Associations between Body Mass Index and Subjective Health Outcomes among Older Adults: Findings from the Yilan Study, Taiwan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Subjects
2.2. Measurements
2.2.1. Demographic Characteristics
2.2.2. Anthropometrical Assessments
2.2.3. Medical Conditions, HRQoL, Self-rated Health and Self-rated Happiness
2.3. Procedure
2.3.1. Ethical Statement
2.3.2. Data Collection
2.4. Statistical Analysis
3. Results
3.1. Participants’ Demographic Characteristics
3.2. Participants’ Medical Conditions by BMI Category
3.3. HRQoL, Self-rated Health and Self-rated Happiness Scores by BMI Categories
3.4. Unadjusted Analysis of Associations between Independent Variables and Scores of PCS, MCS, Self-Rated Health and Self-Rated Happiness
3.5. Hierarchical Regression Models for the Associations between BMI Categories and HRQoL PCS, MCS, Self-Rated Health and Self-Rated Happiness
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristic | Total | Men | Women | p-Value |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
Total | 3722 (100) | 1611 (43.3) | 2111 (56.7) | <0.001 |
Age, years | ||||
65–74 | 1912 (51.4) | 732 (45.4) | 1180 (55.9) | |
75–84 | 1443 (38.8) | 668 (41.5) | 775 (36.7) | |
≥85 | 367 (9.9) | 211 (13.1) | 156 (7.4) | |
BMI category | 0.009 | |||
Underweight | 164 (4.4) | 73 (4.5) | 91 (4.3) | |
Normal weight | 1500 (40.3) | 674 (41.8) | 826 (39.1) | |
Overweight | 1154 (31.0) | 517 (32.1) | 637 (30.2) | |
Obese | 904 (24.3) | 347 (21.5) | 557 (26.4) | |
Educational level | <0.001 | |||
Illiterate | 740 (19.9) | 136 (8.5) | 604 (28.7) | |
Literate/Elementary school | 1605 (43.1) | 642 (40.1) | 963 (45.7) | |
Junior or senior high school | 958 (25.7) | 512 (32.0) | 446 (21.2) | |
University or above | 403 (10.8) | 311 (19.4) | 92 (4.4) | |
Living status | <0.001 | |||
Living alone | 276 (7.4) | 82 (5.1) | 194 (9.2) | |
Living with others | 3445 (92.0) | 1529 (94.9) | 1916 (90.8) | |
Personal characteristics | <0.001 | |||
Smoking | ||||
Nonsmoker | 2826 (75.9) | 767 (47.6) | 2059 (97.5) | |
Former smoker | 541 (14.5) | 523 (32.5) | 18 (0.9) | |
Current smoker | 355 (9.5) | 321 (19.9) | 34 (1.6) | |
Alcohol use | <0.001 | |||
Nondrinker | 3031 (81.4) | 1020 (63.3) | 2011 (95.3) | |
Former drinker | 191 (5.1) | 180 (11.2) | 11 (0.5) | |
Current drinker | 355 (9.5) | 411 (25.5) | 89 (4.2) | |
Volunteering | 0.844 | |||
Yes | 432 (11.6) | 189 (11.8) | 243 (11.6) | |
No | 3260 (87.6) | 1410 (88.2) | 1850 (88.4) |
Medical Condition | BMI Category | p-Value | ||||
---|---|---|---|---|---|---|
Total n (%) | Underweight (n = 164) n (%) | Normal Weight (n = 1499) n (%) | Overweight (n = 1153) n (%) | Obese (n = 904) n (%) | ||
Hypertension | <0.001 | |||||
Count | 2086 (56.0) | 63 (38.4) | 714 (47.6) | 692 (60.0) | 617 (68.3) | |
Diabetes mellitus | <0.001 | |||||
Count | 866 (23.3) | 18 (11.0) | 272 (18.1) | 283 (24.5) | 293 (32.4) | |
Heart disease | <0.001 | |||||
Count | 1132 (30.4) | 40 (24.4) | 410 (27.5) | 363 (31.5) | 319 (35.5) | |
Stroke | 0.561 | |||||
Count | 167 (4.5) | 8 (4.9) | 67 (4.5) | 44 (3.8) | 48 (5.3) |
Subjective Health Outcomes | All Participants | BMI Category | p-Value for Wald Test | |||
---|---|---|---|---|---|---|
Underweight | Normal Weight | Overweight | Obese | |||
Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | ||
HRQoL (SF-12 v2) (n = 3699) | ||||||
PCS | 47.7 (8.9) | 46.4 (10.5) | 48.2 (8.9) | 48.2 (8.5) | 46.6 (8.8) a,b | <0.001 |
MCS | 58.3 (7.6) | 56.6 (8.3) b,c | 57.8 (8.1) b,c | 58.8 (7.7) a,d | 58.9 (7.4) a,d | <0.001 |
Self-rated health (n = 3640) | 69.3 (12.3) | 67.5 (13.0) | 69.6 (12.3) | 69.8 (12.3) | 68.6 (12.0) | 0.029 |
Self-rated happiness (n = 3610) | 74.4 (14.3) | 71.8 (14.0) b | 73.9 (14.7) | 75.1 (13.9) d | 74.7 (14.1) | 0.015 |
Variable | Model for PCS | Model for MCS | Model for Self-Rated Health | Model for Self-Rated Happiness | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
(n = 3643) | (n = 3643) | (n = 3585) | (n = 3562) | |||||||||
B | 95% CI | p-Value | B | 95% CI | p-Value | B | 95% CI | p-Value | B | 95% CI | p-Value | |
BMI, kg/m2 | ||||||||||||
Underweight | −1.80 | −3.23 to −0.37 | 0.014 | −1.19 | −2.46 to 0.08 | 0.066 | −2.08 | −4.08 to −0.08 | 0.042 | −2.14 | −4.48 to 0.20 | 0.073 |
Normal weight | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | ||||
Overweight | − 0.05 | -0.73 to 0.63 | 0.895 | 1.01 | 0.41 to 1.62 | 0.001 | 0.26 | −0.70 to 1.22 | 0.593 | 1.22 | 0.10 to 2.34 | 0.032 |
Obese | −1.60 | −2.33 to − 0.87 | <0.0001 | 1.16 | 0.51 to 1.81 | <0.0001 | −0.96 | −0.98 to 0.07 | 0.067 | 0.83 | −0.36 to 2.03 | 0.173 |
Stroke | −7.88 | −9.25 to −6.50 | <0.0001 | −2.28 | −3.52 to −1.05 | <0.0001 | −3.49 | −5.44 to −1.54 | <0.0001 | −3.84 | −6.15 to −1.54 | .001 |
Heart diseases | −3.13 | −3.74 to −2.52 | <0.0001 | −1.31 | −1.86 to −0.76 | <0.0001 | −5.06 | −5.92 to −4.21 | <0.0001 | −3.25 | −4.26 to −2.23 | <0.0001 |
Diabetes | −1.99 | -2.66 to -1.32 | <0.0001 | −0.02 | 0.58 to 0.62 | 0.943 | −3.65 | −4.59 to −2.71 | <0.0001 | −1.51 | −2.62 to −0.41 | 0.007 |
Hypertension | −2.22 | −2.79 to −1.64 | <0.0001 | 0.11 | −0.40 to 0.62 | 0.676 | −3.49 | −4.29 to −2.69 | <0.0001 | −1.80 | −2.74 to −0.86 | <0.0001 |
Male sex | 0.68 | 0.10 to 1.25 | 0.021 | 0.83 | 0.32 to 1.34 | 0.001 | 1.47 | 0.67 to 2.28 | <0.0001 | 0.73 | −0.22 to 1.67 | 0.131 |
Age, years | ||||||||||||
65–74 | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | ||||
75–84 | −2.41 | −3.01 to −1.81 | <0.0001 | −0.73 | −1.27 to −0.19 | 0.008 | −1.06 | 1.91 to −0.21 | 0.015 | −1.63 | −2.62 to −0.63 | 0.001 |
≥85 | −4.46 | −5.44 to −3.48 | <0.0001 | −0.67 | −1.55 to 0.21 | 0.136 | 0.78 | −0.62 to 2.18 | 0.272 | −1.37 | −3.01 to 0.27 | 0.101 |
Education level | ||||||||||||
Illiterate | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | ||||
Literate/elementary | 2.11 | 1.34 to 2.87 | <0.0001 | 0.21 | −0.48 to 0.89 | 0.554 | 3.17 | 2.10 to 4.23 | <0.0001 | 3.7 | 2.45 to 4.94 | <0.0001 |
school | ||||||||||||
