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Body mass index and mortality among older people living in the community
F Landi1, G Zuccalà, G Gambassi
1Istituto di Medicina Interna e Geriatria, Universită Cattolica del Sacro Cuore, Rome, Italy.
Objectives:
To determine if body mass index (BMI = weight/height2), predictive of mortality in seriously ill hospitalized and institutionalized patients, is also predictive of mortality in a longitudinal epidemiologic study.
Design:
A prospective cohort study.
Setting:
Rovereto, a town in northern Italy.
Participants:
A consecutive sample of 214 patients aged 81.2 +/- 7.3 years receiving community care services.
Main Outcome Measures:
Malnutrition and mortality.
Results:
According to logistic regression analysis, malnutrition status, expressed by a BMI < 22 Kg/m2, was correlated with dependency in Activity of Daily Living (odds ratio 1.21; 95% confidence interval (CI) 1.01-1.45). Only a low BMI was associated with 1-year survival in Cox regression analysis, after adjusting for potential confounders (relative risk 0.85; 95%CI, 0.74-0.97). A high BMI (>27 Kg/m2) was not significantly related to risk of mortality.
Conclusions:
Nutrition variables are a cardinal component of comprehensive geriatric assessment. Our results suggest that BMI, a simple anthropometric measure of nutritional status, is an important predictor of mortality among older people living in the community. Even when controlling for clinical and functional variables, a low BMI remained a significant and independent predictor of shortened survival.