Clinical Trial Summary | Gerontology & Healthy Aging

Associations of Change in Body Size With All-Cause and Cause-Specific Mortality Among Healthy Older Adults

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Published in JAMA Network Open on April 10, 2023, this study investigated the correlation between weight loss in a healthy older population and an increase in their all-cause mortality risk.

While weight loss's benefits for reducing risk have been well documented, very little research exists to determine whether weight loss, other than that associated with dread diseases such as cancer, was an indicator of future mortality risk.
 
Design, Setting and Measurements

 The cohort study analyzed data from 16,523 healthy participants who had participated in the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial and were recruited between March 1, 2010, and December 31, 2014. At the time of the ASPREE trial collation, the participants had no evidence of CVD, dementia, physical disability, or life-limiting chronic illness.
 
Of the 16, 523 participants:

• 16 792 were Australian, aged 79 years and older

• 2 411 were from the US, aged 65 years and older

• The mean age of the group was 75 years [SD 4.3] years, and 55.6% (9193) participants were women

Body weight and waist circumference (WC) were used as primary measurements. Changes were categorized as follows:

• Stable: within 5%

• Decrease by 5-10%

• Decrease by 10% or more.

• Increase by 5-10%

• Increase by 10% or more

The participant's data was measured at baseline and a second annual visit, and they were followed up for an average of 4.4 years.
 
The outcomes under consideration were all-cause mortality and cancer-specific, CVD-specific, and noncancer non-CVD–specific mortality
 
Findings

The findings of this study were significant. Of the 16 523 participants, 1256 died during the 4.4 years under review, most within 1.7 years of review.

In terms of risk, when compared to participants considered as stable ( 5% or less reduction in weight or waist circumference):
 

• Among male participants, a 5-10% weight loss was associated with a 33% higher risk of all-cause mortality, while a weight loss of over 10% correlated with a 289% increased risk.

• For women, a 5-10% weight loss was linked to a 26% higher risk of mortality, while a weight loss over 10% was associated with a 114% increased risk.

They further found that regardless of the individual's baseline weight, for example, those considered clinically obese, unanticipated weight loss was still related to increased mortality.

The researchers posit that the startling increase in mortality risk among men may be related to their different body compositions. Specifically, male body mass comprises muscle and bone compared to women, where body mass is more likely to have a higher fatty component. Furthermore, they note that weight loss in this age group is most frequently attributed to appetite loss and that it most often accompanies chronic illness.
 
Conclusion

The clinical implication of this cohort study's findings is that physicians should be aware of the significant association with mortality of even relatively minor weight loss (≥5%), especially among older men.

Access the original research investigation here

Hussain SM, Newman AB, Beilin LJ, et al. Associations of Change in Body Size With All-Cause and Cause-Specific Mortality Among Healthy Older Adults. JAMA Netw Open. 2023;6(4):e237482. doi:10.1001/jamanetworkopen.2023.7482 

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