Evidence map›Paper›PMID 27492450›Full record

ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2017

Obesity in Older People With and Without Conditions Associated With Weight Loss: Follow-up of 955,000 Primary Care Patients.

Kirsty Bowman, João Delgado, William E Henley, Jane A Masoli, Katarina Kos, Carol Brayne, Praveen Thokala, Louise Lafortune, George A Kuchel, Alessandro Ble and 2 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 1 pooled it
4.1field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.

  1. EffectS of Lifestyle Interventions in Older PEople With Obesity (Effective SLOPE): a Systematic Review With Network Meta-Analyses.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
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  18. The genetics of human ageing.Nature reviews. Genetics · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Kirsty BowmanEpidemiology and Public Health, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, UK.
João DelgadoEpidemiology and Public Health, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, UK.
William E HenleyHealth Statistics Group, Institute of Health Research, University of Exeter Medical School, UK.
Jane A MasoliEpidemiology and Public Health, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, UK.
Katarina KosDiabetes and Obesity Research Group, Institute of Biomedical and Clinical Science, University of Exeter Medical School, UK.
Carol BrayneDepartment of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, UK.
Praveen ThokalaSchool of Health and Related Research (ScHARR), University of Sheffield, UK.
Louise LafortuneDepartment of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, UK.
George A KuchelUConn Center on Aging, University of Connecticut Health Center, Farmington, USA.
Alessandro BleEpidemiology and Public Health, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, UK.
David MelzerEpidemiology and Public Health, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, UK. D.Melzer@exeter.ac.uk.
as part of the Ageing Well Programme of the NIHR School for Public Health Research, England
UConn Health · USUniversity of Cambridge · GBUniversity of Sheffield · GB

Funding

Department of Health DRF-2014-07-177
6 · The paper itself

Abstract

backgroundModerate obesity in later life may improve survival, prompting calls to revise obesity control policies. However, this obesity paradox may be due to confounding from smoking, diseases causing weight-loss, plus varying follow-up periods. We aimed to estimate body mass index (BMI) associations with mortality, incident type 2 diabetes, and coronary heart disease in older people with and without the above confounders.

methodsCohort analysis in Clinical Practice Research Datalink primary care, hospital and death certificate electronic medical records in England for ages 60 to more than 85 years. Models were adjusted for age, gender, alcohol use, smoking, calendar year, and socioeconomic status.

resultsOverall, BMI 30-34.9 (obesity class 1) was associated with lower overall death rates in all age groups. However, after excluding the specific confounders and follow-up less than 4 years, BMI mortality risk curves at age 65-69 were U-shaped, with raised risks at lower BMIs, a nadir between 23 and 26.9 and steeply rising risks above. In older age groups, mortality nadirs were at modestly higher BMIs (all <30) and risk slopes at higher BMIs were less marked, becoming nonsignificant at age 85 and older. Incidence of diabetes was raised for obesity-1 at all ages and for coronary heart disease to age 84.

conclusionsObesity is associated with shorter survival plus higher incidence of coronary heart disease and type 2 diabetes in older populations after accounting for the studied confounders, at least to age 84. These results cast doubt on calls to revise obesity control policies based on the claimed risk paradox at older ages.

Indexed as

Weight LossAgedAged, 80 and overBody Mass IndexCoronary DiseaseDiabetes Mellitus, Type 2FemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedObesityPrimary Health CareSmokingBMIMortalityOverweightParadox

Identifiers

PMID27492450
PMCPMC5233914
OpenAlexW2482954656

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.