Increases in Overweight and Obesity Prevalence and Changes in Disability-Free Survival in the United States

Ryan K. Masters , University of Colorado Boulder
Catherine Talbot, University of Colorado Boulder

Objectives: To estimate older-age survival differences by body mass index (BMI), and to estimate how increases in high BMI prevalence in the United States between 1990 and 2015 changed total and disability-free survival (DFS) rates to age 85. Methods: We estimated BMI-disability and BMI-mortality associations among female and male U.S. adult populations using NHANES 1988-1994 and 1999-2006 linked mortality files through 2015. We also simulated multistate life tables - three BMI levels, two disability statuses, two mortality statuses - to estimate how changes in prevalence of overweight and obesity among the U.S. female and male populations between 1990 and 2015 affected DFS from age 45 to age 85. Results: Compared to populations with low BMI, survival rates to age 85 are much lower among populations with overweight and obese BMI. Disability among these populations is also significantly higher. Among the U.S. male population, increases in high BMI from 1990 to 2015 are estimated to have reduced age 85 survival by 3.7% and to have reduced DFS by 4.7%. Among the U.S. female population, increases in high BMI are estimated to have reduced age 85 survival by 2.2% and to have reduced DFS by 3.4%. Discussion: The effects of rising obesity prevalence on older-age survival have likely been underestimated. Overweight BMI and obese BMI significantly reduce the probability of DFS to older adulthood, and recent increases in overweight and obese BMI prevalence in the United States likely have reduced American men's and women's DFS rates to older adulthood.

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 Presented in Session P2. Health, Mortality, Ageing - Aperitivo