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Waist Circumference and All-Cause Mortality among Older Adults in Rural Indonesia

Author

Listed:
  • Cahya Utamie Pujilestari

    (Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, 90187 Umeå, Sweden)

  • Lennarth Nyström

    (Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, 90187 Umeå, Sweden)

  • Margareta Norberg

    (Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, 90187 Umeå, Sweden)

  • Nawi Ng

    (Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, 90187 Umeå, Sweden)

Abstract

Waist circumference, a measure of abdominal obesity, is associated with all-cause mortality in general adult population. However, the link between abdominal obesity with all-cause mortality in the studies of older adults is unclear. This study aims to determine the association between waist circumference and all-cause mortality in older adults in Indonesia. The association between waist circumference and all-cause mortality was examined in 10,997 men and women aged 50 years and older, in the World Health Organization (WHO) and International Network of field sites for continuous Demographic Evaluation of Populations and their Health in developing countries (INDEPTH) collaboration Study on global AGEing and adult health (SAGE) in Purworejo District Central Java, Indonesia during 2007–2010. Multivariate Cox regression analysis with restricted cubic splines was used to assess the non-linear association between waist circumference and all-cause mortality. During the 3-year follow-up, a total of 511 men and 470 women died. The hazard ratio plot shows a pattern of U-shape relationship between waist circumference and all-cause mortality among rich women, though the result was significant only for women in the lower end of waist circumference distribution ( p < 0.05). Poor men with a low waist circumference (5th percentile) have a two times higher mortality risk (HR = 2.1; 95% CI = 1.3, 3.3) relative to those with a waist circumference of 90 cm. Poor women with a low waist circumference (25th percentile) have a 1.4 times higher mortality risk (HR = 1.4; 95% CI = 1.1, 1.8) relative to those with a waist circumference of 80 cm. This study shows a significant association between low waist circumference measure and mortality, particularly among poor men and women. Though the association between large waist circumference and mortality was not significant, we observed a trend of higher mortality risk particularly among rich women with large waist circumference measure. Public health intervention should include efforts to improve nutritional status among older people and promoting healthy lifestyle behaviours including healthy food and active lifestyle.

Suggested Citation

  • Cahya Utamie Pujilestari & Lennarth Nyström & Margareta Norberg & Nawi Ng, 2019. "Waist Circumference and All-Cause Mortality among Older Adults in Rural Indonesia," IJERPH, MDPI, vol. 16(1), pages 1-13, January.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:1:p:116-:d:194713
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    References listed on IDEAS

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