Junior or senior high | 3.57 | 2.73 to 4.41 | <0.0001 | 0.48 | −0.28 to 1.23 | 0.216 | 5.35 | 4.18 to 6.23 | <0.0001 | 5.47 | 4.10 to 6.84 | <0.0001 |
school | ||||||||||||
University or above | 3.79 | 2.73 to 4.86 | <0.0001 | 1.38 | 0.43 to 2.33 | 0.004 | 7.1 | 5.62 to 8.59 | <0.0001 | 7.88 | 6.14 to 9.61 | <0.0001 |
Living alone | −1.19 | −2.29 to −0.10 | 0.032 | −0.33 | −1.30 to 0.64 | 0.503 | 0.85 | −0.67 to 2.37 | .274 | 1.54 | −0.24 to 3.32 | 0.089 |
Volunteer | 3.49 | 2.61 to 4.37 | <0.0001 | 0.53 | −0.27 to 1.32 | 0.185 | 4.25 | 3.02 to 5.48 | <0.0001 | 5.56 | 4.15 to 7.03 | <0.0001 |
Alcohol | ||||||||||||
Nondrinker | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | ||||
Current drinker | 1.96 | 1.13 to 2.80 | <0.0001 | 1.64 | 0.90 to 2.39 | <0.0001 | 2.2 | 0.85 to 3.20 | 0.001 | 2.35 | 0.97 to 3.72 | 0.001 |
Former drinker | −1.22 | −2.52 to 0.08 | 0.065 | 0.83 | −0.31 to 1.98 | 0.158 | −0.40 | −2.24 to 1.43 | 0.668 | −0.50 | −2.63 to 1.63 | 0.643 |
Smoking | ||||||||||||
Nonsmoker | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | ||||
Current smoker | 0.67 | −0.31 to 1.65 | 0.177 | 0.26 | −0.47 to 0.93 | 0.485 | −0.77 | −0.61 to 2.14 | 0.276 | −0.96 | −2.57 to 0.64 | 0.24 |
Former smoker | −1.10 | −1.69 to −0.29 | 0.008 | 1.09 | 0.23 to 1.96 | 0.014 | −1.77 | −2.92 to −0.62 | 0.002 | −2.35 | −3.68 to −1.01 | 0.001 |
Variable | Model for PCS | Model for MCS | Model for Self-Rated Health | Model for Self-Rated Happiness | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
(n = 3643) | (n = 3643) | (n = 3585) | (n = 3562) | |||||||||
B | 95% CI | p-Value | B | 95% CI | p-Value | B | 95% CI | p-Value | B | 95% CI | p-Value | |
BMI, kg/m2 | ||||||||||||
Underweight | −1.31 | −2.67 to 0.05 | 0.059 | −1.02 | −2.29 to 0.25 | 0.116 | −2.88 | −4.81 to −0.95 | 0.003 | −2.30 | −4.61 to 0.004 | 0.05 |
Normal weight | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | ||||
Overweight | 0.20 | − 0.45 to 0.85 | 0.546 | 1.00 | 0.40 to 1.61 | 0.001 | 1.08 | 0.16 to 2.00 | 0.022 | 1.55 | 0.45 to 2.66 | 0.006 |
Obese | −0.97 | −1.68 to −0.26 | 0.007 | 1.22 | 0.60 to 1.88 | <0.0001 | −0.69 | −0.32 to 1.69 | 0.179 | 1.68 | 0.49 to 2.88 | 0.006 |
Stroke | −7.07 | −8.40 to −5.73 | <0.0001 | −2.24 | −3.48 to −0.99 | <0.0001 | −2.5 | −4.44 to −0.65 | 0.009 | −2.73 | −5.01 to −0.44 | 0.019 |
Heart diseases | −2.21 | −2.81 to −1.60 | <0.0001 | −1.28 | −1.84 to −0.71 | <0.0001 | −4.08 | −4.94 to −3.22 | <0.0001 | −2.46 | −3.49 to −1.43 | <0.0001 |
Diabetes | −1.22 | −1.88 to −0.57 | <0.0001 | 0.04 | −0.58 to 0.65 | 0.91 | −2.33 | −3.26 to −1.40 | <0.0001 | −0.82 | −1.93 to 0.29 | 0.148 |
Hypertension | −0.88 | −1.46 to −0.30 | 0.003 | 0.32 | −0.22 to 0.86 | 0.241 | −2.08 | −2.90 to −1.30 | <0.0001 | −0.95 | −1.92 to −0.03 | 0.058 |
Male sex | 0.95 | 0.20 to 1.70 | 0.013 | 0.51 | − 0.19 to 1.20 | 0.155 | 0.75 | − 0.32 to 1.81 | 0.168 | 0.11 | −1.16 to 1.38 | 0.864 |
Age, years | ||||||||||||
65–74 | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | ||||
