Body-composition predictors of mortality in women aged ≥75 y: data from a large population-based cohort study with a 17-y follow-up

doi:10.3945/ajcn.114.086728

The American Journal of Clinical Nutrition

Volume 100, Issue 5, November 2014, Pages 1352-1360

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ABSTRACT

Background:

The role of body composition as a risk factor for death remains controversial in older persons.

Objective:

We determined the role of body-composition variables in mortality in older women.

Design:

Longitudinal analyses were performed in a prospective cohort study of older women. Participants were 4574 community-dwelling women aged ≥75 y at the baseline visit (between January 1992 and April 1994). Several body-composition variables were assessed by using anthropometric measures and dual-energy X-ray absorptiometry at the baseline visit. The main outcome was overall mortality. Body-composition variables were body mass index (BMI; in kg/m²), hip circumference, waist circumference, waist-to-hip ratio, fat mass/height², lean mass/height², percentage of fat mass, percentage of lean mass, and the lean mass:fat mass ratio.

Results:

The mean (±SD) age at baseline was 80.2 ± 3.8 y. During the 17.7 y (IQR: 17.2–18.1 y) of follow-up, 2876 women died. U-shaped in crude analyses and reversed J-shaped relations in adjusted analyses between BMI, hip and waist circumferences, fat mass/height², and risk of death were shown. Adjusted risk of death was significantly higher in participants with BMI ≤24.6 and fat mass/height² ≤8.2 kg/m². There was a negative linear association between fat mass (%) and risk of death: a 10% increase in fat mass was associated with a 12% reduction of mortality risk (adjusted HR: 0.88; 95% CI: 0.84, 0.92; P < 0.001). Linear and statistically significant relations were shown between lean mass/height² and risk of death in crude but not adjusted analyses.

Conclusions:

Risk of mortality was consistently higher in older women with low adiposity. No lean mass indicator was associated with risk of death. Clinicians should be alerted by low adiposity in older women.

Cited by (0)

^¹: From the Gerontopôle, Toulouse University Hospital, Toulouse, France (YR and MC); the Institut national de la santé et de la recherche médicale (INSERM) Unité Mixte de Recherche 1027, University of Toulouse III, France (YR, AG, and MC); the Laboratory of Epidemiology and Community Health, Faculty of Medicine, Toulouse, France (CC, AG, and VL-C); the Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, University of Lyon, INSERM U1033, Lyon, France (A-MS); the Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University Montpellier 1, Montpellier, France (HB); and the Department of Neuroscience, Division of Geriatric Medicine, Unité Propre de Recherche et d’Enseignement Supérieur–Equipe d’Accueil 4638, Université Nantes Angers Le Mans, Angers University Hospital, Angers, France (OB).

^²: The funding organization had no role in the design, conduct of the study, collection, management, analysis, and interpretation of data, or preparation, review, and decision to submit the manuscript for publication.

^³: Supported by the National Health Minister of France.

^⁴: Address correspondence to Y Rolland, Service de Médecine Interne et de Gérontologie Clinique, Centre Hospitalo-Universitaire La Grave-Casselardit, 170 Avenue de Casselardit, 31300 Toulouse, France. E-mail: [email protected].

^⁵: Abbreviations used: ASMM, appendicular skeletal muscle mass; DXA, dual-energy X-ray absorptiometry; EPIDOS, Epidemiologie de l’Osteoporose; FP, fractional polynomial; IADL, instrumental activities of daily living; RCS, restricted cubic spline.