Most Read Articles
01 Jun 2015
Long-term oral testosterone undecanoate significantly improved IPSS quality of life scores in a 1-year, randomised, multicentre, double-blind trial among aging hypogonadal men.
Rachel Soon, 01 Jun 2016

The inclusion of statins in managing chronic kidney disease (CKD) may help reduce patient mortality from stroke and possibly other cardiovascular events, according to an expert at the 7th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress.

Rachel Soon, 01 Jun 2016

Patients with hypercholesterolaemia with unchanging LDL-cholesterol levels after 6 weeks of statin treatment should be actively assessed for either statin intolerance or resistance, says an expert at the 7th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress.

Prof. Cyrus Rustam Kumana, 07 Jul 2016

This case scenario was presented at a grand round in the Department of Medicine, The University of Hong Kong. Unlike traditional grand rounds that directly or indirectly deal with clinical challenges posed by patients, this one was equally about doctors and how they care for their charges. All doctors who tend patients dread being implicated on the receiving end of medico-legal proceedings. This topic is therefore intimately linked to the professionalism of doctors, their standing in the community, and the ethical aspects of how they interact with patients and relatives.

Overweight elderly patients have elevated CVD- and stroke-related but not all-cause mortality risk

Roshini Claire Anthony
10 Aug 2017

Elderly overweight individuals have an elevated risk of death due to cardiovascular disease (CVD) and stroke but not all-cause mortality, according to findings from the SLAS* cohort.

Individuals aged ≥65 years who were overweight or obese (BMI ≥30 kg/m2) had an elevated risk of CVD- and stroke-related mortality (hazard ratio [HR], 10.0; p=0.0086), though not of all-cause mortality (hazard ratio [HR], 0.98–1.29). [PLoS One 2017;12:e0180818]

Conversely, individuals aged ≥65 years who were underweight (BMI <18.5 kg/m2) had an increased risk of both all-cause (HR, 1.78; p=0.0336) and CVD- and stroke-related mortality (HR, 6.15; p=0.0299).

Among individuals aged 55–64 years, all-cause mortality risk was increased in those who were underweight (HR, 4.92; p<0.0138), of normal weight I (BMI 18.5–22.9 kg/m2, HR, 3.41; p=0.0149), and overweight or obese (HR, 4.05; p=0.0423) compared with individuals with a BMI of 23–24.9 kg/m2 (normal weight II).

Individuals with a BMI of 23–24.99 kg/m2 had the lowest risk of all-cause and CVD- and stroke-related mortality, regardless of age.

Despite the results, the researchers advised caution when interpreting the findings to determine the optimal BMI in elderly patients.

“[I]t should not be interpreted to mean that obesity conveys a lower mortality risk in older persons compared with younger and middle-aged persons … the absolute mortality risk associated with increased BMI is still higher in older persons because of the marked increase in mortality with advancing age,” they said. 

Furthermore, the small number of stroke- and CVD-related deaths may have skewed the results towards an association with obesity.

“[T]he lack of association of overweight-obesity with increased total mortality among the older participants was due to lower mortality predominantly from nonvascular causes of death,” they said.

“[O]lder persons tend to have more body fat at the same BMI as younger adults, with greater BMI possibly reflecting greater fat-free mass, rather than greater body fat,” said the researchers, on the drawback of using BMI as a measure of body fat, and suggested that future research incorporate other measures of body composition to elucidate these findings.

Study participants were 2,604 individuals of Chinese ethnicity aged ≥55 years from the SLAS cohort who were followed up from 2003 to 2011. Of these, 6.1 percent were underweight and 4.6 percent were overweight-obese class I, II, and III (BMI ≥30 kg/m2). There were 224 deaths, 17 percent (n=38) of which were due to CVD and stroke. 

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Most Read Articles
01 Jun 2015
Long-term oral testosterone undecanoate significantly improved IPSS quality of life scores in a 1-year, randomised, multicentre, double-blind trial among aging hypogonadal men.
Rachel Soon, 01 Jun 2016

The inclusion of statins in managing chronic kidney disease (CKD) may help reduce patient mortality from stroke and possibly other cardiovascular events, according to an expert at the 7th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress.

Rachel Soon, 01 Jun 2016

Patients with hypercholesterolaemia with unchanging LDL-cholesterol levels after 6 weeks of statin treatment should be actively assessed for either statin intolerance or resistance, says an expert at the 7th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress.

Prof. Cyrus Rustam Kumana, 07 Jul 2016

This case scenario was presented at a grand round in the Department of Medicine, The University of Hong Kong. Unlike traditional grand rounds that directly or indirectly deal with clinical challenges posed by patients, this one was equally about doctors and how they care for their charges. All doctors who tend patients dread being implicated on the receiving end of medico-legal proceedings. This topic is therefore intimately linked to the professionalism of doctors, their standing in the community, and the ethical aspects of how they interact with patients and relatives.