Obesity in Older People With and Without Conditions Associated With Weight Loss: Follow-up of 955,000 Primary Care Patients
dc.contributor.author | Bowman, K | |
dc.contributor.author | Delgado, J | |
dc.contributor.author | Henley, WE | |
dc.contributor.author | Masoli, JA | |
dc.contributor.author | Kos, K | |
dc.contributor.author | Brayne, C | |
dc.contributor.author | Thokala, P | |
dc.contributor.author | Lafortune, L | |
dc.contributor.author | Kuchel, GA | |
dc.contributor.author | Ble, A | |
dc.contributor.author | Melzer, D | |
dc.contributor.author | Ageing Well Programme of the NIHR School for Public Health Research, England | |
dc.date.accessioned | 2017-07-06T12:30:31Z | |
dc.date.issued | 2016-08-04 | |
dc.description.abstract | BACKGROUND: Moderate obesity in later life may improve survival, prompting calls to revise obesity control policies. However, this obesity paradox may be due to confounding from smoking, diseases causing weight-loss, plus varying follow-up periods. We aimed to estimate body mass index (BMI) associations with mortality, incident type 2 diabetes, and coronary heart disease in older people with and without the above confounders. METHODS: Cohort analysis in Clinical Practice Research Datalink primary care, hospital and death certificate electronic medical records in England for ages 60 to more than 85 years. Models were adjusted for age, gender, alcohol use, smoking, calendar year, and socioeconomic status. RESULTS: Overall, BMI 30-34.9 (obesity class 1) was associated with lower overall death rates in all age groups. However, after excluding the specific confounders and follow-up less than 4 years, BMI mortality risk curves at age 65-69 were U-shaped, with raised risks at lower BMIs, a nadir between 23 and 26.9 and steeply rising risks above. In older age groups, mortality nadirs were at modestly higher BMIs (all <30) and risk slopes at higher BMIs were less marked, becoming nonsignificant at age 85 and older. Incidence of diabetes was raised for obesity-1 at all ages and for coronary heart disease to age 84. CONCLUSIONS: Obesity is associated with shorter survival plus higher incidence of coronary heart disease and type 2 diabetes in older populations after accounting for the studied confounders, at least to age 84. These results cast doubt on calls to revise obesity control policies based on the claimed risk paradox at older ages. | en_GB |
dc.description.sponsorship | This work was supported by the National Institute for Health Research (NIHR) School for Public Health Research Ageing Well programme. Grant number: IS-SPH-0211-10100 - SPHR-SWP-AWP-PR2.The School for Public Health Research (SPHR) is funded by the National Institute for Health Research (NIHR). SPHR is a partnership between the Universities of Sheffield, Bristol, Cambridge, UCL; The London School for Hygiene and Tropical Medicine; the University of Exeter Medical School; the LiLaC collaboration between the Universities of Liverpool and Lancaster and Fuse; The Centre for Translational Research in Public Health, a collaboration between Newcastle, Durham, Northumbria, Sunderland and Teesside Universities. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. J.M. reports fellowship grant from National Institute for Health Research, outside the submitted work. A.B. reports grants from UK National Institute for Health Research (NIHR) School for Public Health Research (Ageing Well programme), during the conduct of the study; and was an employee of Pfizer Italia until November 2012, outside the submitted work. P.T. reports grants from NIHR, during the conduct of the study. | en_GB |
dc.identifier.citation | Vol. 72 (2), pp. 203 - 209 | en_GB |
dc.identifier.doi | 10.1093/gerona/glw147 | |
dc.identifier.uri | http://hdl.handle.net/10871/28339 | |
dc.language.iso | en | en_GB |
dc.publisher | Oxford University Press (OUP) / Gerontological Society of America | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/27492450 | en_GB |
dc.rights | © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com | en_GB |
dc.subject | BMI | en_GB |
dc.subject | Mortality | en_GB |
dc.subject | Overweight | en_GB |
dc.subject | Paradox | en_GB |
dc.title | Obesity in Older People With and Without Conditions Associated With Weight Loss: Follow-up of 955,000 Primary Care Patients | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2017-07-06T12:30:31Z | |
exeter.place-of-publication | United States | en_GB |
dc.description | This is the final version of the article. Available from OUP via the DOI in this record. | en_GB |
dc.identifier.journal | Journals of Gerontology, Series A | en_GB |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ |
Files in this item
This item appears in the following Collection(s)
Except where otherwise noted, this item's licence is described as © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com