scholarly journals Waist Circumference and All-Cause Mortality among Older Adults in Rural Indonesia

2019 ◽  
Vol 16 (1) ◽  
pp. 116 ◽  
Author(s):  
Cahya Utamie Pujilestari ◽  
Lennarth Nyström ◽  
Margareta Norberg ◽  
Nawi Ng
Keyword(s):  
Older Adults ◽  
Waist Circumference ◽  
Abdominal Obesity ◽  
Mortality Risk ◽  
Cox Regression ◽  
Public Health Intervention ◽  
World Health ◽  
Men And Women ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Waist circumference, a measure of abdominal obesity, is associated with all-cause mortality in general adult population. However, the link between abdominal obesity with all-cause mortality in the studies of older adults is unclear. This study aims to determine the association between waist circumference and all-cause mortality in older adults in Indonesia. The association between waist circumference and all-cause mortality was examined in 10,997 men and women aged 50 years and older, in the World Health Organization (WHO) and International Network of field sites for continuous Demographic Evaluation of Populations and their Health in developing countries (INDEPTH) collaboration Study on global AGEing and adult health (SAGE) in Purworejo District Central Java, Indonesia during 2007–2010. Multivariate Cox regression analysis with restricted cubic splines was used to assess the non-linear association between waist circumference and all-cause mortality. During the 3-year follow-up, a total of 511 men and 470 women died. The hazard ratio plot shows a pattern of U-shape relationship between waist circumference and all-cause mortality among rich women, though the result was significant only for women in the lower end of waist circumference distribution (p < 0.05). Poor men with a low waist circumference (5th percentile) have a two times higher mortality risk (HR = 2.1; 95% CI = 1.3, 3.3) relative to those with a waist circumference of 90 cm. Poor women with a low waist circumference (25th percentile) have a 1.4 times higher mortality risk (HR = 1.4; 95% CI = 1.1, 1.8) relative to those with a waist circumference of 80 cm. This study shows a significant association between low waist circumference measure and mortality, particularly among poor men and women. Though the association between large waist circumference and mortality was not significant, we observed a trend of higher mortality risk particularly among rich women with large waist circumference measure. Public health intervention should include efforts to improve nutritional status among older people and promoting healthy lifestyle behaviours including healthy food and active lifestyle.

scholarly journals ‘Fat but powerful’ paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study

2021 ◽  
pp. bjsports-2020-103720
Author(s):  
Julian Alcazar ◽  
David Navarrete-Villanueva ◽  
Asier Mañas ◽  
Alba Gómez-Cabello ◽  
Raquel Pedrero-Chamizo ◽  
...  
Keyword(s):  
Older Adults ◽  
Waist Circumference ◽  
Older People ◽  
Multicentre Study ◽  
Mortality Risk ◽  
Muscle Power ◽  
Smoking Status ◽  
Relative Power ◽  
Fat Percentage ◽  
All Cause Mortality

ObjectivesTo assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the ‘fat but powerful’ (F+P) (or ‘fat but fit’) paradox in older adults.MethodsA total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated.ResultsAccording to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively).ConclusionPowerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

Impact of relative muscle power on hospitalization and all-cause mortality in older adults

2021 ◽  
Author(s):  
Jose Losa-Reyna ◽  
Julian Alcazar ◽  
Jose Carnicero ◽  
Ana Alfaro-Acha ◽  
Carmen Castillo-Gallego ◽  
...  
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
Healthy Aging ◽  
Muscle Power ◽  
Handgrip Strength ◽  
Relative Power ◽  
Men And Women ◽  
Adjusted Risk ◽  
Power Group ◽  
All Cause Mortality

