in older nursing home residents: A meta-analysis of 19,538 elderly subjects', Obesity Reviews, vol. 16, no. 11, pp. 1001-1015. https://doi.org/10.1111/obr.12309

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, M. ; Valentini, L. ; Schindler, K. ; Törmä, J. ; Volpato, S. ; Zuliani, G. ; Wong, M. ; Lok, K. ; Kane, J. M. ; Sergi, G. ; Correll, C. U. / Inverse relationship between body mass index and mortality in older nursing home residents : A meta-analysis of 19,538 elderly subjects. In: Obesity Reviews. 2015 ; Vol. 16, No. 11. pp. 1001-1015.

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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 (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.",

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AU - Abe, E.

AU - Hayashi, K.

AU - Allard, J. P.

AU - Arendt, B. M.

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AU - Miller, M.

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AU - Rondanelli, M.

AU - Sund-Levander, M.

AU - Valentini, L.

AU - Schindler, K.

AU - Törmä, J.

AU - Volpato, S.

AU - Zuliani, G.

AU - Wong, M.

AU - Lok, K.

AU - Kane, J. M.

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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

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