02322nas a2200193 4500008004100000022001400041245008400055210006900139260001600208300000600224490000600230520176400236100001702000700002002017700002302037700001802060700001502078856003502093 2002 eng d a1468-670800aWeight-modification trials in older adults: what should the outcome measure be?0 aWeightmodification trials in older adults what should the outcom c2002 Jan 07 a10 v33 a

BACKGROUND: Overweight older adults are often counseled to lose weight, even though there is little evidence of excess mortality in that age group. Overweight and underweight may be more associated with health status than with mortality, but few clinical trials of any kind have been based on maximizing years of healthy life (YHL), as opposed to years of life (YOL). OBJECTIVE: This paper examines the relationship of body mass index (BMI) to both YHL and YOL. Results were used to determine whether clinical trials of weight-modification based on improving YHL would be more powerful than studies based on survival. DESIGN: We used data from a cohort of 4,878 non-smoking men and women aged 65-100 at baseline (mean age 73) and followed 7 years. We estimated mean YHL and YOL in four categories of BMI: underweight, normal, overweight, and obese. RESULTS: Subjects averaged 6.3 YOL and 4.6 YHL of a possible 7 years. Both measures were higher for women and whites. For men, none of the BMI groups was significantly different from the normal group on either YOL or YHL. For women, the obese had significantly lower YHL (but not YOL) than the normals, and the underweight had significantly lower YOL and YHL. The overweight group was not significantly different from the normal group on either measure. CONCLUSIONS: Clinical trials of weight loss interventions for obese older women would require fewer participants if YHL rather than YOL was the outcome measure. Interventions for obese men or for the merely overweight are not likely to achieve differences in either YOL or YHL. Evaluations of interventions for the underweight (which would presumably address the causes of their low weight) may be conducted efficiently using either outcome measure.

1 aDiehr, Paula1 aNewman, Anne, B1 aJackson, Sharon, A1 aKuller, Lewis1 aPowe, Neil uhttps://chs-nhlbi.org/node/68702836nas a2200397 4500008004100000022001400041245009000055210006900145260001300214300001000227490000700237520176100244653003102005653000902036653002202045653002002067653001602087653001102103653002902114653001102143653002002154653001502174653000902189653001402198653001702212653001602229653001802245653001802263100001702281700002202298700002502320700002002345700001802365700001902383856003602402 2008 eng d a1532-541500aWeight, mortality, years of healthy life, and active life expectancy in older adults.0 aWeight mortality years of healthy life and active life expectanc c2008 Jan a76-830 v563 a

OBJECTIVES: To determine whether weight categories predict subsequent mortality and morbidity in older adults.

DESIGN: Multistate life tables, using data from the Cardiovascular Health Study, a longitudinal population-based cohort of older adults.

SETTING: Data were provided by community-dwelling seniors in four U.S. counties: Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Allegheny County, Pennsylvania.

PARTICIPANTS: Five thousand eight hundred eighty-eight adults aged 65 and older at baseline.

MEASUREMENTS: The age- and sex-specific probabilities of transition from one health state to another and from one weight category to another were estimated. From these probabilities, future life expectancy, years of healthy life, active life expectancy, and the number of years spent in each weight and health category after age 65 were estimated.

RESULTS: Women who are healthy and of normal weight at age 65 have a life expectancy of 22.1 years. Of that, they spend, on average, 9.6 years as overweight or obese and 5.3 years in fair or poor health. For both men and women, being underweight at age 65 was associated with worse outcomes than being normal weight, whereas being overweight or obese was rarely associated with worse outcomes than being normal weight and was sometimes associated with significantly better outcomes.

CONCLUSION: Similar to middle-aged populations, older adults are likely to be or to become overweight or obese, but higher weight is not associated with worse health in this age group. Thus, the number of older adults at a "healthy" weight may be much higher than currently believed.

10aActivities of Daily Living10aAged10aAged, 80 and over10aBody Mass Index10aBody Weight10aFemale10aHealth Status Indicators10aHumans10aLife Expectancy10aLife Style10aMale10aPrognosis10aRisk Factors10aSex Factors10aSurvival Rate10aUnited States1 aDiehr, Paula1 aO'Meara, Ellen, S1 aFitzpatrick, Annette1 aNewman, Anne, B1 aKuller, Lewis1 aBurke, Gregory uhttps://chs-nhlbi.org/node/1000