Abstract Background The purpose of this study was to evaluate the relationship of lower-limb muscle power with mortality and hospitalization. Methods A total of 1928 subjects from the Toledo Study for Healthy Aging were included. Muscle power was assessed with the 5-repetition STS test and subjects were classified into different groups of relative power (i.e. normalized to body mass) according to sex-specific tertiles and their inability to perform the test. Mean follow-up periods for hospitalization and all-cause mortality were 3.3 and 6.3 years, respectively. Results Compared to the high relative muscle power group, men with low (HR [95%CI]= 2.1 [1.2-3.6]) and women with very low and low (HR [95%CI]= 4.7 [3.0-7.4] and 1.8 [1.2-2.7]) relative power had an increased age-adjusted risk of hospitalization. After adjusting for several covariates (age, physical activity, BMI education, depression, comorbidities, disability and handgrip strength) these effects were attenuated (men and women with very low relative power: HR [95%CI]= 1.6 [0.9-2.9] and 2.8 [1.6-4.9]). The very low relative muscle power group had also an increased all-cause mortality risk (age-adjusted) in both men and women (HR [95%CI]= 2.3 [1.4-3.9] and 2.9 [1.6-5.3]). After adjusting for all the covariates, a significantly increased mortality risk was observed only in men (HR [95% CI]= 2.1 [1.1-3.8], (women HR [95% CI]= 1.6 [0.8-3.2]), with very low levels of relative power. Conclusion Relative muscle power was independently and negatively associated with mortality and hospitalization in older adults. An augmented all-cause mortality risk was noted in the lowest group of relative muscle power.

scholarly journals The association of dialysis adequacy, body mass index, and mortality among hemodialysis patients

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Woong-pyo Hong ◽  
Yu-Ji Lee
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Mortality Risk ◽  
Cox Regression ◽  
Target Range ◽  
Dialysis Adequacy ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
All Cause Mortality ◽  
High Bmi

Abstract Background Although hemodialysis (HD) adequacy, single-pool Kt/Vurea (spKt/V), is inversely correlated with body size, each is known to affect patient survival in the same direction. Therefore, we sought to examine the relationship between HD adequacy and mortality according to body mass index (BMI) in HD patients and explore a combination effect of BMI and HD adequacy on mortality risk. Methods We retrospectively reviewed patient data from the Korean Society of Nephrology registry, a nationwide database of medical records of HD patients, from January 2001 to June 2017. We included patients ≥18 years old who were receiving maintenance HD. Patients were categorized into three groups according to baseline BMI (< 20 (low), 20 to < 23 (normal), and ≥ 23 (high) kg/m2). Baseline spKt/V was divided into six categories. Results Among 18,242 patients on HD, the median follow-up duration was 5.2 (IQR, 1.9–8.9) years. Cox regression analysis showed that, compared to the reference (spKt/V 1.2–1.4), lower and higher baseline spKt/V were associated with greater and lower risks for all-cause mortality, respectively. However, among patients with high BMI (n = 5588), the association between higher spKt/V and lower all-cause mortality was attenuated in all adjusted models (Pinteraction < 0.001). Compared to patients with normal BMI and spKt/V within the target range (1.2–1.4), those with low BMI had a higher risk for all-cause mortality at all spKt/V levels. However, the gap in mortality risk became narrower for higher values of spKt/V. Compared to patients with normal BMI and spKt/V in the target range, those with high BMI and spKt/V < 1.2 were not at increased risk for mortality despite low dialysis adequacy. Conclusions The association between spKt/V and mortality in HD patients may be modified by BMI.

scholarly journals Changes in waist circumference and risk of all-cause and CVD mortality: results from the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Angela A. Mulligan ◽  
Marleen A. H. Lentjes ◽  
Robert N. Luben ◽  
Nicholas J. Wareham ◽  
Kay-Tee Khaw
Keyword(s):  
Weight Loss ◽  
Waist Circumference ◽  
Mortality Risk ◽  
Total Mortality ◽  
Later Life ◽  
Central Adiposity ◽  
Men And Women ◽  
All Cause Mortality ◽  
Cvd Mortality ◽  
Prospective Investigation

Abstract Background Measures of abdominal adiposity are strongly associated with all-cause mortality and cardiovascular disease (CVD). However, data are limited and conflicting regarding the consequences of changes in body fat distribution. The main aims of this paper are to investigate the association between changes in waist circumference (WC) and all-cause and CVD mortality and to examine these changes in relation to concurrent changes in weight. Methods The European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) study recruited 25,639 participants between 1993 and 1997, aged 39–79, a number of whom also attended a second examination (1998–2000), and were followed up to 2016 for mortality. Participants were eligible for inclusion if they had WC, weight and height measurements at both time-points; those with a self-reported history of CVD or cancer, body mass index < 18.5 kg/m2 or missing data on covariates were excluded, leaving 12,337 participants for analyses. The median (IQR) follow-up time was 16.4 (15.7, 17.2) years. Hazard Ratios (HRs) for all-cause (2866 deaths) and CVD mortality (822 deaths), by categories of WC change, were determined using Cox proportional hazards analyses. Results After multivariable adjustment, the HRs (95% CIs) for all-cause mortality for men and women with a WC gain (WCG) >  5 cm were 1.51 (1.29–1.75) and 1.25 (1.06–1.46) respectively. For CVD mortality in men and women with a WCG >  5 cm, the HRs were 1.84 (1.39–2.43) and 1.15 (0.85–1.55) respectively. In analyses of concurrent changes in WC and weight, the greatest risk (HRs) (95% CIs) in men occurred with weight loss and WCG: 1.80 (1.13–2.86) for all-cause and 2.22 (1.03–4.82) for CVD mortality. In women, the greatest risk for both all-cause (HR 1.50 (1.16–1.95)) and CVD mortality (HR 1.81 (1.15–2.85)) was observed in those with weight loss and maintenance of WC (WCM). Conclusions Objectively measured WCG > 5 cm, was associated with subsequent higher total mortality risk and higher CVD mortality risk in men. Interventions focusing on preventing increase in central adiposity rather than lowering weight per se in later life may potentially have greater health benefits.

