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Prestroke weight loss is associated with poststroke mortality among men in the Honolulu-Asia Aging Study

TitlePrestroke weight loss is associated with poststroke mortality among men in the Honolulu-Asia Aging Study
Publication TypeJournal Article
Year of Publication2014
AuthorsBell, CL, Rantanen, T, Chen, R, Davis, J, Petrovitch, H, Ross, GW, Masaki, K
JournalArch Phys Med RehabilArch Phys Med Rehabil
Volume95
Pagination472-9
Date PublishedMar
ISBN Number1532-821X (Electronic)<br/>0003-9993 (Linking)
Accession Number24113337
KeywordsActivities of Daily Living, Aged, Aged, 80 and Over, Aging, Asian Americans, Body Mass Index, Comorbidity, Hawaii/epidemiology, Health Behavior, Health Status, Humans, Japan/ethnology, Longitudinal Studies, Male, Overweight/epidemiology, Risk Factors, Stroke/epidemiology/ mortality, Weight Loss
AbstractOBJECTIVE: To examine baseline prestroke weight loss and poststroke mortality among men. DESIGN: Longitudinal study of late-life prestroke body mass index (BMI), weight loss, and BMI change (midlife to late life) with up to 8-year incident stroke and mortality follow-up. SETTING: Community-based aging study data. PARTICIPANTS: Japanese-American men (N=3581; age range, 71-93y) who were stroke free at baseline. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Poststroke mortality: 30 days poststroke, analyzed with stepwise multivariable logistic regression; and long-term poststroke (up to 8y), analyzed with stepwise multivariable Cox regression. RESULTS: Weight loss (4.5kg decrements) was associated with increased 30-day poststroke mortality (adjusted odds ratio=1.48; 95% confidence interval [CI], 1.14-1.92), long-term mortality after incident stroke (all types, n=225; adjusted hazards ratio (aHR)=1.25; 95% CI, 1.09-1.44), and long-term mortality after incident thromboembolic stroke (n=153; aHR=1.19; 95% CI, 1.01 to 1.40). Men with overweight/obese late-life BMI (>/=25kg/m(2), compared with healthy/underweight BMI) had increased long-term mortality after incident hemorrhagic stroke (n=54; aHR=2.27; 95% CI, 1.07-4.82). Neither desirable nor excessive BMI reductions (vs no change/increased BMI) were associated with poststroke mortality. In the overall sample (N=3581), nutrition factors associated with increased long-term mortality included the following: (1) weight loss (10lb decrements; aHR=1.15; 95% CI, 1.09-1.21), (2) underweight BMI (vs healthy BMI; aHR=1.76; 95% CI, 1.40-2.20), and (3) both desirable and excessive BMI reductions (vs no change or gain, separate model from weight loss and BMI; aHR range, 1.36-1.97; P<.001 conclusions:="" although="" obesity="" is="" a="" risk="" factor="" for="" stroke="" incidence="" prestroke="" weight="" loss="" was="" associated="" with="" increased="" poststroke="" types="" and="" thromboembolic="" mortality.="" overweight="" late-life="" bmi="" posthemorrhagic="" desirable="" excessive="" reductions="" were="" not="" underweight="" any="" reduction="" all="" long-term="" mortality="" in="" the="" overall="" sample.="">
Ethno Med: