title: Undernutrition as a major risk factor for death among older Brazilian adults in the community-dwelling setting: SABE survey.
abstract: OBJECTIVE
  To investigate the independent association between undernutrition and death in older adults in a community-dwelling setting.
  
  
  METHODS
  This retrospective study was based on the Health, Well-being and Ageing survey conducted in 2000 that included 1170 older adults (≥60 y) from São Paulo, Brazil. Death occurrences were considered through March, 2007. The variables analyzed were undernutrition (Mini-Nutritional Assessment), gender, income, muscle strength, hip fracture, smoking habits, cancer, depression, diabetes, coronary heart disease, chronic lung disease, cerebral vascular disease, and hypertension. A hierarchical multivariate analysis by logistic regression was performed according to age groups (60-74 and ≥75 y).
  
  
  RESULTS
  Undernutrition frequency was higher in adults ≥75 y old (2.6% versus 2.4%). The frequency of death in undernourished subjects was higher in the 60- to 74-y-old group (7.6%) than in those ≥75 y old (3.9%). Undernutrition was the strongest independent risk factor for death (P < 0.05) in the 60- to 74-y-old group (odds ratio 6.05, 95% confidence interval 5.76-6.35) and in the ≥75-y-old group (odds ratio 2.76, 95% confidence interval 2.51-3.04). All other variables were also associated with death, except for hip fracture and cerebral vascular disease, in the two age groups and hypertension in the 60- to 74-y-old group; however, the effect of these variables was less.
  
  
  CONCLUSIONS
  Undernutrition represented the strongest risk factor for death in Brazilian community-dwelling older adults 60 to 74 y old and showed a stronger association than for adults ≥75 y old.
authors: Department of Nutrition, University of Taubaté, Taubaté, São Paulo, Brazil. lucianasf@usp.br
authors: Luciana Silva
authors: LS
authors: Ferreira
authors: Teresa Freitas
authors: TF
authors: do Amaral
authors: Maria de Fátima Nunes
authors: Mde F
authors: Marucci
authors: Luiz Fernando Costa
authors: LF
authors: Nascimento
authors: Maria Lúcia
authors: ML
authors: Lebrão
authors: Yeda Aparecida de Oliveira
authors: YA
authors: Duarte
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D016001:Confidence Intervals; D003327:Coronary Disease / Q000401:mortality; D003863:Depression / Q000401:mortality; D003920:Diabetes Mellitus / Q000401:mortality; D005260:Female; D006306:Health Surveys; D006798:Housing; D006801:Humans; D006973:Hypertension / Q000401:mortality; D007182:Income; D008171:Lung Diseases / Q000401:mortality; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000401:mortality; D008875:Middle Aged; D053580:Muscle Strength; D009369:Neoplasms / Q000401:mortality; D016017:Odds Ratio; D012111:Residence Characteristics; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking