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Body mass index categories and anxiety symptoms among adults aged ≥ 50 years from low and middle income countries

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Summary

Background

Body weight may be a risk factor for anxiety; however, there is a scarcity of studies on this association in older adults especially from low and middle income countries (LMICs). Therefore, we investigated the association between body mass index (BMI) and anxiety symptoms among adults aged ≥ 50 years from 6 LMICs.

Methods

Cross-sectional, community-based, nationally representative data from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) were analyzed. The BMI was based on measured weight and height and was categorized as: < 18.5 kg/m2 (underweight), 18.5–24.9 kg/m2 (normal weight), 25.0–29.9 kg/m2 (overweight), 30.0–34.9 kg/m2 (obesity class I), 35.0–39.9 kg/m2 (obesity class II), and ≥ 40 kg/m2 (obesity class III). Anxiety symptoms referred to severe/extreme problems with worry or anxiety in the past 30 days. Multivariable logistic regression analysis was conducted.

Results

Data on 34,129 individuals aged ≥ 50 years (mean age 62.4 years, SD 16.0 years; 52.1% female) were analyzed. Overall, compared to normal weight, only underweight was significantly associated with anxiety symptoms (odds ratio, OR = 1.56; 95% confidence interval, CI = 1.26–1.95). Obesity class III (vs. normal weight) was associated with significantly increased odds for anxiety symptoms (OR = 4.15; 95%CI = 1.49–11.59) only among males.

Conclusion

In this large representative sample of older adults from LMICs, underweight was associated with anxiety symptoms in males and females. Class III obesity was associated with anxiety symptoms only in males. Future studies to shed light on the reason why severe obesity was associated with anxiety symptoms only among males in LMICs are needed.

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Acknowledgements

This paper uses data from the WHO Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263.

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Authors and Affiliations

  1. The Cambridge Center for Sport and Exercise Sciences, Anglia Ruskin University, CB1 1PT, Cambridge, UK

    Lee Smith

  2. Italian Agency for Development Cooperation—Khartoum, Khartoum, Sudan

    Damiano Pizzol

  3. Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK

    Guillermo F. López-Sánchez

  4. Suzanne Dworak Peck School of Social Work, University of Southern California, 1149 South Hill Street Suite 1422, 90015, Los Angeles, CA, USA

    Hans Oh

  5. Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain

    Louis Jacob & Ai Koyanagi

  6. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France

    Louis Jacob

  7. Department of Cancer Epidemiology and Prevention Research, University of Calgary, Calgary, Alberta, Canada

    Lin Yang

  8. Department of Medicine, Geriatrics Section, University of Palermo, Palermo, Italy

    Nicola Veronese

  9. Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Pinar Soysal

  10. School of Social Sciences, Nottingham Trent University, 50 Shakespeare St, NG1 4FQ, Nottingham, UK

    Daragh McDermott

  11. Faculty of Science and Engineering, Anglia Ruskin University, CB1 1PT, Cambridge, UK

    Yvonne Barnett & Laurie Butler

  12. ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain

    Ai Koyanagi

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  1. Lee Smith
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All authors have made a substantial, direct and intellectual contribution to the work. All authors have read and approved the final version of the manuscript and agree with the order of presentation of the authors.

Corresponding author

Correspondence to Lee Smith.

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Conflict of interest

L. Smith, D. Pizzol, G.F. López-Sánchez, H. Oh, L. Jacob, L. Yang, N. Veronese, P. Soysal, D. McDermott, Y. Barnett, L. Butler and A. Koyanagi declare that they have no competing interests.

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The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Table 3 Details on the diagnosis of chronic conditions
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Smith, L., Pizzol, D., López-Sánchez, G.F. et al. Body mass index categories and anxiety symptoms among adults aged ≥ 50 years from low and middle income countries. Wien Klin Wochenschr 135, 142–150 (2023). https://doi.org/10.1007/s00508-021-01954-4

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