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Body mass index and mortality in institutionalized elderly
Emanuele Cereda1, Carlo Pedrolli, Annunciata Zagami
1Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. e.cereda@smatteo.pv.it
Journal of the American Medical Directors Association
|February 22, 2011
Summary
Low body mass index (BMI) in elderly individuals residing in institutions is linked to increased mortality risk. A BMI of 21 kg/m² or less signals a need for nutritional support to improve outcomes.
Area of Science:
- Gerontology
- Nutritional Science
- Public Health
Background:
- Malnutrition and sarcopenia are prevalent in institutionalized elderly, significantly impacting prognosis.
- Aging leads to decreased body weight and lean body mass, making BMI a marker of protein stores rather than adiposity in older adults.
- Current guidelines recommend a body mass index (BMI) of 21 kg/m² or lower as a key indicator for initiating nutritional support.
Purpose of the Study:
- To investigate the association between body mass index (BMI) and mortality risk in elderly individuals residing in long-term care facilities.
- To determine if a BMI threshold of 21 kg/m² is a reliable indicator for nutritional intervention in this population.
Main Methods:
- A multicenter prospective cohort study involving 519 institutionalized elderly residents.
- Mortality risk across different BMI tertiles was assessed using Cox proportional hazards regression.
- Analyses were adjusted for potential confounders identified at baseline and during follow-up.
Main Results:
- During a median follow-up of 5.7 years, 78.8% of participants died.
- Elderly individuals in the lowest BMI tertile (≤ 21 kg/m²) faced a significantly higher risk of all-cause and cardiovascular mortality.
- This increased risk persisted even after accounting for nutritional support, which itself was associated with reduced mortality.
Conclusions:
- Body mass index (BMI) is a significant predictor of all-cause and cardiovascular mortality in institutionalized elderly patients.
- A BMI of 21 kg/m² or below serves as a valuable trigger for implementing nutritional support.
- These findings underscore the importance of considering BMI as an indicator of nutritional reserve in institutionalized older adults.
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