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BMI, calculated based on self-reported height and body weight, was classified into five categories: &lt;18.5, 18.5\u201321.4, 21.5\u201324.9, 25.0\u201327.4, and \u226527.5\u2009kg\/m<jats:sup>2<\/jats:sup>. Frailty was assessed using the validated Kihon Checklist. The relationships between BMI and disability and mortality were analysed using multivariate Cox proportional hazards models and Laplace regression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>During the 5.3-year median follow-up period (45472 person-years), 2348 (22.9%) incidences of disabilities occurred. After adjusting for confounders, including medical history and lifestyle, individuals in the lowest and highest BMI categories had a higher hazard ratio (HR) of disability [&lt;18.5\u2009kg\/m<jats:sup>2<\/jats:sup>: HR: 1.31, confidence interval (CI): 1.16\u20131.49; \u226527.5\u2009kg\/m<jats:sup>2<\/jats:sup>: HR: 1.27, 95% CI: 1.08\u20131.49, <jats:italic>p<\/jats:italic> for non-linearity &lt;0.001] compared with that of those with BMI\u2009=\u200921.5\u201324.9\u2009kg\/m<jats:sup>2<\/jats:sup>. In the 50th percentile differences in age at overall and disability-free survival, participants with BMI\u2009&lt;\u200918.5\u2009kg\/m<jats:sup>2<\/jats:sup> were more likely to die before disability incidence [survival with disability (overall survival \u2013 disability-free survival): \u221210.2 months]; those with BMI\u2009\u2265\u200927.5\u2009kg\/m<jats:sup>2<\/jats:sup> had longer survival with disability (12.5 months). These relationships were more marked in the frailty-stratified model, where in the BMI\u2009\u2265\u200927.5\u2009kg\/m<jats:sup>2<\/jats:sup> group, individuals with frailty survived longer with disability (27.2 months) than did individuals without frailty (6.2 months).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Higher BMI is associated with a longer duration of survival with disability among older adults, especially in those with frailty. Therefore, reversing frailty should be prioritised because individuals with frailty have a shorter probability of disability-free survival than do individuals without frailty, regardless of BMI.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41366-024-01681-6","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T09:12:04Z","timestamp":1731661924000},"page":"348-356","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Is a higher body mass index associated with longer duration of survival with disability in frail than in non-frail older adults?"],"prefix":"10.1038","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5644-1428","authenticated-orcid":false,"given":"Daiki","family":"Watanabe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2304-6872","authenticated-orcid":false,"given":"Tsukasa","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misaka","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"key":"1681_CR1","doi-asserted-by":"publisher","first-page":"e96","DOI":"10.1016\/S2666-7568(20)30059-3","volume":"2","author":"JM Blodgett","year":"2021","unstructured":"Blodgett JM, Rockwood K, Theou O. 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