Weight Change and All-Cause Mortality in Later Life: Findings From the National Survey of the Japanese Elderly
Weight Change and All-Cause Mortality in Later Life: Findings From the National Survey of the Japanese Elderly
复制标题
以后的重量变化和全因死亡率：日本老年人的全国调查结果
DOI：
10.1093/geroni/igaa057.1212
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发表时间：
2020-12-16
影响因子：
7
通讯作者：
Shinkai S
中科院分区：
文献类型：
--
作者：
Murayama H;Liang J;Shaw B;Botoseneanu A;Kobayashi E;Fukaya T;Shinkai S
最近主要针对西方人群的研究表明，体重增加和减轻都与老年死亡风险增加有关。然而，在亚洲人群中关于这一主题的证据仍然很少。我们在一个具有全国代表性的日本社区老年人样本中研究了体重变化与全因死亡率之间的关系。数据来自日本老年人全国调查（N = 4,869，年龄≥60岁）。研究人员对参与者进行了长达30年的随访。短期（3年）和中期（6年）体重变化分为“减重≥5%”、“减重2.5%-4.9%”、“稳定”、“增重2.5%-4.9%”和“增重≥5%”。采用Cox比例风险模型评估与体重变化类别相关的相对死亡风险（以稳定体重为参照）。在对社会人口因素、健康行为和健康状况进行调整后，与稳定组相比，短期体重减轻≥5%与更高的死亡率相关（风险比= 1.36；95%可信区间= 1.22-1.51）。其他体重变化类别与死亡率无显著关联。这在男性和女性中都可以观察到。此外，当我们使用中期权重变化指标时，观察到相同的结果模式。总之，我们发现短期和中期体重减轻超过5%会增加日本老年人的死亡风险；然而，其他类型的体重变化没有。这一发现可以为旨在改善老年人健康和生存的体重管理的临床和公共卫生方法提供信息，特别是在亚洲人群中。
Recent studies predominantly in Western populations suggest that both weight gain and weight loss are associated with increased mortality risk in old age. However, evidence on this topic in Asian populations remains sparse. We examined the association between weight change and all-cause mortality in a nationally-representative sample of community-dwelling older Japanese. Data came from the National Survey of the Japanese Elderly (N = 4,869, age ≥ 60 years). Participants were followed for up to 30 years. Short-term (3 years) and medium-term (6 years) weight changes were classified as “loss ≥ 5%,” “loss 2.5%–4.9%,” “stable,” “gain 2.5%–4.9%,” and “gain ≥ 5%.” Cox proportional hazards models were used to assess the relative (stable weight as reference) mortality risk associated with weight change categories. Short-term weight loss ≥ 5% was associated with higher mortality compared to the stable category, after adjusting for sociodemographic factors, health behaviors, and health conditions (hazard ratio = 1.36; 95% confidence interval = 1.22–1.51). The other weight change categories had no significant association with mortality. This was observed both among males and females. Moreover, the same pattern of results was observed when we used the medium-term weight change indicator. In conclusion, we found that both short- and medium-term weight loss greater than 5% increased the risk of dying among older Japanese; however, other types of weight change did not. This finding could inform clinical and public health approaches to body-weight management aimed to improve the health and survival of older adults, particularly in Asian populations.