[Obesity in the elderly and very elderly--prognostic significance and practical conclusions]

Epidemiological work on the age-dependency of the relation between overweight and mortality confirms an opinion which is traditional among physicians and has it roots in a mixture of biological understanding and common sense. The data base can be summarized in three points: 1) Up to the age of 60-65 years, overweight is combined with decreased life expectancy. The excess mortality is found mainly in the cardiovascular area and can be explained by the well-known risk factors of atherosclerosis. In the Framingham-study, overweight per se is a risk factor for this group of diagnoses. 2) In the age group 65-74 years, the relation between overweight and excess mortality vanishes gradually; the right arm of the U- or J-curve levels off. The optimal BMI moves to the right, and the right arm of the curve is shortened. 3) In high age, from 75-80 years on, overweight coincides with improved prognosis. The geriatric literature is in agreement in the sense that overweight is no problem in high age.