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Elderly with higher BMI have lower mortality risk

March 22 2010

Clinical question What is the relationship between body mass index (BMI) and mortality in the elderly?

Bottom line In the elderly, increased BMI is associated with a lower risk of death. This study adds to the growing amount of research that indicates that bigger is better among the elderly. (Level of evidence = 1b)

Synopsis These authors present data from the Jerusalem Longitudinal Study, which follows a cohort of Western Jerusalem residents born in 1920-1921. The residents were first evaluated in 1990 and subsequently in 1998 and 2005. Each participant in the study underwent a two-part assessment. The first part, administered by a nurse or occupational therapist, assessed demographics, personal history, lifestyle, health services use, function, and cognitive status. The second part, performed by physicians, involved an examination and a medical history, including extensive review of systems. The researchers calculated the BMI for each participant. The main outcome—death—was determined by an annual review of the national death registry. The researchers assessed the association between BMI and death, adjusting for diabetes mellitus, ischemic heart disease, hypertension, and cancer; subjective estimate of economic hardship; physical activity; functional independence; smoking (pack years); and self-rated health. At ages 70, 78, and 85 years, each unit increase in BMI was associated with lower mortality risk.

Stessman J, Jacobs JM, Ein-Mor E, Bursztyn M. Normal body mass index rather than obesity predicts greater mortality in elderly people: the Jerusalem Longitudinal Study. J Am Geriatr Soc. 2009;57(12):2232-2238.