title: Body mass index and mortality in elderly men and women from general population. The experience of Cardiovascular Study in the Elderly (CASTEL).
abstract: BACKGROUND
  The role of body mass index (BMI) as a factor influencing longevity of the elderly subject is still under debate.
  
  
  OBJECTIVE
  To evaluate at a population level whether or not BMI is a risk factor of mortality in the elderly, highlighting possible gender-related differences.
  
  
  METHODS
  3,282 Subjects aged 65-95 years, were recruited from an Italian general population and 12-year events were recorded. Blood tests and anthropometric measurements were performed. BMI as a continuous item was divided into quintiles and, for each quintile, adjusted hazard ratio (HR) with 95% confidence intervals for mortality was derived by classes of age and gender from Cox analysis.
  
  
  RESULTS
  BMI inversely predicted overall and cancer mortality in men only. Overall mortality rate was 64.7% (HR = 1.63 [1.23-2.71]) in the 1st quintile of BMI, 54.9% (1.21 [0.92-1.73]) in the 2nd, 54.1% (1.20 [0.85-1.67]) in the 3rd, 53.3% (1.04 [0.82-1.32]) in the 4th and 52.5% in the 5th; cancer mortality rate was 23.1% (HR = 2.35 [1.31-4.23]), 14.2% (HR = 1.19 [0.65-1.80]), 15.8% (HR = 1.49 [0.93-2.39]), 15.8% (HR = 1.36 [0.84-2.16]) and 13.4%, respectively. The relationship between BMI and mortality remained significant only in men aged 76 years or less. No relationship was found between BMI and coronary or cerebrovascular mortality.
  
  
  CONCLUSIONS
  BMI <22.7 kg/m2 does not improve survival in the elderly, while it is an independent predictor of cancer mortality in men aged <or=76 years. No prediction based on BMI is possible in women.
authors.affiliation: Department of Internal Medicine, General Hospital of Rovigo, Rovigo, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Mazza
authors.forename: Sergio
authors.initials: S
authors.lastname: Zamboni
authors.forename: Valérie
authors.initials: V
authors.lastname: Tikhonoff
authors.forename: Laura
authors.initials: L
authors.lastname: Schiavon
authors.forename: Achille C
authors.initials: AC
authors.lastname: Pessina
authors.forename: Edoardo
authors.initials: E
authors.lastname: Casiglia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008136:Longevity / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D009369:Neoplasms / Q000401:mortality; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors