title: Survival in elderly men in relation to midlife and current BMI.
abstract: BACKGROUND
  the relationship between BMI and mortality is U-shaped in the elderly but may be modified by midlife BMI and change in weight.
  
  
  OBJECTIVE
  to elucidate mortality prediction by BMI trajectory in older men.
  
  
  METHODS
  the Oslo cohort of men born in 1923-32 were screened for BMI and cardiovascular risk in 1972-73. Survivors were rescreened at ages of 68-77 years, and all-cause mortality was followed from 2000 to 2011.
  
  
  METHODS
  we calculated Cox regression proportional hazards for 11-year mortality rates in relation to BMI change among 5,240 men with no reported disease in 1972-73 and complete data. Models were adjusted for demographics, medications and disease. Men with BMI < 25 kg/m(2) in midlife (1972-73) and in 2000 were the reference group.
  
  
  RESULTS
  men whose BMI changed from <25 kg/m(2) in midlife to 25-29.9 kg/m(2) in 2000 carried the lowest mortality risk (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.75-0.94). Men with BMI ≥ 30 kg/m(2) in midlife were at highest risk (HR 1.79; 95% CI 1.12-2.88 if reclassified to 25-29.9 kg/m(2) in 2000 and HR 1.39; 95% CI 1.05-1.85 if BMI remained ≥30 kg/m(2) in 2000). Men with BMI 25-29.9 kg/m(2) in midlife that reclassified to <25 kg/m(2) in 2000 had increased risk. Findings were similar when percentage change in BMI was the outcome.
  
  
  CONCLUSIONS
  survival in older men with normal weight at midlife was associated with BMI gain after midlife while midlife obesity increased risk regardless of subsequent change.
authors.affiliation: Oslo Center of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital Ullevål, Building 2, Kirkevn 166, Oslo, Norway Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.
authors.forename: Ingar
authors.initials: I
authors.lastname: Holme
authors.affiliation: Department of Preventive Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.
authors.forename: Serena
authors.initials: S
authors.lastname: Tonstad
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009664:Norway / Q000453:epidemiology; D009765:Obesity / Q000401:mortality; D050177:Overweight / Q000401:mortality; D016016:Proportional Hazards Models
keywords: BMI; ageing; mortality; older people