title: Relationship of BMI, waist circumference, and weight change with use of health services by older adults.
abstract: OBJECTIVE
  To examine the relationship of BMI, waist circumference (WC), and weight change with use of health care services by older adults.
  
  
  METHODS
  This was a prospective cohort study conducted from 2001 to 2003 among 2919 persons representative of the non-institutionalized Spanish population > or =60 years of age. Analyses were performed using logistic regression, with adjustment for age, educational level, size of place of residence, tobacco use, alcohol consumption, and presence of chronic disease.
  
  
  RESULTS
  Obesity (BMI > or = 30 kg/m(2)) and abdominal obesity (WC >102 cm in men and >88 cm in women) in 2001 were associated with greater use of certain health care services among men and women in the period 2001-2003. Compared with women with WC < or = 88 cm, women with abdominal obesity were more likely to visit primary care physicians [odds ratio (OR): 1.36; 95% confidence limit (CL): 1.06-1.73] and receive influenza vaccination (OR: 1.30; 95% CL: 1.03-1.63). Weight gain was not associated with greater health service use by either sex, regardless of baseline BMI. Weight loss was associated with greater health service use by obese and non-obese subjects of both sexes. In comparison with those who reported no important weight change, non-obese women who lost weight were more likely to visit hospital specialists (OR: 1.45; 95% CL: 1.02-2.06), receive home medical visits (OR: 1.61; 95% CL: 1.06-2.45), be hospitalized (OR: 1.88; 95% CL: 1.29-2.74), and have more than one hospital admission (OR: 2.31; 95% CL: 1.19-4.47).
  
  
  CONCLUSIONS
  Obesity and weight loss are associated with greater health service use among the elderly.
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, 28029 Madrid, Spain.
authors.forename: Luz M
authors.initials: LM
authors.lastname: León-Muñoz
authors.forename: Pilar
authors.initials: P
authors.lastname: Guallar-Castillón
authors.forename: Esther
authors.initials: E
authors.lastname: López García
authors.forename: José R
authors.initials: JR
authors.lastname: Banegas
authors.forename: Juan L
authors.initials: JL
authors.lastname: Gutiérrez-Fisac
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity; D011446:Prospective Studies; D013030:Spain; D011795:Surveys and Questionnaires; D049629:Waist-Hip Ratio; D015431:Weight Loss