title: Unintentional weight loss predicts decline in activities of daily living function and life-space mobility over 4 years among community-dwelling older adults.
abstract: BACKGROUND
  The relationship between body mass index (BMI), weight loss, and changes in activities of daily living (ADL) function and mobility in older adults is not clear. We sought to study the relationship between BMI and weight loss on the rate of decline in ADL function and life-space mobility over a 4-year period among older African Americans and whites.
  
  
  METHODS
  The participants were 983 enrollees in the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal study of mobility among community-dwelling older adults stratified to achieve a balanced sample in terms of sex, race, and residence. Primary outcome measures were changes in ADL function and mobility assessed by the UAB Study of Aging Life-Space Assessment (LSA) which were measured every 6 months.
  
  
  RESULTS
  Relative to normal weight participants, those with BMI levels in the obese range did not show more rapid ADL functional decline, but a history of unintentional weight loss predicted more rapid decline. Relative to normal-weight participants, other BMI categories were not associated with more rapid decline in LSA scores. However, unintentional weight loss predicted more rapid declines in LSA. Intentional weight loss had no relation to ADL function or LSA decline.
  
  
  CONCLUSIONS
  In this population of community-dwelling older African Americans and whites, neither BMI nor intentional weight loss had an association with rate of functional decline. Unintentional weight loss had a negative relation with rate of functional decline, regardless of baseline BMI. Whether this is causal remains to be determined.
authors.affiliation: Department of Medicine (Division of Gerontology, Geriatrics, and Palliative Care), University of Alabama at Birmingham, Birmingham, AL, USA. critchie@uab.edu
authors.forename: Christine S
authors.initials: CS
authors.lastname: Ritchie
authors.forename: Julie L
authors.initials: JL
authors.lastname: Locher
authors.forename: David L
authors.initials: DL
authors.lastname: Roth
authors.forename: Theresa
authors.initials: T
authors.lastname: McVie
authors.forename: Patricia
authors.initials: P
authors.lastname: Sawyer
authors.forename: Richard
authors.initials: R
authors.lastname: Allman
mesh_terms: D000203:Activities of Daily Living; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008124:Locomotion; D008297:Male; D051346:Mobility Limitation; D011237:Predictive Value of Tests; D015431:Weight Loss; D044465:White People