Overweight Older Adults Have Lower Mortality After Elective Surgery

Background: Elevated body mass index (BMI) is traditionally associated with higher postoperative morbidity and mortality, leading to recommendations for preoperative weight reduction before elective surgeries. However, in older adults, age-related physiological changes such as sarcopenia, fat redistribution, and loss of height may alter the relationship between BMI and surgical risk. There is also growing evidence that a somewhat higher BMI may be associated with lower mortality in the elderly populations. Objective: To evaluate the association between BMI and all-cause mortality among older adults undergoing major elective surgery. Design: Cohort study. Participants/Methods: The authors included 414 adults aged ≥65 years who had preoperative evaluation followed by major elective surgery at the University of California Los Angeles between February 2019 and January 2022. Mean age of participants was about 76 years, and approximately 55% were women. BMI was typically categorized as more...