75–84 | −1.64 | −2.23 to −1.05 | <0.0001 | −0.53 | −1.09 to 0.02 | 0.058 | 0.52 | −0.32 to 1.35 | 0.228 | −0.03 | −1.04 to 0.97 | 0.947 |
≥ 85 | −3.79 | −4.76 to −2.82 | <0.0001 | −0.20 | −1.10 to 0.70 | 0.664 | 2.27 | 0.27 to 3.65 | 0.001 | 0.44 | −1.20 to 2.09 | 0.598 |
Education level | ||||||||||||
Illiterate | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | ||||
Literate/elementary | 1.63 | 0.88 to 2.37 | <0.0001 | −0.000087 | −0.69 to 0.69 | 1.00 | 2.77 | 1.71 to 3.83 | <0.0001 | 3.57 | 2.31 to 4.83 | <0.0001 |
school | ||||||||||||
Junior or senior high | 2.52 | 1.67 to 3.37 | <0.0001 | 0.18 | −0.61 to 0.97 | 0.659 | 4.55 | 3.34 to 5.75 | <0.0001 | 5.07 | 3.62 to 6.51 | <0.0001 |
school | ||||||||||||
University or above | 2.27 | 1.17 to 3.38 | <0.0001 | 0.93 | −0.10 to 1.96 | 0.077 | 5.94 | 4.74 to 7.51 | <0.0001 | 7.36 | 5.49 to 9.23 | <0.0001 |
Living alone | −1.45 | −2.49 to −0.42 | 0.006 | −0.47 | −1.44 to 0.49 | 0.338 | 0.6 | −0.87 to 2.05 | 0.427 | 1.28 | −0.46 to 3.03 | 0.150 |
Volunteer | 2.36 | 1.51 to 3.21 | <0.0001 | 0.23 | −0.56 to 1.02 | 0.564 | 3.38 | 2.19 to 4.58 | <0.0001 | 4.56 | 3.13 to 5.99 | <0.0001 |
Alcohol | ||||||||||||
Nondrinker | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | ||||
Current drinker | 0.99 | 0.13 to 1.84 | 0.023 | 1.09 | 0.30 to 1.89 | 0.007 | 0.96 | − 0.26 to 2.18 | 0.122 | 1.98 | 0.52 to 3.43 | 0.008 |
Former drinker | −0.67 | −1.99 to 0.64 | 0.315 | 0.65 | −0.58 to 1.88 | 0.299 | −0.13 | −2.01 to 1.75 | 0.894 | 0.85 | − 1.38 to 3.09 | 0.455 |
Smoking | ||||||||||||
Nonsmoker | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | ||||
Current smoker | −0.34 | −1.37 to 0.70 | 0.525 | 0.57 | −0.40 to 1.54 | 0.246 | -0.3 | −0.78 to 1.18 | 0.692 | −1.61 | −3.37 to 0.17 | 0.074 |
Former smoker | −0.96 | −1.91 to −0.02 | 0.046 | −0.09 | −0.97 to 0.80 | 0.839 | −2.32 | −3.67 to −0.99 | 0.001 | −3.12 | −4.72 to −1.11 | <0.0001 |
Adjusted R2 | 0.118 | 0.02 | 0.096 | 0.058 |
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Chang, H.-T.; Hsu, N.-W.; Chen, H.-C.; Tsao, H.-M.; Lo, S.-S.; Chou, P. Associations between Body Mass Index and Subjective Health Outcomes among Older Adults: Findings from the Yilan Study, Taiwan. Int. J. Environ. Res. Public Health 2018, 15, 2645. https://doi.org/10.3390/ijerph15122645
Chang H-T, Hsu N-W, Chen H-C, Tsao H-M, Lo S-S, Chou P. Associations between Body Mass Index and Subjective Health Outcomes among Older Adults: Findings from the Yilan Study, Taiwan. International Journal of Environmental Research and Public Health. 2018; 15(12):2645. https://doi.org/10.3390/ijerph15122645
Chicago/Turabian StyleChang, Hsiao-Ting, Nai-Wei Hsu, Hsi-Chung Chen, Hsuan-Ming Tsao, Su-Shun Lo, and Pesus Chou. 2018. "Associations between Body Mass Index and Subjective Health Outcomes among Older Adults: Findings from the Yilan Study, Taiwan" International Journal of Environmental Research and Public Health 15, no. 12: 2645. https://doi.org/10.3390/ijerph15122645