title: Body mass index and nine-year mortality in disabled and nondisabled older U.S. individuals.
abstract: OBJECTIVE
  To investigate the relationship between body mass index (BMI) and 9-year mortality in older (> or = 65) Americans with and without disability.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  The unique disability-focused National Long Term Care Survey (NLTCS) data that assessed the health and well-being of older individuals in 1994 were analyzed.
  
  
  METHODS
  Four thousand seven hundred ninety-one individuals in the 1994 survey.
  
  
  METHODS
  BMI (kg/m2) was calculated from self- or proxy reports of height and weight. The analysis was adjusted for 1-year change in BMI and demographic and health-related factors, as well as reports by proxies, and death occurring during the first 2 years after the interview.
  
  
  RESULTS
  The relative risk of death as a function of BMI formed a nonsymmetric U-shaped pattern, with larger risks associated with lower BMI (< 22.0) and minimal risks for BMI of 25.0 to 34.9. (BMI 22.0-24.9 was the reference.) Adjustments for demographic and health-related factors had little effect on this pattern. Nondisabled individuals exhibited a similar U-shaped pattern but with lower risks associated with lower BMI. For disabled individuals, the mortality-risk pattern was higher for lower BMI (< 22.0) and flat for higher BMI, thus exhibiting an inverse J shape. BMI patterns were age sensitive, with disability status affecting sensitivity.
  
  
  CONCLUSIONS
  Overweight or mild (grade 1) obesity was not a risk factor for 9-year mortality in older Americans participating in the 1994 NLTCS. A flatter BMI pattern of the relative risk of death for disabled than for nondisabled individuals suggests that optimal body weight can be sensitive to age and health and well-being.
authors.affiliation: Department of Sociology, Center for Population Health and Aging, Population Research Institute, Duke University, Durham, North Carolina 27708, USA. Alexander.Kulminski@duke.edu
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Kulminski
authors.forename: Konstantin G
authors.initials: KG
authors.lastname: Arbeev
authors.forename: Irina V
authors.initials: IV
authors.lastname: Kulminskaya
authors.forename: Svetlana V
authors.initials: SV
authors.lastname: Ukraintseva
authors.forename: Kenneth
authors.initials: K
authors.lastname: Land
authors.forename: Igor
authors.initials: I
authors.lastname: Akushevich
authors.forename: Anatoli I
authors.initials: AI
authors.lastname: Yashin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002423:Cause of Death / Q000639:trends*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009765:Obesity / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014481:United States / Q000453:epidemiology