School of Medicine, Keio University, Tokyo, Japan.
Graduate School of Economics, Keio University, Tokyo, Japan.
Geriatr Gerontol Int. 2018 May;18(5):799-805. doi: 10.1111/ggi.13247. Epub 2018 Jan 22.
The present study aimed to clarify the association between body mass index (BMI) and the activities of daily living (ADL). Although BMI is likely to be concerned regarding the relationship with specific diseases or mortality, few studies have focused on the relationship of BMI and ADL.
A total of 3353 Japanese participants of a 22-year cohort study from 1990 to 2012 aged 45-74 years at baseline were divided into four groups according to their BMI levels: ≤18.5, 18.5-21.9 (reference), 22.0-24.9 and ≥25.0 kg/m . Outcomes were becoming dependent in ADL (including death after ADL decline) and death without observation of ADL decline as a competing risk. Sex-specific multinomial logistic regression analysis was carried out in 2017 to estimate the odds ratios (OR) after adjusting for age, smoking, alcohol drinking, hypertension, hypercholesterolemia, diabetes and serum albumin.
After multivariable adjustment, though the relationship between BMI and risk of ADL decline was U-shaped among women, only those with BMI ≥25.0 showed a higher risk for ADL decline (OR 1.39, 95% CI 1.01-1.92) compared with the reference. The OR for death without observation of ADL decline was significantly lower for men with BMI ≥25.0 (OR 0.70, 95% CI 0.50-0.98).
This study suggests being overweight is a good predictor of future decline in ADL for women, whereas men with BMI 22.0-24.9 had lower risks of ADL decline. Appropriate management of weight in older women could prevent disabilities. Geriatr Gerontol Int 2018; 18: 799-805.
本研究旨在阐明体重指数（BMI）与日常生活活动（ADL）之间的关系。虽然 BMI 可能与特定疾病或死亡率有关，但很少有研究关注 BMI 与 ADL 的关系。
本研究共纳入了 1990 年至 2012 年期间一项为期 22 年的队列研究中的 3353 名日本参与者，他们在基线时年龄为 45-74 岁，BMI 水平分为四组：≤18.5、18.5-21.9（参考组）、22.0-24.9 和≥25.0kg/m 。结局为 ADL 依赖（包括 ADL 下降后死亡）和 ADL 下降无观察到的死亡作为竞争风险。2017 年进行了男女特异性多项逻辑回归分析，以调整年龄、吸烟、饮酒、高血压、高胆固醇血症、糖尿病和血清白蛋白后估计比值比（OR）。
经过多变量调整后，尽管 BMI 与女性 ADL 下降风险之间呈 U 形关系，但只有 BMI≥25.0 的女性 ADL 下降风险较高（OR 1.39，95%CI 1.01-1.92）。与参考组相比，BMI≥25.0 的男性 ADL 下降无观察到死亡的 OR 显著降低（OR 0.70，95%CI 0.50-0.98）。
本研究表明，超重是女性未来 ADL 下降的良好预测指标，而 BMI 为 22.0-24.9 的男性 ADL 下降风险较低。对于老年女性，适当的体重管理可能预防残疾。老年医学与老年病学国际 2018；18：799-805。
