BMI Trajectories, Mortality and Comorbidity in Older Adults
Author(s)
Gray L
University of Sheffield, Sheffield, DBY, UK
OBJECTIVES : Changes in BMI have been shown to be a better indicator of health and better predict comorbidities than single BMI measures. This study aims to identify BMI trajectories which are linked to a higher risk of subsequent mortality and comorbidities. METHODS : Data from the English Longitudinal Study of Aging (ELSA) is used. The ELSA uses a sample of 17,587 individuals of 50 years of age from the Health Survey for England (1998 – 2000). The data includes information on BMI and a range of comorbidities and mortality. A growth mixture model identifies latent BMI trajectories that individuals follow. Distal outcomes are estimated using discrete-time survival analysis; risk of mortality, type II diabetes, cancer, asthma, arthritis, heart problems and stroke. A 2-step approach is used to estimate hazard ratios for the multiple distal outcomes for each of the latent BMI trajectory classes. RESULTS : Four BMI trajectories were identified: persistent obesity, persistent overweight, increasingly obese and decreasing BMI. Individuals had 3.1% probability of being a member of the decreasing BMI trajectory and compared to the persistent overweight trajectory (85.7%) had a higher risk of mortality (OR=1.625, p<0.001), developing diabetes (OR=0.883, p<0.001), arthritis (OR=1.727, p=0.013), asthma (OR=2.119, p=0.041), stroke (OR=1.778, p=0.080) and heart problems (OR=1.532, p=0.037). Following the ‘consistently obese’ trajectory (3.7%) increased the risk of diabetes considerably compared to the ‘stable overweight’ trajectory (OR=3.148, p<0.001). BMI trajectory had no significant influence on risk of cancer. CONCLUSIONS Individuals exhibiting decreasing BMI should be closely monitored due to their increased risks of mortality and comorbidities. One possible explanation is that these individuals are losing muscle and so they see a decrease in BMI but an increase in body fat percentage. Further research into the predictors of riskier BMI trajectories could help to target interventions appropriately.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PMU30
Topic
Epidemiology & Public Health, Methodological & Statistical Research
Topic Subcategory
Confounding, Selection Bias Correction, Causal Inference, Public Health
Disease
Cardiovascular Disorders, Diabetes/Endocrine/Metabolic Disorders, Geriatrics, Respiratory-Related Disorders