Association of Different Physical Activity Domains on All-Cause Mortality in Adults Participating in Primary Care in the Brazilian National Health System: 4-Year Follow-up

2017 ◽  
Vol 14 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Bruna C. Turi ◽  
Jamile S. Codogno ◽  
Romulo A. Fernandes ◽  
Xuemei Sui ◽  
Carl J. Lavie ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Cox Regression ◽  
National Health System ◽  
Circulatory System ◽  
Cox Regression Analysis ◽  
Circulatory System Diseases ◽  
All Cause Mortality ◽  
Males And Females

Background:Evidence has shown that physical activity (PA) is associated with low mortality risk. However, data about reduced mortality due to PA are scarce in developing countries and the dose–response relationship between PA from different domains and all-cause mortality remains unclear. Thus, the aim of this study is to investigate the association of PA from different domains on all-cause mortality among Brazilian adults.Methods:679 males and females composed the study sample. Participants were divided into quartile groups according to PA from different domains (occupational, sports, and leisure-time). Medical records were used to identify the cause of the death. Cox regression analysis was performed to determine the independent associations of PA from different domains and all-cause mortality.Results:During the follow-up period, 59 participants died. The most prevalent cause of death was circulatory system diseases (n = 20; 33.9% [21.8%–45.9%]). Higher scores of occupational (HR= 0.45 [95% CI: 0.20–0.97]), sports (HR= 0.44 [95% CI: 0.20–0.95]) and overall PA (HR= 0.40 [95% CI: 0.17–0.90]) were associated with lower mortality, even after adjustment for confounders.Conclusions:The findings in this study showed the importance of being active in different domains to reduce mortality risk.

scholarly journals Fluctuations in waist circumference increase diabetes risk: a 4-year cohort study in 61,587 older adults

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Linna Wu ◽  
Hongyan Liu ◽  
Zhuang Cui ◽  
Fang Hou ◽  
Xiaowen Gong ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Gain ◽  
Waist Circumference ◽  
Abdominal Obesity ◽  
Cox Regression ◽  
Weight Maintenance ◽  
Diabetes Risk ◽  
Healthy Weight ◽  
Diabetes Onset ◽  
Hazard Ratios

Abstract Purpose To evaluate the effect of fluctuations in waist circumference (WC), weight, and body mass index (BMI) on the incidence of diabetes in older adults. Patients and methods A prospective cohort of 61,587 older adults (age, 60–96 years) who did not have diabetes at study initiation was examined. Data on weight, BMI, and WC were collected, and participants were followed up until 31 December 2018. The main end point was new-onset diabetes. A Cox regression model was used to estimate the risk of diabetes (hazard ratios [HRs] and confidence intervals [CI]) in these participants. Results During a mean follow-up of 3.6 years, being overweight (HR [95% CI] 1.87 [1.62–2.17]), obesity (1.41 [1.26–1.59]), abdominal obesity (1.42 [1.28–1.58]), and obesity plus abdominal obesity at baseline (1.93 [1.66–2.25]) increased the risk of diabetes onset. Compared with older adults who “maintained normal WC”, those who “remained abdominally obese” (HR = 1.66), “became abdominally obese” (HR = 1.58), or “achieved normal WC” (HR = 1.36) were at a higher risk of diabetes onset, as well as those with an increase in WC > 3 cm or > 5% compared with the baseline level. Weight gain or loss > 6 kg or weight gain > 5%, increase or decrease in BMI > 2 kg/m2, or an increase in BMI > 10% were associated with a higher diabetes risk. The diabetes risk was reduced by 19% in overweight older adults who exercised daily. Conclusion For older adults, WC, BMI, and healthy weight maintenance reduce the diabetes risk. The findings may provide evidence for developing guidelines of proper weight and WC control for older adults.

