Height loss starting in middle age predicts increased mortality in the elderly

Masunari N, Fujiwara S, Kasagi F, Takahashi I, Yamada M, Nakamura T
J Bone Miner Res 2012 (January); 27(1):138-45
doi:10.1002/jbmr.513

Abstract

The purpose of this study was to determine the mortality risk among Japanese men and women with height loss starting in middle age, taking into account lifestyle and physical factors. A total of 2498 subjects (755 men and 1743 women) aged 47 to 91 years old underwent physical examinations during the period 1994 to 1995. Those individuals were followed for mortality status through 2003. Mortality risk was estimated using an age-stratified Cox proportional hazards model. In addition to sex, adjustment factors such as radiation dose, lifestyle, and physical factors measured at the baseline—including smoking status, alcohol intake, total cholesterol, blood pressure, and diagnosed diseases—were used for analysis of total mortality and mortality from each cause of death. There were a total of 302 all-cause deaths, 46 coronary heart disease and stroke deaths, 58 respiratory deaths including 45 pneumonia deaths, and 132 cancer deaths during the follow-up period. Participants were followed for 20,787 person-years after baseline. Prior history of vertebral deformity and hip fracture were not associated with mortality risk. However, more than 2 cm of height loss starting in middle age showed a significant association with all-cause mortality among the study participants (HR  =  1.76, 95% CI 1.31 to 2.38, p  =  0.0002), after adjustment was made for sex, attained age, atomic-bomb radiation exposure, and lifestyle and physical factors. Such height loss also was significantly associated with death due to coronary heart disease or stroke (HR  =  3.35, 95% CI 1.63 to 6.86, p =  0.0010), as well as respiratory-disease death (HR  =  2.52, 95% CI 1.25 to 5.22, p  =  0.0130), but not cancer death. Continuous HL also was associated with all-cause mortality and CHD- or stroke-caused mortality. Association between height loss and mortality was still significant, even after excluding persons with vertebral deformity. Height loss of more than 2 cm starting in middle age was an independent risk factor for cardiovascular and respiratory-disease mortality among the elderly, even after adjusting for potential risk factors. Reproduced from J Bone Miner Res 2012; 27:138–45 with permission of the American Society for Bone and Mineral Research.