Psychological impact of body mass index changes in older adults: a 12-year longitudinal study
5 affiliations
- 1Department of Health Promotion and Health Education, National Taiwan Normal University, No. 162, Sec. 1, Heping E. Rd., Da’an Dist., Taipei, 106209 Taiwan
- 2Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- 3University of Taipei, Taipei, Taiwan
- 4Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
- 5Institute of Environmental Engineering and Management, National Taipei University of Technology, Taipei, Taiwan
Abstract
Background: Significant changes in body mass index (BMI) may be associated with psychological distress, particularly in older adults. However, few longitudinal studies have examined this relationship over time. This study aimed to investigate the association between BMI changes and psychological distress assessed repeatedly among community-dwelling older adults in Taiwan.
Methods: This 12-year prospective cohort study included 70,570 adults aged ≥ 65 years who participated in the Taipei City Government’s annual physical examination program between 2005 and 2016. BMI changes were classified relative to baseline (Definition 1) and prior follow-up measurements (Definition 2). Psychological distress was assessed using the Brief Symptom Rating Scale (BSRS-5). Multivariable generalized estimating equation (GEE) models were used to evaluate associations between BMI changes and psychological distress. Sensitivity analyses included a Cox proportional-hazards model treating incident psychological distress (first BSRS-5 ≥ 6) as the outcome, with BMI change as a time-varying covariate, and a lagged model relating BMI change to distress at the subsequent examination.
Results: Under both definitions, participants with major weight loss (> 10%) had the highest risk of psychological distress (Definition 1: adjusted odds ratio [aOR] = 1.90, 95% confidence interval [CI]: 1.77–2.04; Definition 2: aOR = 1.96, 95% CI: 1.80–2.14). Minor weight loss (5%–10%) also increased the risk (Definition 1: aOR = 1.60, 95% CI: 1.52–1.68; Definition 2: aOR = 1.52, 95% CI: 1.44–1.60). Minor and major weight gains were associated with elevated but comparatively lower risks. In sensitivity analyses, the association between weight loss and psychological distress remained significant and dose-dependent, although attenuated; associations with weight gain were not robust.
Conclusion: Weight loss was consistently and dose-dependently associated with psychological distress in older adults and may serve as an early marker of declining health. Regular monitoring of weight change, rather than static weight status, may help prompt timely mental-health screening and nutritional or psychosocial assessment in this population.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12877-026-08050-0.
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BibTeX
@article{chou2026psychological,
title = {{Psychological impact of body mass index changes in older adults: a 12-year longitudinal study}},
author = {Yi-Chang Chou and Feng-Shiang Cheng and Shih-Han Weng and Chih-Hao Tseng and Hsiao-Yun Hu and Chieh-Hsing Liu},
journal = {BMC Geriatrics},
year = {2026},
month = jul,
doi = {10.1186/s12877-026-08050-0},
url = {https://doi.org/10.1186/s12877-026-08050-0},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Psychological impact of body mass index changes in older adults: a 12-year longitudinal study
AU - Yi-Chang Chou
AU - Feng-Shiang Cheng
AU - Shih-Han Weng
AU - Chih-Hao Tseng
AU - Hsiao-Yun Hu
AU - Chieh-Hsing Liu
PY - 2026
DA - 2026/07/29
JO - BMC Geriatrics
DO - 10.1186/s12877-026-08050-0
UR - https://doi.org/10.1186/s12877-026-08050-0
AB - Background: Significant changes in body mass index (BMI) may be associated with psychological distress, particularly in older adults. However, few longitudinal studies have examined this relationship over time. This study aimed to investigate the association between BMI changes and psychological distress assessed repeatedly among community-dwelling older adults in Taiwan. Methods: This 12-year prospective cohort study included 70,570 adults aged ≥ 65 years who participated in the Taipei City Government’s annual physical examination program between 2005 and 2016. BMI changes were classified relative to baseline (Definition 1) and prior follow-up measurements (Definition 2). Psychological distress was assessed using the Brief Symptom Rating Scale (BSRS-5). Multivariable generalized estimating equation (GEE) models were used to evaluate associations between BMI changes and psychological distress. Sensitivity analyses included a Cox proportional-hazards model treating incident psychological distress (first BSRS-5 ≥ 6) as the outcome, with BMI change as a time-varying covariate, and a lagged model relating BMI change to distress at the subsequent examination. Results: Under both definitions, participants with major weight loss (> 10%) had the highest risk of psychological distress (Definition 1: adjusted odds ratio [aOR] = 1.90, 95% confidence interval [CI]: 1.77–2.04; Definition 2: aOR = 1.96, 95% CI: 1.80–2.14). Minor weight loss (5%–10%) also increased the risk (Definition 1: aOR = 1.60, 95% CI: 1.52–1.68; Definition 2: aOR = 1.52, 95% CI: 1.44–1.60). Minor and major weight gains were associated with elevated but comparatively lower risks. In sensitivity analyses, the association between weight loss and psychological distress remained significant and dose-dependent, although attenuated; associations with weight gain were not robust. Conclusion: Weight loss was consistently and dose-dependently associated with psychological distress in older adults and may serve as an early marker of declining health. Regular monitoring of weight change, rather than static weight status, may help prompt timely mental-health screening and nutritional or psychosocial assessment in this population. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12877-026-08050-0.
SN - 1471-2318
ER -