Effect of age on the association between body mass index and all-cause mortality: The Ohsaki cohort study

Masato Nagai, Shinichi Kuriyama, Masako Kakizaki, Kaori Ohmori-Matsuda, Yumi Sugawara, Toshimasa Sone, Atsushi Hozawa, Ichiro Tsuji

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Abstract

Background: To clarify the effect of age on the association between body mass index (BMI) and all-cause mortality. Methods: We followed 43 972 Japanese participants aged 40 to 79 years for 12 years. Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs), using the following BMI categories: <18.5 (underweight), 18.5-20.9, 21.0-22.9, 23.0-24.9 (reference), 25.0-27.4, 27.5-29.9, and ≥30.0 kg/m2 (obese). Analyses were stratified by age group: middle-aged (40-64 years) vs elderly (65-79 years). Results: We observed a significantly increased risk of mortality in underweight elderly men: the multivariate HR was 1.26 (0.92-1.73) in middle-aged men and 1.49 (1.26-1.76) in elderly men. In addition, we observed a significantly increased risk of mortality in obese middle-aged men: the multivariate HR was 1.71 (1.17-2.50) in middle-aged men and 1.25 (0.87-1.80) in elderly men. In women, there was an increased risk of mortality irrespective of age group in the underweight: the multivariate HR was 1.46 (0.96-2.22) in middle-aged women and 1.47 (1.19-1.82) in elderly women. There was no excess risk of mortality with age in obese women: the multivariate HR was 1.47 (0.94-2.27) in middle-aged women and 1.26 (0.95-1.68) in elderly women. Conclusions: As compared with the reference category, obesity was associated with a high mortality risk in middle-aged men, whereas underweight, rather than obesity, was associated with a high mortality risk in elderly men. In women, obesity was associated with a high mortality risk during middle age; underweight was associated with a high mortality risk irrespective of age. The mortality risk due to underweight and obesity may be related to sex and age.

Original languageEnglish
Pages (from-to)398-407
Number of pages10
JournalJournal of epidemiology
Volume20
Issue number5
DOIs
Publication statusPublished - 03-11-2010

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Body Mass Index
Cohort Studies
Thinness
Mortality
Obesity
Age Groups
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Epidemiology

Cite this

Nagai, Masato ; Kuriyama, Shinichi ; Kakizaki, Masako ; Ohmori-Matsuda, Kaori ; Sugawara, Yumi ; Sone, Toshimasa ; Hozawa, Atsushi ; Tsuji, Ichiro. / Effect of age on the association between body mass index and all-cause mortality : The Ohsaki cohort study. In: Journal of epidemiology. 2010 ; Vol. 20, No. 5. pp. 398-407.
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title = "Effect of age on the association between body mass index and all-cause mortality: The Ohsaki cohort study",
abstract = "Background: To clarify the effect of age on the association between body mass index (BMI) and all-cause mortality. Methods: We followed 43 972 Japanese participants aged 40 to 79 years for 12 years. Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs), using the following BMI categories: <18.5 (underweight), 18.5-20.9, 21.0-22.9, 23.0-24.9 (reference), 25.0-27.4, 27.5-29.9, and ≥30.0 kg/m2 (obese). Analyses were stratified by age group: middle-aged (40-64 years) vs elderly (65-79 years). Results: We observed a significantly increased risk of mortality in underweight elderly men: the multivariate HR was 1.26 (0.92-1.73) in middle-aged men and 1.49 (1.26-1.76) in elderly men. In addition, we observed a significantly increased risk of mortality in obese middle-aged men: the multivariate HR was 1.71 (1.17-2.50) in middle-aged men and 1.25 (0.87-1.80) in elderly men. In women, there was an increased risk of mortality irrespective of age group in the underweight: the multivariate HR was 1.46 (0.96-2.22) in middle-aged women and 1.47 (1.19-1.82) in elderly women. There was no excess risk of mortality with age in obese women: the multivariate HR was 1.47 (0.94-2.27) in middle-aged women and 1.26 (0.95-1.68) in elderly women. Conclusions: As compared with the reference category, obesity was associated with a high mortality risk in middle-aged men, whereas underweight, rather than obesity, was associated with a high mortality risk in elderly men. In women, obesity was associated with a high mortality risk during middle age; underweight was associated with a high mortality risk irrespective of age. The mortality risk due to underweight and obesity may be related to sex and age.",
author = "Masato Nagai and Shinichi Kuriyama and Masako Kakizaki and Kaori Ohmori-Matsuda and Yumi Sugawara and Toshimasa Sone and Atsushi Hozawa and Ichiro Tsuji",
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Nagai, M, Kuriyama, S, Kakizaki, M, Ohmori-Matsuda, K, Sugawara, Y, Sone, T, Hozawa, A & Tsuji, I 2010, 'Effect of age on the association between body mass index and all-cause mortality: The Ohsaki cohort study', Journal of epidemiology, vol. 20, no. 5, pp. 398-407. https://doi.org/10.2188/jea.JE20090204