scholarly journals Fluctuations in Waist Circumference Increase the Risk of Diabetes in 61,587 Older Adults: 4 Years’ Chort Study

2021 ◽  
Author(s):  
Linna Wu ◽  
Hongyan Liu ◽  
Zhuang Cui ◽  
Fang Hou ◽  
Xiaowen Gong ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Gain ◽  
Waist Circumference ◽  
Abdominal Obesity ◽  
Cox Regression ◽  
Weight Maintenance ◽  
Diabetes Risk ◽  
Diabetes Incidence ◽  
Healthy Weight ◽  
Diabetes Onset

Abstract Purpose:To evaluate the effect of fluctuations in waist circumference (WC), weight, body mass index (BMI) on diabetes incidence in older adults.Patients and methods:We examined a prospective cohort of 61,587 older adults (age, 60-96 years) who did not have diabetes at study initiation. Data on weight, BMI, and WC were collected and participants were followed-up until 31 December 2019 . The main endpoint was new-onset diabetes. A Cox regression model was used to estimate the risk of diabetes (hazard ratios [HRs] and confidence intervals [CI]) in these participants.Results:During a mean followed-up of 3.6 years, individuals being overweight (HR [95% CI] 1.87 [1.62-2.17]), obesity (1.41 [1.26-1.59]), abdominal obesity (1.42 [1.28-1.58]), and obesity plus abdominal obesity at baseline (1.93 [1.66-2.25]) had higher risk of diabetes onset. Compared with older adults who “remained normal WC”, who “remained abdominally obese” (HR=1.66), “became abdominally obese”(HR=1.58) and “achieved normal WC” (HR=1.36) were also significantly associated with diabetes onset,as well as increase in WC >3 cm or >5% compared with baseline level . Weight gain or loss >6 kg or weight gain >5%; increase or decrease in BMI >2 kg/m2 or an increase in BMI >10% were associated with a higher diabetes risk. Diabetes risk reduced by 19% in overweight older adults who exercised daily.Conclusion:For old adults, waist circumference, BMI and healthy weight maintenance reduce diabetes risk. The findings may provide evidence for developing guidelines of proper weight and waist circumference control for older adults.

scholarly journals Relationship Between Multimorbidity, Combination and All-Cause Mortality Among Older Adults: A Retrospective Cohort Analysis

2020 ◽  
Author(s):  
Kun He ◽  
Wenli Zhang ◽  
Xueqi Hu ◽  
Hao Zhao ◽  
Bingxin Guo ◽  
...  
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
Cox Regression ◽  
Cohort Analysis ◽  
Relative Effect ◽  
Long Term Conditions ◽  
Cox Models ◽  
Chinese Older Adults ◽  
All Cause Mortality ◽  
The Impact

Abstract Background: Previous studies have evaluated the association of multimorbidity with higher mortality, but epidemiologic data on the association between the combination of multimorbidity and all-cause mortality risk are rare. We aimed to examine the relationship between multimorbidity (number/combination) and all-cause mortality in Chinese older adults. Methods: We conducted a population-based study of 50,100 Chinese participants. Cox regression models were used to estimate the impact of long-term conditions (LTCs) on all-cause mortality. Results: The prevalence of multimorbidity was 31.35% and all-cause mortality was 8.01% (50,100 participants). In adjusted Cox models, the hazard rations (HRs) and 95% confidence intervals (CIs) of all-cause mortality risk for those with 1, 2, and ≥ 3 LTCs compared with those with no LTCs was 1.10 (1.01-1.20), 1.21 (1.10-1.33), and 1.46 (1.27-1.67), respectively (Ptrend <0.001). In the LTCs ≥ 2 category, the combination of chronic diseases that included hypertension, diabetes, CHD, COPD, and stroke had the greatest impact on mortality. In the stratified model by age and sex, absolute all-cause mortality was higher among the ≥ 75 age group with an increasing number of LTCs. However, the relative effect size of the increasing number of LTCs on higher mortality risk was larger among those < 75 years.Conclusions: The risk of all-cause mortality is increased with the number of multimorbidity among Chinese older adults, particularly combinations.

