Weight change, body composition, and risk of XXXX and mortality in older adults: a population-based cohort study.

@entity1 @entity717 @entity1017 @entity353
OBJECTIVES: To examine associations between weight change, body composition, risk of @entity717 , and mortality in older adults. DESIGN: Prospective, longitudinal, population-based cohort. SETTING: The Health, Aging, and Body Composition Study. @entity1 : @entity1 (n  =  1,044) and @entity1 (n  =  931) aged 70 to 79. MEASUREMENTS: Weight and lean and fat mass from dual-energy X-ray absorptiometry measured annually over 5  years. Weight was defined as stable (n  =  664, reference), loss (n  =  662), gain (n  =  321), or cycling (gain and loss, n  =  328) using change of 5% from year to year or from Year 1 to 6. Mobility disability (two consecutive reports of difficulty walking one-quarter mile or climbing 10 steps) and mortality were determined for 8  years after the weight change period. Associations were analyzed using Cox proportional hazards regression adjusted for covariates. RESULTS: During follow-up, 313 @entity1 and 375 @entity1 developed @entity717 , and 322 @entity1 and 378 @entity1 died. There was no risk of @entity717 or mortality with @entity1017 . Weight loss (hazard ratio (HR)  =  1.88, 95% confidence interval (CI)  =  1.40-2.53) and weight cycling (HR  =  1.59, 95% CI  =  1.11-2.29) were associated with @entity717 in @entity1 , and @entity353 was associated with @entity717 in @entity1 (HR  =  1.30, 95% CI  =  1.01-1.69). Weight loss and weight cycling were associated with mortality risk in @entity1 ( @entity353 : HR  =  1.47, 95% CI  =  1.07-2.01; weight cycling: HR  =  1.62, 95% CI  =  1.15-2.30) and in @entity1 ( @entity353 : HR  =  1.41, 95% CI  =  1.09-1.83; weight cycling: HR  =  1.50, 95% CI  =  1.08-2.08). Adjustment for lean and fat mass and change in lean and fat mass from Year 1 to 6 attenuated the relationships between @entity353 and @entity717 in @entity1 and between @entity353 and mortality in @entity1 and @entity1 . CONCLUSION: Weight cycling and @entity353 predict impending @entity717 and mortality in old age, underscoring the prognostic importance of weight history.
