title: Body mass index as a predictor of all-cause mortality in nursing home residents during a 5-year follow-up.
abstract: BACKGROUND
  Body mass index (BMI) is considered a short-term mortality predictor, but a consensus has not been reached on its role and that of other nutritional parameters in predicting long-term mortality in nursing home residents.
  
  
  OBJECTIVE
  To correlate BMI, Mini Nutritional Assessment scores, and serum albumin levels with the 5-year mortality rate in institutionalized elderly subjects.
  
  
  METHODS
  A total of 181 nursing home residents aged ≥ 70 years were included in a 5-year longitudinal study. Data were collected on all participants' nutritional, health, cognitive, and functional status by means of a comprehensive geriatric assessment. Data on the participants' vital status were obtained 5 years after beginning the study, and a survival analysis was conducted using Kaplan-Meier curves and multivariate Cox proportional hazards models.
  
  
  RESULTS
  The 5-year mortality rate was 63%. The deceased subjects (n = 115) had a lower BMI (24.7 ± 4.6 vs 26.6 ± 5.0 kg/m(2); P = .03) and Mini Nutritional Assessment score (18.6 ± 3.7 vs 20.1 ± 3.6; P = .02) than those still alive. Serum albumin levels did not differ between the two groups. Among the three indicators of nutritional status considered in this study, only BMI ≥ 30 kg/m(2) was significantly associated with a lower mortality risk at 5 years (hazard ratio = 0.432; 95% CI 0.20-0.70; P = .04), the risk for death being greater the lower the BMI class (log-rank test: P < .001).
  
  
  CONCLUSIONS
  Our findings suggest that BMI is the best of the three parameters considered as a nutritional predictor of nursing home residents' mortality in the longer term, and indicate that a lower mortality risk coincides with a higher BMI.
authors.affiliation: Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy. ilmannato@gmail.com
authors.forename: Nicola
authors.initials: N
authors.lastname: Veronese
authors.forename: Marina
authors.initials: M
authors.lastname: De Rui
authors.forename: Elena Debora
authors.initials: ED
authors.lastname: Toffanello
authors.forename: Irene
authors.initials: I
authors.lastname: De Ronch
authors.forename: Egle
authors.initials: E
authors.lastname: Perissinotto
authors.forename: Francesco
authors.initials: F
authors.lastname: Bolzetta
authors.forename: Barbara
authors.initials: B
authors.lastname: D'Avanzo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Cardin
authors.forename: Alessandra
authors.initials: A
authors.lastname: Coin
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sergi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012720:Severity of Illness Index