Journals of Gerontology Series A: Biological Sciences and Medical Sciences Large Type Edition
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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 60:866-871 (2005)
© 2005 The Gerontological Society of America

An Adequate Threshold for Body Mass Index to Detect Underweight Condition in Elderly Persons: The Italian Longitudinal Study on Aging (ILSA)

Giuseppe Sergi1,, Egle Perissinotto2, Claudia Pisent1, Alessandra Buja2, Stefania Maggi3, Alessandra Coin1, Francesco Grigoletto2, Giuliano Enzi1 and for the ILSA Working Group

1 Department of Medical and Surgical Sciences, Division of Geriatrics
2 Department of Environmental Medicine and Public Health, University of Padua, Italy.
3 National Research Council, Institute of Neuroscience, Section on Aging, Padua, Italy.

Address correspondence to Giuseppe Sergi, MD, Clinica Geriatrica, Ospedale Giustinianeo (2° Piano), via Giustiniani 2, 35100 Padova, Italy. E-mail: giuseppe.sergi{at}tin.it

Background. The present study aims at defining a body mass index (BMI) threshold for risk of being underweight in elderly persons on the basis of the BMI distribution in a large Italian population-based sample and on its ability to predict short-term mortality.

Methods. At baseline (1992), BMI was obtained for 3110 (1663 males and 1447 females) persons aged 65–84 participating in the Italian Longitudinal Study on Aging (ILSA). BMI and risk factors (age, sex, education, smoking status, disability, and disease status) have been considered for their potential association with 4-year all-cause mortality. Information on vital status at 1995 was obtained for 2551 participants.

Results. The fifth centile of BMI was well approximated by a value of 20 for both sexes. Also in both sexes, at a BMI value of 24 the a posteriori probability of death started to increase, doubling at a value of 22 for men and 20 for women. Crude mortality was 14.6% for men and 9.8% for women. The hazard ratios and confidence intervals (CIs) comparing mortality for each BMI two-unit class to the 26–28 class, after adjusting for confounding variables, showed significantly higher rates only for BMI values below 20 (2.9; 95% CI, 1.2–7.0), although a consistent increase in hazard ratio (1.6; 95% CI, 0.9–3.0) already appeared for the 20–22 BMI group.

Conclusions. Our study confirms that low BMI is an independent predictive factor of short-term mortality in elderly persons. A BMI value of 20 kg/m2 seems to be a reliable threshold for defining underweight elderly persons at high risk. Nevertheless, more careful clinical and nutritional management should also be applied to elderly persons with higher BMI values.






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