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April 18, 2023
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Weight loss in older healthy adults associated with increased mortality risk

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Key takeaways:

  • As little as 5% of weight loss was linked to an increased risk for all-cause mortality in men and women.
  • Experts recommend physicians regularly watch patients’ weight changes for early risks.
Perspective from Danine Fruge, MD, ABFP

Weight loss of 5% or greater was associated with an increased risk for all-cause mortality among older healthy adults, particularly men, highlighting the importance of monitoring these patients for weight changes, according to researchers.

“As people get older, their weight may change, but it's not clear how much this matters for their health,” Sultana Monira Hussain, PhD, a senior research fellow at Monash University in Australia, told Healio. “Previous studies often involve people who already have health problems. We wanted to study this issue in a group of older adults who were generally healthy.”

PC0423Hussain_Graphic_01_WEB
Data derived from: Hussain S, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2023.7482

To analyze associations between changes in body weight and waist circumference (WC) with mortality, the researchers conducted a post hoc analysis of the Aspirin in Reducing Events in the Elderly randomized trial, which ran from March 1, 2010, to Dec. 31, 2014.

The trial involved 16,523 Australian participants with a mean age of 75 years, 55.6% of whom were women. The researchers measured participants’ body weight and WC at baseline and 2 years later. For both measurements, they defined changes within 5% as stable.

In men, compared with those with stable weight, there was a greater risk for:

  • all-cause mortality among those with 5% to 10% weight loss (HR = 1.33; 95% CI, 1.07-1.66);
  • all-cause mortality among those with greater than 10% weight loss (HR = 3.89; 95% CI, 2.93-5.18);
  • cancer-specific mortality among those with greater than 10% weight loss (HR = 3.49; 95% CI, 2.26-5.40);
  • CVD-specific mortality among those with greater than 10% weight loss (HR = 3.14; 95% CI, 1.63-6.04); and
  • noncancer non-CVD-specific mortality among those with greater than 10% weight loss (HR = 4.98; 95% CI, 3.14-7.91).

In women, compared with those with stable weight, there was a greater risk for:

  • all-cause mortality among those with 5% to 10% weight loss (HR = 1.26; 95% CI, 1-1.6);
  • cancer-specific mortality among those with 5% to 10% weight loss (HR = 1.44; 95% CI, 1.46-2.04);
  • all-cause mortality among those with greater than 10% weight loss (HR = 2.14; 95% CI, 1.58-2.91);
  • cancer-specific mortality among those with greater than 10% weight loss (HR = 2.78; 95% CI, 1.82-4.26); and
  • CVD-specific mortality among those with greater than 10% weight loss (HR = 1.92; 95% CI, 1.05-3.51).

In addition, Hussain and colleagues reported that a decrease of more than 10% in WC was associated with a higher risk for all-cause mortality in men (HR = 2.14; 95% CI, 1.57-2.91) and women (HR = 1.34; 95% CI, 1.02-1.78)

The researchers suggested mortality risk differences between sexes could be due to body composition characteristics.

“For men, a higher proportion of body mass is constituted of muscle and bone mass, whereas for women, a higher proportion of body mass is composed of fat,” they wrote in JAMA Network Open. “If weight loss preceding chronic illness is predominantly loss of muscle mass and bone mass, it could explain the differences observed between men and women.”

Hussain recommended that primary care physicians “should be aware that even minor weight loss (5%) in older adults without life-limiting illnesses can increase mortality risk.”

“Regular monitoring of weight changes can help early identification of associated risks,” she said.

Hussain also highlighted the importance for older adults “to adhere to a healthy lifestyle, including regular physical activity and a balanced diet, to promote overall health and well-being.”