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Weight loss may mean a risk of death for older adults, study shows
As much as people may celebrate their own weight loss, it is not always healthy.
A new study shows that weight loss in older adults is associated with early death and life-limiting conditions.
Weight gain, on the other hand, was not associated with mortality, according to the study published Monday in JAMA Network Open.
Medical professionals have known to be concerned when older people with health conditions lose weight but researchers have not fully understood the impact of weight change on healthy older adults, according to lead study author Dr. Monira Hussain, a clinical epidemiologist and senior research fellow in public health and preventative medicine at Monash University in Melbourne, Australia.
The study looked at nearly 17,000 adults at least 70 years old in Australia and more than 2,000 adults in the United States who were at least 65 years old. Everyone who participated in the study was weighed at their annual checkup between 2010 and 2014, according to the study.
“Our study found that even a 5% weight loss increases mortality risk, particularly in older men,” Hussain said.
Weight gain in healthy older people, on the other hand, showed no association, she added.
The association was found across starting weights, meaning people who are medically classified as obese also were at an increased risk when losing weight, said Perri Halperin, the clinical nutrition director for the Mount Sinai Health System. Halperin was not involved in the study.
Other health issues
The study was able to account for health issues at the start. It excluded people who had conditions like cardiovascular disease, dementia, physical disabilities or chronic illness, Hussain said.
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“It also excluded those with recent hospitalizations, which is important because hospitalization is often followed by weight loss due to acute conditions,” Halperin said in an email.
But the study wasn’t able to distinguish if people involved lost weight intentionally or unintentionally, Hussain added.
“No questions were asked about changes in activity level and diet quality between the baseline study visit and subsequent study visits, so we do not have any information on how those factors may have impacted the results,” Haperin said.
Why weight loss can be a risk
Weight loss may be a warning sign for conditions like cancer and dementia, and it is “often linked to reduced appetite influenced by inflammation and hormones,” Hussain said.
Underlying chronic health conditions can also trigger weight loss in older adults by impacting appetite, metabolism and eating habits, Halperin said. Mobility issues and medication side effects can also affect weight.
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Changes in weight can also signal concerns in lifestyle, Halperin said.
“A major contributing factor to weight loss in older adults is social isolation. Other concerns include financial constraints and pain and discomfort,” she added.
In studies like these, remembering that correlation is not causation is important, Halperin said. Weight loss was associated with mortality, which means it’s correlated – but that doesn’t mean the weight loss caused a person’s death.
“It’s also important to say that the opposite cannot be extrapolated nor recommended – ie gaining weight would not necessarily decrease your mortality risk,” she said in an email. “As always, discuss your weight changes with your doctor or other medical professional.”
The takeaway is for older adults to monitor their weight change, Halperin said.
“If they notice a decrease in the number on the scale (weight loss) or perhaps pants that were once snug fitting looser (decreased waist circumference),” she added, “bring it up with their doctor for possible further screening or testing.”
But the advice also goes for the medical community, she said. Doctors and health care providers need to know that changes in weight require further investigation.
注释：
epidemiologist: n
表示" 流行病学家"，means "a medical scientist who studies the transmission and control of epidemic diseases"，如：The state epidemiologist toured the plant. 流行病学家也造访了该厂。
obese: adj
表示"极肥胖的"，means "excessively fat"，如：Obese people find it difficult to stop overeating. 胖人觉得一吃就过量，难以控制。
cardiovascular
表示" 心脏血管的"，means "of or pertaining to or involving the heart and blood vessels"，如：Cardiovascular disease is the leading cause of death among Americans. 心脏血管的疾病是美国人死亡的首要原因。
snug: adj
表示"温暖舒适的；合身的"，means "offering safety; well protected or concealed;"，如：He sat in a snug little room. 他坐在一个舒适的小房间里。
circumference: n
表示" 圆周；周长"，means "the size of something as given by the distance around it"，如：This tree has a circumference of 6 feet. 这棵树周长六英尺。
中文简要说明：
对不少人来说，成功「减肥」是件值得庆祝的事，但对长辈而言恐怕并非如此。一项研究指出，年长者的体重下降，可能与早逝和死亡有关。该研究由澳洲墨尔本蒙纳许大学（Monash University）资深公卫和预防医学研究员胡赛恩教授（Dr. Monira Hussain）主持，发表在最新一期的《美国医学会网络公开》期刊（JAMA Network Open）。
美国有线新闻网（CNN）报导，这项研究调查将近1万7千位70岁以上的澳洲人，以及2千多位65岁以上的美国人，根据他们在2010至2014年间的体重变化进行分析。结果发现，年长者的体重即使只下降5%，也会增加死亡的风险，对男性而言尤其如此；反之，体重的增加与死亡并没有太大关联。
值得注意的是，这项研究排除了患有心血管疾病、失智症、身体失能等慢性病患者，只探讨体重减轻对于「健康」年长者的影响。胡赛恩教授表示，体重减轻「通常是因为发炎或贺尔蒙改变，导致食欲下降」，暗示身体存在着一些潜在的问题，像是癌症和失智症。
纽约西奈山医疗系统（Mount Sinai Health System）的临床营养部主任赫尔佩林认为，体重改变也意味着生活方式发生变化：「导致老年人体重下降的主要原因之一是社会孤立。其他因素则包括财务紧张、痛苦和不适。」她并未参与澳洲这项研究。赫尔佩林提醒读者，这类研究探讨的是关联性而非因果性。体重下降与死亡有关，但并不代表会导致死亡，反之亦然。对年长者来说，重要的是经常监测自己的体重变化，一旦发现异常就和医生讨论，才能及早发现并解决问题。
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