Decline in Body Weight Leads to Higher Mortality in Elderly, According to Pittsburgh Study

PITTSBURGH, October 3, 2001 — Modest decline in body weight is an important marker of risk of mortality in older adults, according to a University of Pittsburgh study published in the October issue of the Journal of the American Geriatrics Society.

The multi-center study, led by Anne B. Newman, M.D., M.P.H., associate professor in the division of geriatric medicine at the University of Pittsburgh School of Medicine, found that weight loss of as little as five percent over a three-year period was associated with an increased risk of mortality. Weight stability was associated with optimal mortality rates.

"Although the weight loss is subtle, this study illustrates the need for physicians to closely monitor the weight of their older patients, including those who are already thin or at ideal weight," Dr. Newman reported.

People who had a weight loss of five percent and who had a lower starting weight over the course of three years had a mortality rate as high as 7.4 percent while those people who gained weight or whose weight was stable had a mortality rate of around 2 percent.

The study included 4,255 people, age 65 or older, who are part of the multi-center Cardiovascular Health Study established in 1989. An additional group of 459 African- Americans was added to the study in 1992.

"The participants in this study were somewhat healthier than those seen in general practice. However, compared with previous studies, this group was more representative of older adults living in the community, including men and women and a sizeable number of African- American, and detailed information about health habits and history," Dr. Newman said.

Weight change was determined by comparing the participants' baseline weight upon study entry to their weight three years later. The follow-up for mortality began at the end of the three-year period through an additional one to four years. People were excluded from the final analysis who were hospitalized or who had a new diagnosis of cardiovascular disease or cancer during the study period.

Over the three years, 18.7 percent of women and 16.2 percent of men had a weight loss of greater than five percent, while 6.3 percent of women and 4.1 percent of men had a weight loss greater than 10 percent.

Those who lost weight had a higher prevalence of stroke, diabetes, hypertension or gastrointestinal illness and used a higher number of medications than the weight-stable group.

The minority group was similar to the original group in that those whose weight was stable had more optimal health status and lower disability than those who gained or lost weight. However, those in the minority group who gained weight had the lowest income and education whereas in the original group, lower income and education were associated with weight loss.

"Those on a medically prescribed diet at baseline were more likely to lose weight than those who were not on a diet, suggesting that weight loss may have been a treatment goal," said Dr. Newman. "Weight loss was also associated with a self-initiated diet, again suggesting intentionality. However, those who lost weight in these two subgroups did not have either a lower or higher risk of mortality than did those who reported no special diet."

Dr. Newman also reported that "although many potentially identifiable risk factors for weight loss can be identified and treated, the extent to which weight can be regained and whether weight regain would improve survival is not known."

Other centers participating in the study include the University of Washington, Seattle; the University of Alabama, Birmingham; the University of Arizona, Tucson; The Johns Hopkins University and the National Institute on Aging.

The study is funded by the National Heart, Lung and Blood Institute.