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Weight, height and body mass index distributions in geographically and ethnically diverse samples of older persons

Age and Ageing, July, 1996 by Lenore J. Launer, Tamara Harris

Keywords: Anthropometry, Elderly people, Screening, Epidemiology.

Introduction

Height and weight are two of the most easily obtained anthropometric measurements. In combination, they have been used to demonstrate the health risks associated with overweight as well as underweight and are used extensively in screening and monitoring programmes [1]. However, much of what is known about these relationships relates to children, adolescents, and middle-aged adults; little is known about older people [2].

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The WHO Expert Committee on Physical Status: The Use and Interpretation of Anthropometry recently formulated guidelines for data obtained from people aged over 60 [3]. Data were obtained on height, weight and body mass index (BMI; weight in kg/height in [m.sup.2]) in older persons from geographically and ethnically diverse populations. In this report, we examine those data with regard to differences in sex-specific distributions by geographic region/ethnic group, age, and reported health status. These factors produce different distributions of anthropometric data in studies of younger populations. Geographic region/ethnic group differences may reflect differences in early childhood experiences and life-style during adulthood, as well as genetic background [4, 5]. Differences by age may emerge that are related to survival, or to physiological, cohort and health status factors [6-9]. Health status may be related to the distribution of weight and BMI because of its association with the risk for, and the consequences of, disease [2]. How these factors may influence distributions of anthropometric data for older populations is not clear.

Methods

On the basis of literature, personal contacts and suggestions from colleagues, 13 groups were identified with candidate data-sets based on surveys of randomly selected community-dwelling elderly people. Twelve groups contributed data, 11 of whom had at least one sample that included individuals aged 70-79 years. Some groups contributed data collected from multiple sites and data from each site are presented separately. The number of older persons in individual studies ranged from 68 to over 4000. Complete details on the design and results of individual studies are available from the investigators (Appendix). As is reported in Table I, the studies in general do not include institutionalized residents. Some studies explicitly excluded this group, while others included the institutionalized group in the larger study, but did not collect anthropometric data from them. For all studies, it is likely that the most disabled are underrepresented owing to non-response.

[TABULAR DATA I OMITTED]

From the eligible 24 studies, we compared 19 study sites (described more fully in Table I) that used standard methods to measure weight (to the nearest 0.1 kg to 1.0kg) and height (to the nearest 0.1 cm). To assess geographic/ethnic differences, comparisons were limited to persons aged 70-79 years old. To assess age trends within and between studies, three age groups were defined (60-69 years old, 70-79 years old, 80+ years old). Comparisons between these age groups were limited to eight studies with complete data for these age strata. We also compared the BMI distributions of persons aged 70-79 by three levels of reported global health status: poor/fair, good, and very good/excellent. Since not all studies collected data on health status, used the same question, or had adequate numbers ([greater than or equal to]10 per health status category), comparisons by health status were limited to five studies.

Data on height, weight and BMI are presented separately for men and women. Distributions were compared using the mean and standard deviation. The proportion in each sample that fell within the BMI categories of <20 (underweight), 20-24.99, 25-29.99, and [greater than or equal to]30 (overweight) was also calculated. These categories were in general use at the time of data collection [10].

Results

Variation by geographic/ethnic group in 70-79-year-old men and women

Height and weight: As expected, men were taller than women. In general, the rank order of samples with regard to height was similar in men and women; men and women in Guatemala were the shortest and people in Sweden the tallest. The mean (SD) height for men in the Guatemalan sample was 1.56 (0.06)m and in the Swedish sample 1.74 (0.06) m; the mean height for women was 1.40 (0.07) m and 1.61 (0.05) m respectively for Guatemala and Sweden (Table II). There was a strong linear association between height and weight in men (weighted r= 0.79; p < 0.001) and women (weighted r = 0.73; p = 0.01). However, the Mediterranean samples [Italy (n = 2), Greece (n = 1), and Greeks living in Australia (n= 1)] showed relatively greater weight for height.

[TABULAR DATA II OMITTED]

BMI: Women had a higher mean BMI and standard deviation than men in most samples (Table II), which may reflect greater variability in weight among women. The highest mean BMI was generally found in the samples of Mediterranean origin, as expected from the data presented in Table II. Mean BMI was highest among Australian women of Greek origin [30.7 (5.1)] and women in Barbados [29.2 (6.9)].

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Weight, height and body mass index distributions in geographically and ethnically diverse samples of older persons

Age and Ageing, July, 1996 by Lenore J. Launer, Tamara Harris

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