Waist circumference may be a better indicator of premature death risk in older adults than body mass index, according to a new long-term study.
Researchers analyzed health data from 6,905 people aged 65 and older over a 13-year period between 2011 and 2024. Their findings were published in the Journal of the American Geriatrics Society.
The study compared body mass index, which evaluates weight relative to height, with waist measurement, which gauges fat accumulated around the abdomen. Investigators found that an enlarged waist circumference was associated with a higher risk of death regardless of a person's overall body mass index.
For men with an increased waist measurement, the risk of premature death was 24 percent higher. A similar pattern of elevated mortality risk was observed among women with larger waistlines.
Fat distribution and mortality risk
By contrast, having a high body mass index on its own was not linked to an increased risk of dying early. Researchers noted that the most unfavorable health outcome occurred when an individual maintained a normal body mass index but carried an enlarged waist circumference.
Body mass index has long served as a standard clinical tool to classify individuals as underweight, normal weight, overweight, or obese. However, the calculation relies strictly on height and weight, meaning it cannot distinguish between muscle mass and fat or identify where fat is stored.
Visceral fat and health risks
The authors concluded that relying solely on height and weight measurements is insufficient when evaluating the health of older adults. Measuring waist circumference provides a clearer assessment of mortality risks because it reflects the accumulation of visceral fat.
Visceral fat builds up deep inside the abdominal cavity around internal organs. Unlike subcutaneous fat beneath the skin, visceral fat is closely linked to heart disease, vascular conditions, and metabolic disorders.
The Journal of the American Geriatrics Society is a peer-reviewed medical publication focusing on clinical care and research in aging populations. The findings suggest that monitoring waist size alongside standard weight checks could help healthcare providers better identify mortality risks in elderly patients.
