TY - JOUR
T1 - Self-Reported Early and Later Life Weight and the Risk of All-Cause Mortality in Older Adults
AU - Alharbi, T. A.
AU - Ryan, J.
AU - Freak-Poli, R.
AU - Gasevic, D.
AU - McNeil, J.
AU - Woods, R. L.
AU - Britt, C.
AU - Nelson, M. R.
AU - Owen, Alice J.
N1 - Funding Information:
Funding: ASPREE was supported by grants from the National Institute on Aging and the National Cancer Institute at the U.S. National Institutes of Health (Grant Nos. U01AG029824 and U19AG062682); the National Health and Medical Research Council of Australia (Grant Nos. 334047 and 1127060); Monash University (Australia) and the Victorian Cancer Agency (Australia). ALSOP was supported by funding from Monash University, ANZ Trustees, the Wicking Trust, and the Mason Foundation. TAA is a recipient of the Custodian of the two Holy Mosques Overseas Scholarship Program. JR is a recipient of an NHMRC Boosting Dementia Research Leadership Fellowship (APP1135727). RFP is supported by a National Heart Foundation of Australia Postdoctoral Fellowship (Grant No. 101927). Funders played no role in the design of the study, in the collection, analysis and interpretation of data and in the writing of the manuscript. Open Access funding enabled and organized by CAUL and its Member Institutions.
Funding Information:
This study utilised data from community-dwelling Australian participants aged ≥70 years participating in the randomised, double-blind, placebo-controlled ASPirin in Reducing Events in the Elderly (ASPREE, n = 19,114) clinical trial of low dose aspirin, and the ASPREE Longitudinal Study of Older Persons (ALSOP, n = 14,892) sub-study (, ). Between 2010–14 ASPREE recruited a cohort of initially healthy, independently living, older adults who were free of cardiovascular disease, dementia or major physical disability at baseline (). The major findings of the ASPREE study have been previously published (, , ). Australian ASPREE clinical trial participants were invited to participate in the ALSOP sub-study (, ) with 89% (n = 14,892) completing the baseline Medical Health questionnaire in which historical and current self-reported weight was captured. Ethics approval for ASPREE and ALSOP were obtained through the Monash University Human Research Ethics Committee, reference numbers: 2006/745MC, CF11/1100 and CF11/1935. The ASPREE and ALSOP studies were conducted in accordance with the Declaration of Helsinki 1964 (including 2008 revision) and the National Health and Medical Research Council Guidelines on Human Experimentation. The ASPREE clinical trial was funded by the National Institute on Aging and others, and is registered at ClinicalTrials.gov, NCT01038583.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/4
Y1 - 2023/4
N2 - Objectives: The extent to which body weight in early adulthood is associated with late-life mortality risk is unclear. This study aimed to determine the association between body mass index (BMI) in early adulthood (at 18 years of age) and older age (70 years and over), and the risk of mortality in later life. Design: Secondary analysis of the ASPREE Longitudinal Study of Older Persons (ALSOP). Setting, Participants: Data were from 14,853 relatively healthy community-dwelling Australians aged ≥70 years when enrolled in the study. Measurements: Self-reported weight atage ≥70 years and recalled weight at age 18 years were collected at ALSOP study baseline. Height was measured with a stadiometer and was used for calculation of BMI at both timepoints. BMI at each timepoint was defined as: underweight, normal weight, overweight and obese. Individuals were categorised into one of five ‘lifetime’ BMI groups: normal weight (BMI between 18.5 and 24.9 at both times), overweight (25.0–29.9 at either or both times), obesity to non-obese (≥30.0 at age 18 and <30.0≥70 years), non-obese to obesity (<30.0 at age 18 and ≥30.0 at age≥70 years), and early and later life obesity (≥30.0 at both times). Results: During a median 4.7 years follow-up, 715 deaths occurred. Obesity at 18 years, but not in older age (p=0.44), was significantly associated with the risk of mortality in later life, even after accounting for current health status (HR: 2.35, 95% CI: 1.53–3.58, p<0.001). Compared with participants with normal BMI at both time points, being obese at both time points was associated with increased mortality risk (HR=1.99, 95% CI: 1.04–3.81, p=0.03), and the risk was even greater for individuals who were obese at 18 years but were no longer obese in older age (HR=2.92, 95% CI: 1.65–5.16, p<0.001), in fully adjusted models. Participants who were normal weight at 18 years and were obese in later life, did not have an increased mortality risk (p=0.78). Conclusions: Obesity in early adulthood, and obesity in both early and later life, were associated with increased mortality risk in later life. This highlights the importance of preventing obesity in early adulthood and maintaining a normal weight over an adult lifespan.
AB - Objectives: The extent to which body weight in early adulthood is associated with late-life mortality risk is unclear. This study aimed to determine the association between body mass index (BMI) in early adulthood (at 18 years of age) and older age (70 years and over), and the risk of mortality in later life. Design: Secondary analysis of the ASPREE Longitudinal Study of Older Persons (ALSOP). Setting, Participants: Data were from 14,853 relatively healthy community-dwelling Australians aged ≥70 years when enrolled in the study. Measurements: Self-reported weight atage ≥70 years and recalled weight at age 18 years were collected at ALSOP study baseline. Height was measured with a stadiometer and was used for calculation of BMI at both timepoints. BMI at each timepoint was defined as: underweight, normal weight, overweight and obese. Individuals were categorised into one of five ‘lifetime’ BMI groups: normal weight (BMI between 18.5 and 24.9 at both times), overweight (25.0–29.9 at either or both times), obesity to non-obese (≥30.0 at age 18 and <30.0≥70 years), non-obese to obesity (<30.0 at age 18 and ≥30.0 at age≥70 years), and early and later life obesity (≥30.0 at both times). Results: During a median 4.7 years follow-up, 715 deaths occurred. Obesity at 18 years, but not in older age (p=0.44), was significantly associated with the risk of mortality in later life, even after accounting for current health status (HR: 2.35, 95% CI: 1.53–3.58, p<0.001). Compared with participants with normal BMI at both time points, being obese at both time points was associated with increased mortality risk (HR=1.99, 95% CI: 1.04–3.81, p=0.03), and the risk was even greater for individuals who were obese at 18 years but were no longer obese in older age (HR=2.92, 95% CI: 1.65–5.16, p<0.001), in fully adjusted models. Participants who were normal weight at 18 years and were obese in later life, did not have an increased mortality risk (p=0.78). Conclusions: Obesity in early adulthood, and obesity in both early and later life, were associated with increased mortality risk in later life. This highlights the importance of preventing obesity in early adulthood and maintaining a normal weight over an adult lifespan.
KW - Body mass index
KW - later life
KW - mortality
KW - obesity
KW - older adults
UR - http://www.scopus.com/inward/record.url?scp=85152786975&partnerID=8YFLogxK
U2 - 10.1007/s12603-023-1907-1
DO - 10.1007/s12603-023-1907-1
M3 - Article
C2 - 37170438
AN - SCOPUS:85152786975
SN - 1279-7707
VL - 27
SP - 301
EP - 308
JO - Journal of Nutrition, Health and Aging
JF - Journal of Nutrition, Health and Aging
IS - 4
ER -
