title: Body mass index, poor diet quality, and health-related quality of life are associated with mortality in rural older adults.
abstract: In an aging population, potentially modifiable factors impacting mortality such as diet quality, body mass index (BMI), and health-related quality of life (HRQOL) are of interest. Surviving members of the Geisinger Rural Aging Study (GRAS) (n = 5,993; aged ?74 years) were contacted in the fall of 2009. Participants in the present study were the 2,995 (1,267 male, 1,728 female; mean age 81.4 ± 4.4 years) who completed dietary and demographic questionnaires and were enrolled in the Geisinger Health Plan over follow-up (mean = 3.1 years). Cox proportional hazards multivariate regression models were used to examine the associations between all-cause mortality and BMI, diet quality, and HRQOL. Compared to GRAS participants with BMIs in the normal range, a BMI < 18.5 was associated with increased mortality (HR 1.85 95%CI 1.09, 3.14, P = 0.02), while a BMI of 25-29.9 was associated with decreased risk of mortality (HR 0.71 95%CI 0.55, 0.91, P =0.007). Poor diet quality increased risk for mortality (HR 1.53 95%CI 1.06, 2.22, P = 0.02). Finally, favorable health-related quality of life was inversely associated with mortality (HR 0.09 95%CI 0.06, 0.13, P < 0.0001). Higher diet quality and HALex scores, and overweight status, were associated with reduced all-cause mortality in a cohort of advanced age. While underweight (BMI < 18.5) increased risk of all-cause mortality, no association was found between obesity and all-cause mortality in this aged cohort.
authors.affiliation: a Department of Nutritional Sciences , The Pennsylvania State University , University Park , Pennsylvania , USA.
authors.forename: Dara W
authors.initials: DW
authors.lastname: Ford
authors.forename: Terryl J
authors.initials: TJ
authors.lastname: Hartman
authors.forename: Christopher
authors.initials: C
authors.lastname: Still
authors.forename: Craig
authors.initials: C
authors.lastname: Wood
authors.forename: Diane C
authors.initials: DC
authors.lastname: Mitchell
authors.forename: Pennifer
authors.initials: P
authors.lastname: Erickson
authors.forename: Regan
authors.initials: R
authors.lastname: Bailey
authors.forename: Helen
authors.initials: H
authors.lastname: Smiciklas-Wright
authors.forename: Donna L
authors.initials: DL
authors.lastname: Coffman
authors.forename: Gordon L
authors.initials: GL
authors.lastname: Jensen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015992:Body Mass Index; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects*; D005260:Female; D006279:Health Maintenance Organizations; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D006278:Medicare; D009026:Mortality; D009765:Obesity / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D050177:Overweight / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D010414:Pennsylvania / Q000453:epidemiology; D016016:Proportional Hazards Models; D011788:Quality of Life; D012423:Rural Health; D013851:Thinness / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D014481:United States