Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News
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Weight loss may be associated with increased mortality risk among seemingly healthy older adults, according to a recent study published in JAMA Network Open.
Researchers analyzed data from more than 16,000 participants that had previously been involved in the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial. Participants were from Australia and the United States and were aged 65 and older and did not have heart disease, dementia, or chronic illness.
However, the study and the analysis have numerous limitations. The researchers failed to differentiate between intended, purposeful weight loss through dietary restrictions and the possibility of malnutrition and unintended weight loss. They also did not account for changes in activity levels, diet, or if the participants developed a disease that preceded the weight loss.
The study found that out of 1,523 healthy older adult participants, 1,256 died over an average of 4.4 years of follow-up. Researchers found a correlation between weight loss and a reduction in waist circumference and an increase in mortality, particularly for older men.
The main finding of the study was that weight loss of more than 10% was associated with higher all-cause mortality in both men and women. However, among the men in the study, a loss of 5% to 10% of body weight and a loss of more than 10% of body weight were associated with a 33% and 289% increase in mortality, respectively. Men who had a stable weight over the course of the trial all-cause mortality was 8.4%.
Among women, a loss of 5% to 10% of body weight and a loss of more than 10% of body weight were associated with a 26% and 114% increase in mortality, respectively. When compared to women that also maintained a stable weight corresponding mortality rates were 5.5% and 12.6%.
The researchers assume that weight loss is related to an increase in all-cause mortality in both men and women and higher cancer mortality for women and higher noncancer or non-cardiovascular disease for men. The researchers acknowledge that body composition may explain the difference in mortality rates between men and women. The researchers call on physicians to monitor and investigate weight loss in older adult patients.
UNINTENDED WEIGHT LOSS
According to the American Family Physician, unintentional weight loss in people older than 65 years has been linked to increased morbidity and mortality. The majority of cases involving unintentional weight loss are not linked to cancer, which accounts for one-third of cases, and can be attributed to other factors such as medications, social isolation, financial constraints, and underlying disease processes. In 6 to 28% of cases, a cause is not able to be identified.
Unintended weight loss is often a sign of an underlying condition or disease process which would increase the risk of death. The research could be misinterpreted to suggest that weight loss, in any event, is linked to a shorter lifespan and is therefore less healthy overall. However, it lacks evidence to support that weight loss is a direct contributor to all-cause mortality and suggests that there is no evidence that weight gain has any impact on mortality.
Previous research shows that weight gain and obesity are responsible for certain cancers, heart disease, diabetes, high blood pressure, sleep apnea, and osteoarthritis. More than 30% of American adults and more than 20% of children and adolescents are considered obese. The World Health Organization (WHO) estimates that 2.8 million people die each year as a result of being overweight or obese.