title: Body-composition predictors of mortality in women aged ≥ 75 y: data from a large population-based cohort study with a 17-y follow-up.
abstract: BACKGROUND
  The role of body composition as a risk factor for death remains controversial in older persons.
  
  
  OBJECTIVE
  We determined the role of body-composition variables in mortality in older women.
  
  
  METHODS
  Longitudinal analyses were performed in a prospective cohort study of older women. Participants were 4574 community-dwelling women aged ≥ 75 y at the baseline visit (between January 1992 and April 1994). Several body-composition variables were assessed by using anthropometric measures and dual-energy X-ray absorptiometry at the baseline visit. The main outcome was overall mortality. Body-composition variables were body mass index (BMI; in kg/m(2)), hip circumference, waist circumference, waist-to-hip ratio, fat mass/height(2), lean mass/height(2), percentage of fat mass, percentage of lean mass, and the lean mass:fat mass ratio.
  
  
  RESULTS
  The mean (± SD) age at baseline was 80.2 ± 3.8 y. During the 17.7 y (IQR: 17.2-18.1 y) of follow-up, 2876 women died. U-shaped in crude analyses and reversed J-shaped relations in adjusted analyses between BMI, hip and waist circumferences, fat mass/height(2), and risk of death were shown. Adjusted risk of death was significantly higher in participants with BMI ≤ 24.6 and fat mass/height(2) ≤ 8.2 kg/m(2). There was a negative linear association between fat mass (%) and risk of death: a 10% increase in fat mass was associated with a 12% reduction of mortality risk (adjusted HR: 0.88; 95% CI: 0.84, 0.92; P < 0.001). Linear and statistically significant relations were shown between lean mass/height(2) and risk of death in crude but not adjusted analyses.
  
