How Changes in Weight Affect Life Beyond 90
In recent times, the pursuit of lifestyle changes that promote longevity has piqued the interest of many. Among these changes, one of the most closely examined areas is the impact of excess weight and obesity on survival in older age. A fresh study, featured in The Journals of Gerontology, takes a closer look at how fluctuations in weight and intentional weight loss influence life expectancy among individuals aged above 90 years.
Introduction
Previous research has already highlighted the risks associated with becoming obese in middle age, revealing a staggering increase in mortality risk of over 20%. On the flip side, those who were obese but managed to shed weight and reach an overweight status during this period experienced a remarkable reduction in mortality risk by more than half.
These shifts in weight not only impact health during one’s later years but also influence the occurrence of chronic conditions and physical or cognitive impairments in older individuals.
Research studies like the Nurses’ Health and Health Professionals Follow-up study have illustrated that losing 2.5-10 kg before middle age can reduce the risk of developing 11 chronic conditions by over 20% in older women and by more than 10% in older men.
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One limitation in previous research was the failure to distinguish between voluntary and involuntary weight loss. The former has been linked to reduced mortality, while the latter has been associated with an increased risk of death in some studies.
Some studies even found no significant associations between intentional weight loss and mortality in adults or observed associations between weight changes in any direction and higher mortality in later life. Read about our Abbott FreeStyle Libre days.
Unintentional weight loss often occurs due to age-related muscle mass reductions. One study suggests that the most significant weight loss typically occurs during the last decade of life, particularly in the last three years for individuals with cancer or the last five years for those suffering from cardiovascular disease.
The present study is groundbreaking as it is the first to explore how changes in weight later in life may affect lifespan beyond the age of 90.
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Key Findings
The study drew data from the Women’s Health Initiative, a cohort comprising over 54,000 individuals aged between 61 and 81. Longitudinal data analysis was conducted to investigate associations between weight fluctuations, intentional weight loss, and survival rates at ages 90, 95, and 100. The baseline age of participants was 70 years, with nearly 90% being of White ethnicity.
Weight measurements were recorded at three-time points: baseline, year 3, and year 10. This allowed participants to be categorized into three groups: those who had lost 5% or more of their baseline weight, those with stable weight (less than 5% change), and those who had gained 5% or more.
At year three from the baseline, approximately 70% maintained a stable weight, 17% experienced weight loss, and 15% reported weight gain. Notably, over half of those who lost weight did not do so intentionally.
By year 10, with participants averaging around 77 years old, fewer than 50% had maintained stable weight. About 35% had experienced weight loss, and nearly 20% had gained weight.
Factors associated with stable weight included non-Black ethnicity, non-smoker status, and the absence of major illnesses. Conversely, women who intentionally lost weight tended to be less physically active, more physically impaired, and more likely to have diabetes or high blood pressure. Intentional weight loss was often driven by dieting, increased exercise, or participation in weight loss programs. Have a look at our CGM Devices
In contrast, unintentional weight loss was more prevalent among older Black women with a sedentary lifestyle, a higher likelihood of obesity, lower education levels, and an increased likelihood of other major illnesses. This type of weight loss was primarily attributed to illness, reduced appetite, or stress.
Among the participants who lived to or past the age of 90 years (over 30,600 women), the study found that those who had lost weight at year 3, as previously defined, had a significantly reduced likelihood of reaching the age of 90—almost a one-third lower chance compared to those with stable weight. Similar reductions in the odds of reaching 90 were observed among those who had gained 5% or more of their body weight.
By year 10, weight loss was associated with a 40% lower likelihood of reaching age 90 and a 50% lower likelihood of reaching age 95.
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Of particular note, among women who had lost weight, involuntary weight loss emerged as a stronger predictor of lower odds of survival at age 90, with these individuals showing less Compared to people with constant weight, those with less than half the chances of survival. On the other hand, those who intentionally lost weight also had lower odds of survival, albeit by a smaller margin compared to those with involuntary weight loss.
The study found no significant differences in these associations based on body mass index (BMI) categories, whether participants were normal weight, overweight, or obese. Furthermore, weight gain did not appear to impact survival odds in later life.
Implications
In summary, the research suggests that compared to individuals who experienced weight loss, maintaining stable weight increases the likelihood of living to ages 90 to 100 by 1.2 to 2-fold. Both unintentional and intentional weight loss are associated with poorer survival in extreme old age, with unintentional weight loss exerting a more pronounced impact, irrespective of BMI.
These findings align with previous studies, such as the Cardiovascular Health Study. However, it’s worth noting that some randomized controlled trials (RCTs) indicate a different outcome, suggesting a lower impact of intentional weight loss on survival rates. Further research is needed to gain a more comprehensive understanding of the interplay between changes in weight and longevity.
