Weight gain, loss may increase risk of all-cause, CVD mortality in older adults

Moderate-to-large weight gain and loss are both associated with an increased risk of all-cause and cardiovascular disease (CVD) mortality, with a slightly higher risk for weight loss than gain, according to a study involving middle-aged and elderly Chinese.

Data from the Singapore Chinese Health Study were used, including 36,338 participants aged 45–74 years at recruitment (1993–1998). Weight change was computed as the difference between weights at baseline and at the follow-up 1 (1999–2004) survey and was classified as moderate-to-large weight loss (≥10 percent), small weight loss (5.1–9.9 percent), stable weight (±5 percent), small weight gain (5.1–9.9 percent) and moderate-to-large weight gain (≥10 percent).

Participants were free of cancer and CVD at the follow-up 1 survey. They were followed for mortality through linkage with the Singapore Birth and Death Registry.

During a mean follow-up of 14.2 years (until 31 December 2016), 7,551 deaths occurred (517,128 person-years of follow-up). Participants with moderate-to-large weight loss (hazard ratio [HR], 1.39, 95 percent confidence interval [CI], 1.30–1.49), small loss (HR, 1.14, 95 percent CI, 1.06–1.22) and moderate-to-large gain (HR, 1.13, 95 percent CI, 1.05–1.22) had a significantly higher risk of all-cause mortality than those with stable weight.

Moderate-to-large weight loss significantly correlated with an increased risk of death from CVD (including both ischaemic heart disease and stroke) and respiratory disease. In addition, moderate-to-large weight gain significantly correlated with CVD mortality.

These associations persisted when analyses were stratified by age (<60 and ≥60 years old), sex, smoking status (never, former and current smoking) and baseline body mass index (<23 and ≥23 kg/m²), although significant effect modifications existed for certain strata.

“[I]t remains to be examined in clinical trials whether maintaining stable body weight should be proposed to reduce mortality risk in middle-aged and elderly populations,” the authors said.