title: Mortality risk in older men associated with changes in weight, lean mass, and fat mass.
abstract: OBJECTIVE
  To evaluate risk of all-cause mortality associated with changes in body weight, total lean mass, and total fat mass in older men.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Six U.S. clinical centers.
  
  
  METHODS
  Four thousand three hundred thirty-one ambulatory men aged 65 to 93 at baseline.
  
  
  METHODS
  Repeated measurements of body weight and total lean and fat mass were taken using dual-energy X-ray absorptiometry 4.6 ± 0.4 years apart. Percentage changes in these measures were categorized as gain (+5%), loss (-5%), or stable (-5% to +5%). Deaths were verified centrally according to death certificate reviews, and proportional hazard models were used to estimate the risk of mortality.
  
  
  RESULTS
  After accounting for baseline lifestyle factors and medical conditions, a higher risk of mortality was found for men with weight loss (hazard rat (HR)=1.84, 95% confidence interval (CI)=1.50-2.26), total lean mass loss (HR=1.78, 95% CI=1.45-2.19), and total fat mass loss (HR=1.72, 95% CI=1.34-2.20) than for men who were stable for each body composition measure. Men with total fat mass gain had a slightly greater mortality risk (HR=1.29, 95% CI=0.99-1.67) than those who remained stable. These associations did not differ according to baseline age, obesity, or self-reported health status (P for interactions >.10), although self-reported weight loss intent altered mortality risks with total fat mass (P for interaction=.04) and total lean mass (P for interaction=.09) change.
  
  
  CONCLUSIONS
  Older men who lost weight, total lean mass, or total fat mass had a higher risk of mortality than men who remained stable.
authors.affiliation: Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA. leechr@ohsu.edu
authors.forename: Christine G
authors.initials: CG
authors.lastname: Lee
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: Carrie M
authors.initials: CM
authors.lastname: Nielson
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Stefanick
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Hoffman
authors.forename: Thuy-Tien L
authors.initials: TT
authors.lastname: Dam
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Lapidus
authors.forename: Peggy Mannen
authors.initials: PM
authors.lastname: Cawthon
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
authors.forename: Eric S
authors.initials: ES
authors.lastname: Orwoll
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001835:Body Weight; D002423:Cause of Death / Q000639:trends; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D050177:Overweight / Q000150:complications / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D015430:Weight Gain; D015431:Weight Loss