Weight loss and mortality among free-living frail elders: A prospective study

Background. Numerous studies of the elderly population have indicated that belly weight and weight changes are related to mortality, but the one group at particularly high risk of nutritional inadequacies-frail elders receivi ng home help services-has not been studied. Methods. A prospective cohort of 288 frail elders (81 men; 207 women; mean age: 78.2 +/- 7.6 yrs) receiving home support services was followed for 3-5 years. Nutritional variables included baseline body mass index (BMI), weig ht loss prior to baseline, and energy and protein intake. Covariates includ ed age, gender, smoking, and health and functional status. Cox's multivaria te survival analysis was used to identify independent predictors of mortali ty. Results. There were 102 deaths (35.4%) over the follow-up period. Univariat e predictors included age, sex, BMI, weight loss, and functional status. In multivariate analysis, weight loss at baseline was a significant predictor of mortality, RR = 1.76 (95% CI: 1.15 - 271) was was male gender, RR = 2.7 1 (95% CI: 1.73 - 4.24), and age at baseline, RR = 1.40 (95% CI: 1.06 - 1.8 6). Conclusion. Among free-living frail elders, weight loss is a predictor of e arly mortality after controlling for smoking, and functional and health sta tus indicators. From our observations, however, we cannot conclude that pre vention of weight loss would lead to increased survival. This needs to be e xplored in an intervention study.