Weight loss may mean a risk of death for older adults, study shows

By Madeline Holcombe, CNN

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.

“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 risk factor for mortality because it can signal underlying issues.

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.

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.

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