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 journalArticlepeer-review

4 Scopus citations

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

Bibliographical note

Funding Information:
We thank Cassie Angus of the Kaiser Permanente Center for Health Research for help with manuscript preparation. We thank Katherine K. Essick of the Kaiser Permanente Center for Health Research for editorial assistance. Conflict of Interest: ESL's institution has received grant funding from Merck, Inc., Amgen, Astrazeneka, and Bristol Meyer Squibb for unrelated projects on which she was principal investigator or co-investigator. Author Contributions: All authors: study concept and design, acquisition of subjects and data, analysis and interpretation of data, preparation of manuscript. Sponsor's Role: The sponsor had no role in the design, methods, subject recruitment, data collections, analysis, or preparation of paper. Funding Source: This work was supported by the National Institutes of Health. The National Institute on Aging provides support under the following grant numbers: R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, and R01 AG027576.

Funding Information:
Conflict of Interest: ESL’s institution has received grant funding from Merck, Inc., Amgen, Astrazeneka, and Bristol Meyer Squibb for unrelated projects on which she was principal investigator or co-investigator.

Funding Information:
Funding Source: This work was supported by the National Institutes of Health. The National Institute on Aging provides support under the following grant numbers: R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, and R01 AG027576.

Publisher Copyright:
© 2018, Copyright the Author Journal compilation © 2018, The American Geriatrics Society

Keywords

  • fracture
  • mortality
  • physical function
  • weight loss

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