The aim of this study was to examine the association between body mass index and weight changes on disability transitions and mortality among Brazilian older adults. Longitudinal data from the Health, Well-Being, and Aging in Latin America and the Caribbean Study conducted in S？o Paulo, Brazil (2000 and 2006), were used to examine the impact of obesity on disability and mortality and of weight changes on health transitions related to disability. Logistic and multinomial regression models were used in the analyses. Individuals who were obese were more likely than those of normal weight to have limitations on activities of daily living (ADL), instrumental activity of daily living (IADL), and Nagi's limitations. Obesity was associated with higher incidence of ADL and IADL limitations and with lower recovery from Nagi's limitations. Compared to those who maintained their weight, those who gained weight experienced higher incidence of ADL and Nagi's limitations, even after controlling for initial body mass index. Higher mortality among overweight individuals was only found when the reference category was “remaining free of Nagi limitations.” The findings of the study underline the importance of maintaining normal weight for preventing disability at older ages. 1. Introduction Brazil is among the 25 countries in the world with the fastest aging rates [1, 2]. In 1950, 2.6 million (4.9%) Brazilians were older than 60？years of age, and this number has increased to 20.6 million people (10.8%) according to the 2010 census [3]. Improvements in medical care and living standards have been shown to translate into higher life expectancy. In 1950, for example, life expectancy at birth in Brazil was 50.9？years, but the figure increased to 72.2？years in 2010 [3]. However, the number of disabled people is expected to increase in the coming years, given the rapid growth rate of the elderly population and the rise in the prevalence of obesity and chronic diseases [4]. Fast changes in the population’s nutritional intake that have occurred in Brazil in recent decades [5] have resulted in an increase in the prevalence of obesity [6, 7]. In the past three decades, obesity rates in Brazil tripled among men and almost doubled among women [6]. With the exception of higher-income urban women [8], the prevalence of obesity is higher among women than among men. Few studies focus on the impact of BMI on mortality and disability in the Latin American and the Caribbean (LAC) region. Based on the baseline for the Health, Well-Being, and Aging in Latin America and the Caribbean Study
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