scholarly journals A dose-independent association of triglyceride levels with all-cause mortality among adults population

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Yu-qing Huang ◽  
Xiao-cong Liu ◽  
Kenneth Lo ◽  
Ying-qing Feng ◽  
Bin Zhang
Keyword(s):  
Mortality Risk ◽  
Cox Regression ◽  
Cox Model ◽  
Additive Model ◽  
Cardiovascular Death ◽  
Cox Regression Analysis ◽  
Health And Nutrition ◽  
All Cause Mortality ◽  
Independent Association ◽  
Stratified Analysis

Abstract Background The relationship between triglyceride (TG) level and the mortality risk of all-cause and cardiovascular disease is not entirely consistent among adults. Methods The present analysis included adult participants from National Health and Nutrition Examination Surveys (NHANES) between the periods 1999–2014. The levels of TG were categorized into < 150, 150–199, 200–250 and ≥ 250 mg/dL respectively. Multivariate Cox regression analysis, stratified analysis and generalized additive model were conducted to reveal the correlation between TG and mortality risk. Results were presented in hazard ratio (HRs) and 95% confidence intervals (CIs). Results There were 18,781 (9130 males, mean age was 45.64 years) participants being included in the analysis. The average follow-up period was 8.25 years, where 1992 (10.61%) cases of all-cause and 421 (2.24%) cardiovascular death have occurred. In the multivariate Cox model, every 1 mg/dL raise in TG has significantly associated with all-cause mortality (HR: 1.08, 95% CI: 1.02, 1.15) but not cardiovascular mortality (HR: 1.10, 95% CI: 0.97, 1.24). When using TG <  150 mg/dL as reference, TG ≥ 250 mg/dL associated with death from all-cause (HR = 1.34, 95% CI: 1.12, 1.60; P = 0.0016 but not cardiovascular death (HR = 1.26, 95% CI: 0.85, 1.88; P = 0.2517). According to smoothing spline plots, the risk of all-cause was the lowest when TG was approximately 135 mg/dL. Conclusion TG might have a dose-independent association with all-cause mortality among adults in United States.

scholarly journals Fitness, Fatness, and Mortality in Men and Women From the UK Biobank: Prospective Cohort Study

2021 ◽  
Author(s):  
Jakob Tarp ◽  
Anders Grøntved ◽  
Miguel A. Sanchez‐Lastra ◽  
Knut Eirik Dalene ◽  
Ding Ding ◽  
...  
Keyword(s):  
Body Composition ◽  
Cardiorespiratory Fitness ◽  
Cox Regression ◽  
World Health ◽  
Uk Biobank ◽  
Men And Women ◽  
Increased Risk ◽  
All Cause Mortality ◽  
The Uk

Background Cardiorespiratory fitness may moderate the association between obesity and all‐cause mortality (ie, the “fat‐but‐fit” hypothesis), but unaddressed sources of bias are a concern. Methods and Results Cardiorespiratory fitness was estimated as watts per kilogram from a submaximal bicycle test in 77 169 men and women from the UK Biobank cohort and combined with World Health Organization standard body mass index categories, yielding 9 unique fitness‐fatness combinations. We also formed fitness‐fatness combinations based on bioimpedance as a direct measure of body composition. All‐cause mortality was ascertained from death registries. Multivariable‐adjusted Cox regression models were used to estimate hazard ratios and 95% CIs. We examined the association between fitness‐fatness combinations and all‐cause mortality in models with progressively more conservative approaches for accounting for reverse causation, misclassification of body composition, and confounding. Over a median follow‐up of 7.7 years, 1731 participants died. In our base model, unfit men and women had higher risk of premature mortality irrespective of levels of adiposity, compared with the normal weight–fit reference. This pattern was attenuated but maintained with more conservative approaches in men, but not in women. In analysis stratified by sex and excluding individuals with prevalent major chronic disease and short follow‐up and using direct measures of body composition, mortality risk was 1.78 (95% CI, 1.17–2.71) times higher in unfit‐obese men but not higher in obese‐fit men (0.94 [95% CI, 0.60–1.48]). In contrast, there was no increased risk in obese‐unfit women (1.09 [95% CI, 0.44–1.05]) as compared with the reference. Conclusions Cardiorespiratory fitness modified the association between obesity and mortality in men, but this pattern appeared susceptible to biases in women.

Sign in / Sign up

Export Citation Format

Share Document