The association of weight change and all-cause mortality in older adults: a systematic review and meta-analysis
Open accessAbstract
Objective: there may be age-related differences in the impact of weight change on health. This study systematically reviewed the evidence on the relationship between weight change and all-cause mortality in adults aged 65 years and older. Methods: MEDLINE, EMBASE and CINAHL were searched from inception to 11 June 2020, PROSPERO CRD 42019142268. We included observational studies reporting on the association between weight change and all-cause mortality in older community-dwelling adults. A random-effects meta-analysis was performed to calculate pooled hazard ratios and scored based on the Agency for Healthcare Research and Quality guidelines. Results: a total of 30 studies, including 1,219,279 participants with 69,255 deaths, demonstrated that weight loss was associated with a 59% increase in mortality risk (hazard ratio (HR): 1.59; 95% confidence interval (CI): 1.45–1.74; P < 0.001). Twenty-seven studies that reported outcomes for weight gain (1,210,116 participants with 65,481 deaths) indicated that weight gain was associated with a 10% increase in all-cause mortality (HR: 1.10; 95%CI: 1.02, 1.17; P = 0.01). Four studies investigated weight fluctuation (2,283 events among 6,901 participants), which was associated with a 63% increased mortality risk (HR: 1.66; 95%CI: 1.28, 2.15). No evidence of publication bias was observed (all P > 0.05). Conclusion: for community-dwelling older adults, weight changes (weight loss, gain or weight fluctuation) are associated with an increased risk of all-cause mortality risk relative to stable weight. Further research is needed to determine whether these associations vary depending upon initial weight, and whether or not the weight loss/gain was intentional.
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A meta-analysis of observational studies in older adults found weight loss was associated with a 59% increase in mortality risk.
“A meta-analysis of observational studies in older adults raised concerns regarding weight loss and mortality outcomes. Weight loss was associated with a 59% increase in mortality risk.”
From Obesity pharmacotherapy in older adults: a narrative review of evidence (2025) · cites this paper as [63]
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Obesity pharmacotherapy in older adults: a narrative review of evidence
Henney, A. E., Wilding, J. P. H., Alam, U., & Cuthbertson, D. J. (2025) · International Journal of Obesity · doi:10.1038/s41366-024-01529-z · Cited by 51 · see citing works
- Authors
- Alharbi, T. A., Paudel, S., Gasevic, D., Ryan, J., Freak-Poli, R., & Owen, A. J.
- Affiliations
- Monash University (AU)
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Inserm (FR)
- Corresponding author
- Owen, Alice J
- Venue
- Age and Ageing
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-11-07
- Volume
- 50
- Issue
- 3
- Pages
- 697-704
- ISSN
- 0002-0729 (ISSN-L)
- 1468-2834
- OpenAlex
- W3104198073
- Cited by
- 80
- References
- 30
- Citations by year
- 2026: 12 · 2025: 17 · 2024: 19 · 2023: 17 · 2022: 13 · 2021: 2
- FWCI
- 1.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Age and Ageing (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Own your potential (DEAKIN) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Health & Medical Research Dementia Leader (APP1135727)
- Australian Heart Foundation (101927)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- weight change, weight loss, weight gain, weight variation, all-cause mortality, older adults, community-dwelling older adults, mortality risk
- MeSH terms
- Aged, Humans, Weight Gain, Weight Loss, Proportional Hazards Models, Independent Living
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