Body Mass Trajectories and Mortality Among Older Adults: A Joint Growth MixtureDiscrete-Time Survival Analysis
Body Mass Trajectories and Mortality Among Older Adults: A Joint Growth MixtureDiscrete-Time Survival Analysis
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DOI：
10.1093/geront/gns164
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发表时间：
2014-04-01
期刊：
影响因子：
5.7
通讯作者：
Ailshire, Jennifer
中科院分区：
文献类型：
--
作者：
Zajacova, Anna;Ailshire, Jennifer
研究目的：本研究的目的是调查老年人体重轨迹的异质性及其与死亡风险的关系。设计和方法：关于体重指数(BMI)和存活率的信息来自健康和退休研究的九波，这是一项为期16年的调查，对象是基线年龄为5161岁的成年人(N9703)。我们使用性别分层关节生长混合离散时间生存模型来表征体重指数轨迹组及其相关死亡率。结果：确定了三种不同的BMI轨迹：稳定超重、肥胖增加和肥胖减少。相对于占样本约90%的稳定超重类别，肥胖增加类别的死亡风险约高50%；肥胖失去类别的死亡率最高(OR>；2.7，p<；.001)。男性和女性的结果是相似的。启示：这些发现突出了美国老年人体重轨迹的显著异质性，以及不同阶层之间的巨大生存差异。在预测老年人寿命方面，体重变化的方向似乎与整体BMI水平密不可分。体重减轻与特别高的死亡风险有关，即使典型的BMI变化是从肥胖到超重。
Purpose of the Study: The aim of this study was to investigate heterogeneity in body weight trajectories among older adults and their association with mortality risks. Design and Methods: Information on body mass index (BMI) and survival come from nine waves of the Health and Retirement Study, a 16-year survey of adults aged 5161 at baseline (N 9,703). We used a sex-stratified joint growth mixture-discrete time survival model to characterize BMI trajectory groups and their associated mortality. Results: Three distinct classes of BMI trajectories were identified: stable overweight, obese gaining, and obese losing. Relative to the stable overweight class, which comprised about 90% of the sample, the obese gaining class had approximately 50% higher mortality risk; the highest mortality was found in the obese losing category (OR > 2.7, p < .001). The results were similar for men and women. Implications: The findings highlight substantial heterogeneity in weight trajectories of older Americans, as well as large survival differentials across the classes. The direction of weight changes appears inextricably linked to the overall BMI level in terms of predicting older adults longevity. Weight loss is associated with particularly high mortality risk even when the typical BMI change is from obesity to overweight.