Abstract:
OBJECTIVES:We examined the dose-response relationships of body composition indices with mortality and identified the best predictor. DESIGN AND SETTING:Kusatsu Longitudinal Study and Hatoyama Cohort Study, Japan. PARTICIPANTS:In total, 1977 community-dwelling Japanese adults age ≥65 years (966 men and 1011 women) participated. MEASUREMENTS:Body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and skeletal muscle mass index (SMI) were determined by segmental multifrequency bioelectrical impedance analysis. The main outcome was all-cause mortality. We determined multivariate-adjusted hazard ratios for mortality relative to sex-specific medians of each body composition index and examined the association shapes. RESULTS:During the median follow-up of 5.3 years, 128 (13.3%) men and 75 (7.4%) women died. Compared with median BMIs (23.3 kg/m2 in men and 22.8 kg/m2 in women), a BMI >23.3 and ≤26.1 kg/m2 was associated with significantly lower mortality risk in men, and a BMI <22.8 kg/m2 was associated with significantly higher mortality risk in women. The inverse dose-response relationship with mortality was clearer for FFMI [hazard ratios (95% confidence interval) of 10th and 90th percentiles: 1.58 (1.23-2.03) and 0.58 (0.44-0.79), respectively, in men and 1.56 (1.12-2.16) and 0.68 (0.51-0.91), respectively, in women] and SMI [1.57 (1.22-2.01) and 0.60 (0.45-0.80), respectively, in men and 1.45 (1.05-2.01) and 0.77 (0.61-0.96), respectively, in women] than for BMI [1.30 (0.92-1.83) and 0.65 (0.41-1.03), respectively, in men and 1.87 (1.18-2.95) and 0.88 (0.54-1.42), respectively, in women]. FMI was not associated with mortality in either sex. CONCLUSIONS AND IMPLICATIONS:FFMI and SMI were more definitive predictors of mortality than were BMI and FMI. The lower mortality risk with higher FFMI, regardless of FMI, may explain the age-related weakening of the association between higher BMI and mortality (the "obesity paradox"). FFMI and SMI evaluation should be introduced to clinical assessments of older adults because mortality risk might be reduced by maintaining muscle mass.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Seino S,Kitamura A,Abe T,Taniguchi Y,Yokoyama Y,Amano H,Nishi M,Nofuji Y,Narita M,Ikeuchi T,Fujiwara Y,Shinkai Sdoi
10.1016/j.jamda.2019.11.018subject
Has Abstractpub_date
2020-06-01 00:00:00pages
726-733.e4issue
6eissn
1525-8610issn
1538-9375pii
S1525-8610(19)30827-8journal_volume
21pub_type
杂志文章abstract::Loneliness is a common experience within long-term care and, to promote well-being and quality of life among people with dementia, it is important to draw upon a repertoire of strategies that provide social stimulation, companionship, and enjoyment. This paper describes and reflects on a program of co-operative social...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.01.013
更新日期:2017-04-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
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doi:10.1016/j.jamda.2007.03.001
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journal_title:Journal of the American Medical Directors Association
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journal_title:Journal of the American Medical Directors Association
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journal_title:Journal of the American Medical Directors Association
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of the American Medical Directors Association
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更新日期:2020-09-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
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doi:10.1016/j.jamda.2013.06.005
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.11.015
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.11.002
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:To evaluate whether STOPP/START v2 potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) are associated with 6-month mortality and unplanned hospitalization in hospital-discharged older patients. DESIGN:Multicenter prospective cohort observational study. SETTING AND PARTIC...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.03.023
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.11.027
更新日期:2017-03-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
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更新日期:2012-02-01 00:00:00
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doi:10.1016/j.jamda.2020.05.028
更新日期:2020-07-19 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.09.009
更新日期:2017-01-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2007.01.003
更新日期:2007-06-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.023
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journal_title:Journal of the American Medical Directors Association
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更新日期:2014-01-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
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更新日期:2020-03-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
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更新日期:2011-01-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2013.01.021
更新日期:2013-06-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.05.012
更新日期:2012-09-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
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更新日期:2011-06-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
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更新日期:2012-03-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
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更新日期:2005-09-01 00:00:00