Effect of age on the association between body mass index and all-cause mortality : The Ohsaki cohort study. / Nagai, Masato; Kuriyama, Shinichi; Kakizaki, Masako; Ohmori-Matsuda, Kaori; Sugawara, Yumi; Sone, Toshimasa; Hozawa, Atsushi; Tsuji, Ichiro.

In: Journal of epidemiology, Vol. 20, No. 5, 03.11.2010, p. 398-407.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of age on the association between body mass index and all-cause mortality

T2 - The Ohsaki cohort study

AU - Nagai, Masato

AU - Kuriyama, Shinichi

AU - Kakizaki, Masako

AU - Ohmori-Matsuda, Kaori

AU - Sugawara, Yumi

AU - Sone, Toshimasa

AU - Hozawa, Atsushi

AU - Tsuji, Ichiro

PY - 2010/11/3

Y1 - 2010/11/3

N2 - Background: To clarify the effect of age on the association between body mass index (BMI) and all-cause mortality. Methods: We followed 43 972 Japanese participants aged 40 to 79 years for 12 years. Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs), using the following BMI categories: <18.5 (underweight), 18.5-20.9, 21.0-22.9, 23.0-24.9 (reference), 25.0-27.4, 27.5-29.9, and ≥30.0 kg/m2 (obese). Analyses were stratified by age group: middle-aged (40-64 years) vs elderly (65-79 years). Results: We observed a significantly increased risk of mortality in underweight elderly men: the multivariate HR was 1.26 (0.92-1.73) in middle-aged men and 1.49 (1.26-1.76) in elderly men. In addition, we observed a significantly increased risk of mortality in obese middle-aged men: the multivariate HR was 1.71 (1.17-2.50) in middle-aged men and 1.25 (0.87-1.80) in elderly men. In women, there was an increased risk of mortality irrespective of age group in the underweight: the multivariate HR was 1.46 (0.96-2.22) in middle-aged women and 1.47 (1.19-1.82) in elderly women. There was no excess risk of mortality with age in obese women: the multivariate HR was 1.47 (0.94-2.27) in middle-aged women and 1.26 (0.95-1.68) in elderly women. Conclusions: As compared with the reference category, obesity was associated with a high mortality risk in middle-aged men, whereas underweight, rather than obesity, was associated with a high mortality risk in elderly men. In women, obesity was associated with a high mortality risk during middle age; underweight was associated with a high mortality risk irrespective of age. The mortality risk due to underweight and obesity may be related to sex and age.

AB - Background: To clarify the effect of age on the association between body mass index (BMI) and all-cause mortality. Methods: We followed 43 972 Japanese participants aged 40 to 79 years for 12 years. Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs), using the following BMI categories: <18.5 (underweight), 18.5-20.9, 21.0-22.9, 23.0-24.9 (reference), 25.0-27.4, 27.5-29.9, and ≥30.0 kg/m2 (obese). Analyses were stratified by age group: middle-aged (40-64 years) vs elderly (65-79 years). Results: We observed a significantly increased risk of mortality in underweight elderly men: the multivariate HR was 1.26 (0.92-1.73) in middle-aged men and 1.49 (1.26-1.76) in elderly men. In addition, we observed a significantly increased risk of mortality in obese middle-aged men: the multivariate HR was 1.71 (1.17-2.50) in middle-aged men and 1.25 (0.87-1.80) in elderly men. In women, there was an increased risk of mortality irrespective of age group in the underweight: the multivariate HR was 1.46 (0.96-2.22) in middle-aged women and 1.47 (1.19-1.82) in elderly women. There was no excess risk of mortality with age in obese women: the multivariate HR was 1.47 (0.94-2.27) in middle-aged women and 1.26 (0.95-1.68) in elderly women. Conclusions: As compared with the reference category, obesity was associated with a high mortality risk in middle-aged men, whereas underweight, rather than obesity, was associated with a high mortality risk in elderly men. In women, obesity was associated with a high mortality risk during middle age; underweight was associated with a high mortality risk irrespective of age. The mortality risk due to underweight and obesity may be related to sex and age.

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