中年及老年成年人10年间体重指数变化的预测因素：与性别、心血管疾病风险状况、抑郁症状及社会支持的关联
Predictors of change in BMI over 10 years among midlife and older adults: Associations with gender, CVD risk status, depressive symptoms, and social support.
作者信息
Arigo Danielle, Ainsworth M Cole, Pasko Kristen, Brown Megan M, Travers Laura
机构信息
Department of Psychology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA; Department of Family Medicine, Rowan School of Osteopathic Medicine, One Medical Center Drive, Stratford, NJ, 08084, USA.
Department of Psychology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA.
出版信息
Soc Sci Med. 2021 Jun;279:113995. doi: 10.1016/j.socscimed.2021.113995. Epub 2021 May 6.
RATIONALE
Change in BMI is recognized as a key health indicator among midlife and older adults, though predictors of BMI change in this group have received little attention.
OBJECTIVE
The aim of this study was to examine relations between hypothesized predictors (i.e., gender, cardiovascular disease [CVD] risk status, depressive symptoms, social support) and BMI change over 10 years, among midlife and older adults.
METHODS
Participants were adults ages 50-74 at baseline (N = 5,688, 64% women) who completed four assessments over 10 years. Gender, CVD risk status (i.e., diagnosis of hypertension, type 2 diabetes, or both), depressive symptoms, and perceived social support were assessed at baseline, and BMI was calculated from height and weight reports at all assessments. Multilevel models tested for concurrent and prospective relations between predictors and BMI change (effect size estimates as semipartial correlation coefficients, sr), as well as whether observed relations were further moderated by baseline BMI category (underweight, healthy weight, overweight, or obese).
RESULTS
Baseline BMI was higher among those with (vs. without) CVD risk, higher (vs. lower) depressive symptoms, and lower (vs. higher) social support; all of these relations were moderated by gender (ps < 0.05, srs 0.03-0.32). Moreover, BMI showed significant change over 10 years, and BMI variability during this time was higher among women (vs. men) and those with (vs. without) CVD risk (ps < 0.0001). BMI change also differed by CVD risk status, and this relation was moderated by gender, baseline depressive symptoms, and baseline BMI category (ps < 0.05, srs 0.03-0.08).
CONCLUSIONS
Although the predictors of interest were not associated with steady BMI decreases (which are associated with long term health risks for older adults), findings reveal unique patterns of change in BMI among subgroups of midlife and older adults, and may allow for early identification of those with noteworthy BMI changes after age 50.
理论依据
体重指数（BMI）的变化被认为是中年及老年人群的一项关键健康指标，不过该群体中BMI变化的预测因素却很少受到关注。
目的
本研究旨在探讨中年及老年人群中假设的预测因素（即性别、心血管疾病[CVD]风险状况、抑郁症状、社会支持）与10年间BMI变化之间的关系。
方法
参与者为基线时年龄在50 - 74岁的成年人（N = 5688，64%为女性），他们在10年间完成了四项评估。在基线时评估性别、CVD风险状况（即高血压、2型糖尿病或两者的诊断）、抑郁症状和感知到的社会支持，并根据所有评估中的身高和体重报告计算BMI。多水平模型检验了预测因素与BMI变化之间的同时性和前瞻性关系（效应大小估计为半偏相关系数，sr），以及观察到的关系是否会因基线BMI类别（体重过轻、健康体重、超重或肥胖）而进一步受到调节。
结果
有（vs. 无）CVD风险、抑郁症状较高（vs. 较低）以及社会支持较低（vs. 较高）的人群，其基线BMI更高；所有这些关系均受到性别的调节（p值 < 0.05，sr为0.03 - 0.32）。此外，BMI在10年间有显著变化，在此期间，女性（vs. 男性）以及有（vs. 无）CVD风险的人群的BMI变异性更高（p值 < 0.0001）。BMI变化也因CVD风险状况而异，并且这种关系受到性别、基线抑郁症状和基线BMI类别的调节（p值 < 0.05，sr为0.03 - 0.08）。
结论
尽管所关注的预测因素与BMI的持续下降无关（BMI持续下降与老年人的长期健康风险相关），但研究结果揭示了中年及老年人群亚组中BMI变化的独特模式，并可能有助于早期识别50岁以后BMI有显著变化的人群。
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