Larger body mass index and waist circumference are associated with lower mortality in chinese long-term care facility residents

OBJECTIVES: To investigate the association between body mass index (BMI) and waist circumference (WC) and all-cause mortality of Chinese residents in long-term care facilities in Taiwan. DESIGN: Prospective cohort study. SETTING: Eight long-term care facilities in Taiwan. PARTICIPANTS: Three hundred fifty-four residents aged 60 and older (median 78.4, range 60-101; 156 men, 198 women) were recruited during the study period. MEASUREMENTS: Anthropometrics and metabolic parameters were measured at baseline. Mean BMI was 21.7±4.2 kg/m2 (range 11.6-35.3 kg/m2, and mean WC was 82.4±10.9 cm (range 55.0-124.0 cm). Mortality data were from the Department of Health in Taiwan. RESULTS: There were 219 deaths during the 5 years of follow-up. After adjusting for age, sex, albumin, Karnofsky performance status scale, hypertension, and diabetes mellitus, subjects in the highest quartile of BMI (27.3± 2.8 kg/m2) and WC (96.7±7.4 cm) had a significantly lower mortality rate than did subjects in the lowest quartile (BMI, 16.7±1.7 kg/m2; WC, 69.6±4.2 cm). After further stratification according to central obesity status, the subjects in the two highest BMI quartiles had a lower mortality rate than those in the lowest BMI quartile but only in the central obesity group (?90 cm in men or ?80 cm in women). The adjusted relative risk for all-cause mortality in the highest versus lowest BMI quartile was 0.17 (95% confidence interval=0.05-0.57). CONCLUSION: BMI and WC were negative predictors for all-cause mortality in older Chinese adults living in long-term care facilities. Participants with higher WC and BMI had lower all-cause mortality. ? 2010, The American Geriatrics Society.