Long-Term Weight Trajectory and Risk of Hip Fracture, Falls, Impaired Physical Function, and Death

For the Study of Osteoporotic Fractures Research Group

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: To determine the association between weight trajectory, health status, and mortality in older women. Design: Cohort study. Setting: Study of Osteoporotic Fractures. Participants: Older community-dwelling women (age: baseline (1986–88), mean 68, range 65–81; Year 20 (2006–08), mean 88, range 83–102 (N = 1,323)). Measurements: Body weight measured repeatedly over 20 years (mean 8 times). Logistic and Cox proportional hazard models were used to evaluate whether 20-year weight trajectory measures were associated with hip fracture, falls, physical performance, and mortality. Results: In models adjusted for age, clinic, calcium use, Year 20 weight, walking speed, comorbidity score, smoking, self-reported health, and walking for exercise, women with moderate weight loss (>9.0 kg) over 20 years had a 74% greater risk of death (hazard ratio (HR) = 1.74, 95% confidence interval (CI) = 1.37–2.20) in the 5 years after the Year 20 visit than those with no weight loss and more than twice the risk of hip fracture (HR = 2.56, 95% CI = 1.39–4.70). They were 3.6 times (odds ratio (OR) = 3.60, 95% CI = 1.86–6.95) as likely to have poor physical function at the Year 20 visit as women with no weight loss but no greater risk of 2 or more falls in the 1.5 years after the Year 20 visit. Weight variability and abrupt weight decline were not associated with adverse health oucomes (falls, fractures, mortality), but those in the highest quartile of variability were 2.3 times (OR = 2.26, 95% CI = 1.34–3.80) as likely to have poor physical function scores. Conclusion: In women surviving past 80 years of age, moderate weight loss over 20 years was associated with greater risk of hip fracture, poor physical function, and mortality but not of falls. Future work should separate voluntary from involuntary weight loss.

Original languageEnglish (US)
Pages (from-to)1972-1979
Number of pages8
JournalJournal of the American Geriatrics Society
Volume66
Issue number10
DOIs
StatePublished - Oct 2018

Fingerprint

Hip Fractures
Weight Loss
Weights and Measures
Confidence Intervals
Mortality
Odds Ratio
Independent Living
Osteoporotic Fractures
Health
Proportional Hazards Models
Health Status
Walking
Comorbidity
Cohort Studies
Smoking
Body Weight
Exercise
Calcium

Keywords

  • fracture
  • mortality
  • physical function
  • weight loss

Cite this

Long-Term Weight Trajectory and Risk of Hip Fracture, Falls, Impaired Physical Function, and Death. / For the Study of Osteoporotic Fractures Research Group.

In: Journal of the American Geriatrics Society, Vol. 66, No. 10, 10.2018, p. 1972-1979.

Research output: Contribution to journalArticle

For the Study of Osteoporotic Fractures Research Group. / Long-Term Weight Trajectory and Risk of Hip Fracture, Falls, Impaired Physical Function, and Death. In: Journal of the American Geriatrics Society. 2018 ; Vol. 66, No. 10. pp. 1972-1979.
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AU - Rizzo, Joanne H.

AU - Pedula, Kathryn L.

AU - Yaffe, Kristine

AU - Ensrud, Kristine E.

AU - Cauley, Jane A.

AU - Ensrud, Kristine E

AU - Cummings, Steven R.

AU - Hillier, Teresa A.

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AB - Objectives: To determine the association between weight trajectory, health status, and mortality in older women. Design: Cohort study. Setting: Study of Osteoporotic Fractures. Participants: Older community-dwelling women (age: baseline (1986–88), mean 68, range 65–81; Year 20 (2006–08), mean 88, range 83–102 (N = 1,323)). Measurements: Body weight measured repeatedly over 20 years (mean 8 times). Logistic and Cox proportional hazard models were used to evaluate whether 20-year weight trajectory measures were associated with hip fracture, falls, physical performance, and mortality. Results: In models adjusted for age, clinic, calcium use, Year 20 weight, walking speed, comorbidity score, smoking, self-reported health, and walking for exercise, women with moderate weight loss (>9.0 kg) over 20 years had a 74% greater risk of death (hazard ratio (HR) = 1.74, 95% confidence interval (CI) = 1.37–2.20) in the 5 years after the Year 20 visit than those with no weight loss and more than twice the risk of hip fracture (HR = 2.56, 95% CI = 1.39–4.70). They were 3.6 times (odds ratio (OR) = 3.60, 95% CI = 1.86–6.95) as likely to have poor physical function at the Year 20 visit as women with no weight loss but no greater risk of 2 or more falls in the 1.5 years after the Year 20 visit. Weight variability and abrupt weight decline were not associated with adverse health oucomes (falls, fractures, mortality), but those in the highest quartile of variability were 2.3 times (OR = 2.26, 95% CI = 1.34–3.80) as likely to have poor physical function scores. Conclusion: In women surviving past 80 years of age, moderate weight loss over 20 years was associated with greater risk of hip fracture, poor physical function, and mortality but not of falls. Future work should separate voluntary from involuntary weight loss.

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