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Epidemiology and Population Health

Obesity in older adults and life expectancy with and without cardiovascular disease

International Journal of Obesity volume 40, pages 1535–1540 (2016)Cite this article

Subjects

Abstract

Background:

The prevalence of overweight and obesity is increasing globally and is an established risk factor for cardiovascular disease (CVD). Our objective was to evaluate the impact of overweight and obesity on life expectancy and years lived with and without CVD in older adults.

Methods:

The study included 6636 individuals (3750 women) aged 55 years and older from the population-based Rotterdam Study. We developed multistate life tables by using prevalence, incidence rate and hazard ratios (HR) for three transitions (free-of-CVD-to-CVD, free-of-CVD-to-death and CVD-to-death), stratifying by the categories of body mass index (BMI) at baseline and adjusting for confounders.

Results:

During 12 years of follow-up, we observed 1035 incident CVD events and 1902 overall deaths. Obesity was associated with an increased risk of CVD among men (HR 1.57 (95% confidence interval (CI) 1.17, 2.11)) and women (HR 1.49 (95% CI 1.19, 1.86)), compared with normal weight individuals. Overweight and obesity were not associated with mortality in men and women without CVD. Among men with CVD, obesity compared with normal weight, was associated with a lower risk of mortality (HR 0.67 (95% CI 0.49, 0.90)). Overweight and obesity did not influence total life expectancy. However, obesity was associated with 2.6 fewer years (95% CI −4.8, −0.4) lived free from CVD in men and 1.9 (95% CI −3.3, −0.9) in women. Moreover, men and women with obesity lived 2.9 (95% CI 1.1, 4.8) and 1.7 (95% CI 0.6, 2.8) more years suffering from CVD compared with normal weight counterparts.

Conclusions:

Obesity had no effect on total life expectancy in older individuals, but increased the risk of having CVD earlier in life and consequently extended the number of years lived with CVD. Owing to increasing prevalence of obesity and improved treatment of CVD, we might expect more individuals living with CVD and for a longer period of time.

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Acknowledgements

The dedication, commitment and contribution of inhabitants, general practitioners and pharmacists of the Ommoord district to the Rotterdam Study are gratefully acknowledged. The Rotterdam Study is funded by Erasmus MC and Erasmus University, Rotterdam, the Netherlands; the Netherlands Organization for Scientific Research (NWO); the Netherlands Organization for the Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE); the Ministry of Education, Culture and Science; the Ministry for Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. KD is supported Erasmus Mundus Western Balkans (ERAWEB), a project funded by the European Commission. MK is supported by AXA Research Fund. MAI is supported by the Netherlands Heart Foundation (2012T008). OHF works in ErasmusAGE, a center for aging research across the life course funded by Nestlé Nutrition (Nestec Ltd.) and Metagenics Inc. Nestlé Nutrition (Nestec Ltd.) and Metagenics Inc. had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review or approval of the manuscript. The Rotterdam Study has been approved by the institutional review board (medical ethics committee) of the Erasmus Medical Center and by the medical ethics committee according to the Wet Bevolkingsonderzoek ERGO (Population Study Act Rotterdam Study), executed by the Ministry of Health, Welfare and Sports of The Netherlands.

Author contributions

The contribution of the authors were as follows: KD and OHF had the original idea for the study. OHF supervised analyses of study data. MB, AP, MAI, HT, AH, WN, MK and OHF revised the manuscript critically for important intellectual content and gave final approval of the version to be published.

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Authors and Affiliations

  1. Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands,

    K Dhana, M A Berghout, M A Ikram, H Tiemeier, A Hofman, M Kavousi & O H Franco

  2. Department of Obesity and Population Health, Baker IDI Heart and Diabetes Institute, Melbourne, Australia

    A Peeters

  3. Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands

    M A Ikram

  4. Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands

    M A Ikram

  5. Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands

    H Tiemeier

  6. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA

    A Hofman

  7. Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands

    W Nusselder

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  1. K Dhana
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Correspondence to K Dhana.

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Dhana, K., Berghout, M., Peeters, A. et al. Obesity in older adults and life expectancy with and without cardiovascular disease. Int J Obes 40, 1535–1540 (2016). https://doi.org/10.1038/ijo.2016.94

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