  
  CONCLUSIONS
  Risk of mortality was consistently higher in older women with low adiposity. No lean mass indicator was associated with risk of death. Clinicians should be alerted by low adiposity in older women.
authors.affiliation: From the Gerontopôle, Toulouse University Hospital, Toulouse, France (YR and MC); the Institut national de la santé et de la recherche médicale (INSERM) Unité Mixte de Recherche 1027, University of Toulouse III, France (YR, AG, and MC); the Laboratory of Epidemiology and Community Health, Faculty of Medicine, Toulouse, France (CC, AG, and VL-C); the Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, University of Lyon, INSERM U1033, Lyon, France (A-MS); the Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University Montpellier 1, Montpellier, France (HB); and the Department of Neuroscience, Division of Geriatric Medicine, Unité Propre de Recherche et d'Enseignement Supérieur-Equipe d'Accueil 4638, Université Nantes Angers Le Mans, Angers University Hospital, Angers, France (OB).
authors.forename: Yves
authors.initials: Y
authors.lastname: Rolland
authors.affiliation: From the Gerontopôle, Toulouse University Hospital, Toulouse, France (YR and MC); the Institut national de la santé et de la recherche médicale (INSERM) Unité Mixte de Recherche 1027, University of Toulouse III, France (YR, AG, and MC); the Laboratory of Epidemiology and Community Health, Faculty of Medicine, Toulouse, France (CC, AG, and VL-C); the Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, University of Lyon, INSERM U1033, Lyon, France (A-MS); the Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University Montpellier 1, Montpellier, France (HB); and the Department of Neuroscience, Division of Geriatric Medicine, Unité Propre de Recherche et d'Enseignement Supérieur-Equipe d'Accueil 4638, Université Nantes Angers Le Mans, Angers University Hospital, Angers, France (OB).
authors.forename: Adeline
authors.initials: A
authors.lastname: Gallini
authors.affiliation: From the Gerontopôle, Toulouse University Hospital, Toulouse, France (YR and MC); the Institut national de la santé et de la recherche médicale (INSERM) Unité Mixte de Recherche 1027, University of Toulouse III, France (YR, AG, and MC); the Laboratory of Epidemiology and Community Health, Faculty of Medicine, Toulouse, France (CC, AG, and VL-C); the Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, University of Lyon, INSERM U1033, Lyon, France (A-MS); the Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University Montpellier 1, Montpellier, France (HB); and the Department of Neuroscience, Division of Geriatric Medicine, Unité Propre de Recherche et d'Enseignement Supérieur-Equipe d'Accueil 4638, Université Nantes Angers Le Mans, Angers University Hospital, Angers, France (OB).
authors.forename: Christelle
authors.initials: C
authors.lastname: Cristini
authors.affiliation: From the Gerontopôle, Toulouse University Hospital, Toulouse, France (YR and MC); the Institut national de la santé et de la recherche médicale (INSERM) Unité Mixte de Recherche 1027, University of Toulouse III, France (YR, AG, and MC); the Laboratory of Epidemiology and Community Health, Faculty of Medicine, Toulouse, France (CC, AG, and VL-C); the Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, University of Lyon, INSERM U1033, Lyon, France (A-MS); the Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University Montpellier 1, Montpellier, France (HB); and the Department of Neuroscience, Division of Geriatric Medicine, Unité Propre de Recherche et d'Enseignement Supérieur-Equipe d'Accueil 4638, Université Nantes Angers Le Mans, Angers University Hospital, Angers, France (OB).
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Schott
authors.affiliation: From the Gerontopôle, Toulouse University Hospital, Toulouse, France (YR and MC); the Institut national de la santé et de la recherche médicale (INSERM) Unité Mixte de Recherche 1027, University of Toulouse III, France (YR, AG, and MC); the Laboratory of Epidemiology and Community Health, Faculty of Medicine, Toulouse, France (CC, AG, and VL-C); the Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, University of Lyon, INSERM U1033, Lyon, France (A-MS); the Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University Montpellier 1, Montpellier, France (HB); and the Department of Neuroscience, Division of Geriatric Medicine, Unité Propre de Recherche et d'Enseignement Supérieur-Equipe d'Accueil 4638, Université Nantes Angers Le Mans, Angers University Hospital, Angers, France (OB).
authors.forename: Hubert
authors.initials: H
authors.lastname: Blain
authors.affiliation: From the Gerontopôle, Toulouse University Hospital, Toulouse, France (YR and MC); the Institut national de la santé et de la recherche médicale (INSERM) Unité Mixte de Recherche 1027, University of Toulouse III, France (YR, AG, and MC); the Laboratory of Epidemiology and Community Health, Faculty of Medicine, Toulouse, France (CC, AG, and VL-C); the Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, University of Lyon, INSERM U1033, Lyon, France (A-MS); the Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University Montpellier 1, Montpellier, France (HB); and the Department of Neuroscience, Division of Geriatric Medicine, Unité Propre de Recherche et d'Enseignement Supérieur-Equipe d'Accueil 4638, Université Nantes Angers Le Mans, Angers University Hospital, Angers, France (OB).
authors.forename: Olivier
authors.initials: O
authors.lastname: Beauchet
authors.affiliation: From the Gerontopôle, Toulouse University Hospital, Toulouse, France (YR and MC); the Institut national de la santé et de la recherche médicale (INSERM) Unité Mixte de Recherche 1027, University of Toulouse III, France (YR, AG, and MC); the Laboratory of Epidemiology and Community Health, Faculty of Medicine, Toulouse, France (CC, AG, and VL-C); the Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, University of Lyon, INSERM U1033, Lyon, France (A-MS); the Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University Montpellier 1, Montpellier, France (HB); and the Department of Neuroscience, Division of Geriatric Medicine, Unité Propre de Recherche et d'Enseignement Supérieur-Equipe d'Accueil 4638, Université Nantes Angers Le Mans, Angers University Hospital, Angers, France (OB).
authors.forename: Matteo
authors.initials: M
authors.lastname: Cesari
authors.affiliation: From the Gerontopôle, Toulouse University Hospital, Toulouse, France (YR and MC); the Institut national de la santé et de la recherche médicale (INSERM) Unité Mixte de Recherche 1027, University of Toulouse III, France (YR, AG, and MC); the Laboratory of Epidemiology and Community Health, Faculty of Medicine, Toulouse, France (CC, AG, and VL-C); the Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, University of Lyon, INSERM U1033, Lyon, France (A-MS); the Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University Montpellier 1, Montpellier, France (HB); and the Department of Neuroscience, Division of Geriatric Medicine, Unité Propre de Recherche et d'Enseignement Supérieur-Equipe d'Accueil 4638, Université Nantes Angers Le Mans, Angers University Hospital, Angers, France (OB).
authors.forename: Valérie
authors.initials: V
authors.lastname: Lauwers-Cances
mesh_terms: D015502:Absorptiometry, Photon; D000203:Activities of Daily Living; D000273:Adipose Tissue / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D009765:Obesity / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D055105:Waist Circumference