Body mass index, weight loss, and mortality in community-dwelling older adults.

BACKGROUND The relationship between body mass index (BMI), weight loss, and mortality in older adults is not entirely clear. The purpose of this article is to evaluate the associations between BMI, weight loss (either intentional or unintentional), and 3-year mortality in a cohort of older adults participating in the University of Alabama at Birmingham (UAB) Study of Aging. METHODS This article reports on 983 community-dwelling older adults who were enrolled in the UAB Study of Aging, a longitudinal observational study of mobility among older African American and white adults. RESULTS In both raw and adjusted Cox proportional hazards models, unintentional weight loss and underweight BMI were associated with elevated 3-year mortality rates. There was no association with being overweight or obese on mortality, nor was there an association with intentional weight loss and mortality. CONCLUSIONS Our study suggests that undernutrition, as measured by low BMI and unintentional weight loss, is a greater mortality threat to older adults than is obesity or intentional weight loss.