The Impact of Obesity on LTC Disability and Mortality: Population Estimates from the National Long Term Care Survey

Eric Stallard, Duke University

Purpose: To estimate the impact of obesity on LTC disability and mortality above age 65 using the 2004 NLTCS with LTC disability based on the HIPAA ADL and CI Triggers. Methods: Self-reported height and weight yielded three measures of BMI: current, age 50, and one year prior; with standard cutpoints <18.5, 18.5–24.9, 25.0–29.9, 30.0–34.9, and 35+. Relative risks were assessed using odds-ratios and combinations using the Mantel-Haenzel procedure. Results: High current BMI is associated with increased current and lifetime disability among elderly persons; but not with increased mortality or a reduction in residual life expectancy among elderly persons. Obesity is associated with an increase in lifetime disability among elderly persons on the order of 50–60%. Conclusions: The impact of BMI varies over age in a manner consistent with a complex multistage/multi-path disablement process involving, e.g., diabetes and cardiovascular diseases, as intermediate stages.