title: Impact of midlife weight change on mortality and quality of life in old age. Prospective cohort study.
abstract: OBJECTIVE
  To examine the effects of weight change during midlife on long-term mortality risk and quality of life in old age.
  
  
  METHODS
  Prospective cohort study with a 26-y follow-up.
  
  
  METHODS
  Socioeconomically homogeneous sample of 1657 men (born 1919-1934) who had attended health checks during the 1960s, were healthy and professionally active in 1974, and could recall their weight at the age of 25 y.
  
  
  METHODS
  Total mortality 1974-2000, scales of the RAND-36 (SF-36) health survey in 91% (n=1147) of the survivors in 2000.
  
  
  RESULTS
  Body weight increased from 25 y of age until midlife, but not thereafter. During the 26-y follow-up, 392 men (23.7% of the initial 1974 cohort) died. Weight at 25 y of age did not predict death, but the adjusted mortality risk was significantly increased in the highest quartile of midlife weight gain (>/=15.0 kg) compared with lower quartiles (RR 1.39, 95% CI 1.12-1.73). In 2000, multivariate analyses (adjusted for body weight at the age of 25 y and in 2000, age, smoking, alcohol and subjective health and physical fitness in 1974) showed impairment in all eight RAND-36 scales (statistically significantly in seven) with increasing weight gain in midlife.
  
  
  CONCLUSIONS
  In this homogeneous male cohort, only the largest weight gain from 25 y of age to midlife predicted long-term mortality. Weight gain sensitively affected later health-related quality of life, and zero weight gain up to midlife was associated with the best quality of life in old age.
authors.affiliation: Department of Medicine, Geriatric Clinic, University of Helsinki, Helsinki, Finland. timo.strandberg@hus.fi
authors.forename: T E
authors.initials: TE
authors.lastname: Strandberg
authors.forename: A
authors.initials: A
authors.lastname: Strandberg
authors.forename: V V
authors.initials: VV
authors.lastname: Salomaa
authors.forename: K
authors.initials: K
authors.lastname: Pitkälä
authors.forename: T A
authors.initials: TA
authors.lastname: Miettinen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D009026:Mortality; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015430:Weight Gain / Q000502:physiology*