Body composition

Weight and height history; weight change


LASA160

Marjolein Visser

Background
Weight change in older persons is an important indicator of health status (1). In older persons, weight loss is associated with a greater risk for mobility disability (2) and hip fracture risk (3). Weight loss since maximum lifetime weight or since middle-age is a risk factor for all-cause mortality risk, independent of current weight (4-5). In middle-aged persons, weight gain since age 18 is an important predictor of CHD risk (6).
Although weight at young age is highly correlated with weight at older age (7), recall of height and weight has been shown to contribute useful information independent of current weight status (8). A validation study among 650 elderly men and women aged 62-100 years showed a correlation coefficient of 0.822 between reported and measured weight (28-year recall). However, recalled weights tend to be influenced by current weight and cognitive status (9).

Variables
Self-reported history of weight and height was obtained at the LASA medical interviews. An overview of the variables is shown in the table below.

Availabilty of information per wave1

 

B

C

D

E


2B

F

G

H

3B
MB* I*

Short-term

                     

1. Weight change past 6 months

Me

Me

Me

Me

Me

Me

Me

Me Me   Me

2. The amount of loss/gain (kg)

Me

Me

Me

Me

Me

Me

Me

Me Me   Me

3. Reason for loss/gain

Me

Me

Me

Me

Me

Me

Me

Me Me   Me

Long-term

                     

4. Highest weight in life

Me

      Me       Me    

5. Age at highest weight

Me

      Me       Me    
6. Weight at age 25         Me     Me Me   Me

7. Weight at age 40

Me

      Me       Me   Me

8. Lowest weight after age 25

 

Me

                 

9. Height at age 40

Me

                   

10. Height at age 25

 

Me

    Me       Me   Me

1 More information is available on:
http://www.lasa-vu.nl/data/lasa/sampleLASAdatacollection.html

* 2B=baseline second cohort;
   3B=baseline third cohort;
   MB=migrants: baseline first cohort (Under Construction);
   I=Under Construction

Me=data collected in medical interview

Weight history
Information was obtained on the reason of the short-term weight change. Based on this question, a distinction can be made between voluntary and involuntary weight change (also called intentional and unintentional weight change) in the past 6 months. Voluntary weight change can be due to diet or physical activity, while involuntary weight change may be the result of disease, social factors, or unknown reasons (for review, see 10).

Height history
Vertebral fractures generally cause a decline in height. Height loss since age 25 (the age at which maximum height is reached) or age 40 can therefore be used as a crude indicator of osteoporosis.

Previous use in LASA
Persons with one or more vertebral deformities in 1995/1996 were more likely to have experienced a height loss greater than 5 cm since age 40 (11). The relationship of body weight change since age 40 with hip bone mineral density, total body fat mass, and appendicular skeletal muscle mass (measured in 1995/1996) has also been investigated (12). More recently, the relationship between lifestyle (including BMI) and decline in functional performance has been examined using a lifecycle approach (13,14). Finally, recent weight loss has also been used to identify undernutrition (15).

References

  1. Willett WC. Weight loss in the elderly: cause or effect of poor health? Am J Clin Nutr 1997;66:737-8.
  2. Launer LJ, Harris T, Rumpel C, madans J. Body mass index, weight change and risk of mobility disability in middle-aged and older women. JAMA 1994;271:1093-8.
  3. Langlois JA, Mussolino ME, Visser M, Looker AC, Harris T, Madans J. Weight loss from maximum body weight among middle-aged and older white women and the risk of hip fracture: the NHANES I epidemiologic follow-up study. Osteoporos Int 2001;12:763-8.
  4. Cornoni-Huntley JC, Harris TB, Everett DF, Albanes D, Micozzi MS, Miles TP, Feldman JJ. An overview of body weight of older persons, including the impact on mortality. J Clin Epidemiol 1991;44:743-53.
  5. Losconczy KG, Harris TB, Cornoni-Huntley J, Simonsick EM, Wallace RB, Cook NR, Ostfeld AM, Blazer DG. Does weight loss from middle-age to old age explain the inverse weight mortality relation in old age? Am J Epidemiol 1995;141:312-21.
  6. Willett WC, Manson JE, Stampfer MJ, Colditz GA, Rosner B, Speizer FE, Hennekens CH. Weight, weight change, and coronary heart disease in women. JAMA 1995;273:461-5.
  7. Grinker JA, Tucker K, Vokonas PS, Rush D. Overweight and leanness in adulthood: prospective study of male participants in the Normative Aging Study. Int J Obes Relat Metab Disord 1996;0:561-9.
  8. Must A, Willett WC, Dietz WH. Remote recall of childhood height, weight, and body build by elderly subjects. Am J Epdemiol 1993;138:56-64.
  9. Stevens J, Keil JE, Waid LR, Gazes PC. Accuracy of current, 4-year, and 28-year self-reported body weight in an elderly population. Am J Epidemiol 1990;132:1156-63.
  10. Williamson DF. Intentional weight loss patterns in the general population and its association with morbidity and mortality. Int J Obes 1997;21(suppl1):S14-9.
  11. Pluijm SMF, Tromp AM, Smit JH, Deeg DJH, Bouter LM, Lips P. Consequences of vertebral deformities in older men and women. J Bone Miner Res 2000;15:1564-72.
  12. Pluijm SMF, Visser M, Smit JH, Popp-Snijders C, Roos JC, Lips P. Determinants of bone mineral density in older men and women: body composition as mediator. J Bone Miner Res 2001;16:2142-51.
  13. Pluijm SMF, Visser M, Puts MTE, Dik MG, Schalk BWM, van Schoor NM, Schaap LA, Bosscher RJ, Deeg DJH. Unhealthy lifestyles during the life course: association with physical decline in late life. Aging Clin Exp Res 2007;19:75-83.
  14. Pluijm SMF, Visser M, Puts MTE, Dik MG, Schalk BWM, van Schoor NM, Schaap LA, Bosscher RJ, Deeg DJH. Ongezonde leefstijl in de loop van het leven: samenhang met lichamelijke achteruitgang op oudere leeftijd. Tijdschr Gerontol Geriatr 2006;37:227-37.
  15. Visser M. Ondervoeding bij ouderen. Resultaten van de Longitudinal Aging Study Amsterdam. Rapportage voor VWS, 2009.