title: Normal body mass index rather than obesity predicts greater mortality in elderly people: the Jerusalem longitudinal study.
abstract: OBJECTIVE
  To examine the association between body mass index (BMI) and mortality in older people.
  
  
  METHODS
  A longitudinal cohort study of an age-homogenous, representative sample born in 1920/21.
  
  
  METHODS
  Community-based home assessments.
  
  
  METHODS
  West Jerusalem residents born in 1920/21 examined at baseline in 1990 (n=447), with additional recruitment waves in 1998 (n=870) and 2005 (n=1,086).
  
  
  METHODS
  Comprehensive assessment of health variables including BMI (m/kg(2)) at ages 70, 78, and 85. The primary outcome of mortality was collected from age 70 to 88 (1990-2008). Adjusted Cox proportional hazards analysis was used to calculate hazard ratios (HRs) for mortality according to unit increase in BMI.
  
  
  RESULTS
  A unit increase in BMI in women resulted in HRs of 0.94, (95% confidence interval (CI)=0.89-0.99) at age 70, 0.95 (95% CI=0.91-0.98) at age 78, and 0.91 (95% CI=0.86-0.98) at age 85. Similarly, in men, HRs were 0.99 (95% CI=0.95-1.05) at age 70, 0.94 (95% CI=0.91-0.98) at age 78, and 0.91 (95% CI=0.86-0.98) at age 85. A time-dependent analysis of 450 subjects followed for 18 years confirmed the above findings; a unit increase in BMI resulted in HRs of 0.93 (95% CI=0.87-0.99) in women and 0.93(95% CI=0.88-0.98) in men. Eliminating the first third of follow-up mortality to account for possibility of reverse causality did not change the results.
  
  
  CONCLUSIONS
  Higher BMI was associated with lower mortality from age 70 to 88.
authors.affiliation: Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center, Mount-Scopus, Jerusalem, Israel.
authors.forename: Jochanan
authors.initials: J
authors.lastname: Stessman
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Jacobs
authors.forename: Eliana
authors.initials: E
authors.lastname: Ein-Mor
authors.forename: Michael
authors.initials: M
authors.lastname: Bursztyn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality / Q000639:trends; D009765:Obesity / Q000401:mortality*; D012016:Reference Values