BACKGROUND _ AIMS: A protective effect of @entity28 on @entity204 has been reported in the context of various co-morbidities. We studied if the @entity28 paradox applied to nursing home (NH) older residents according to @entity303 status. METHODS: Prospective data from 3741 NH residents from France. All-cause mortality was the dependent measure. Subjects were categorized according with body mass index (BMI) as underweight, normal-weight, overweight, and @entity28 . @entity303 status was obtained from medical charts. Cox regressions were performed. RESULTS: There were 344 (9.2%) residents who were underweight, 1367 (43.8%) normal weight, 1069 (28.6%) overweight and 691 (18.5%) @entity28 . 1083 (28.9%) @entity1 died during follow-up. In residents with @entity303 , mortality risk was reduced by almost half in overweight and @entity28 @entity1 (HRs of 0.60 [0.48-0.76] and 0.53 [0.38-0.75], respectively; p  <  0.001), and increased in underweight (HR  =  1.65 [1.29-2.12]; p  <  0.001) compared to normal-weight residents; moreover, each 1  kg/m(2) increase in BMI decreased the risk of @entity204 by 12% and 9% in underweight and normal-weight subjects with @entity303 . For @entity1 without @entity303 , mortality risk was reduced in overweight and @entity28 @entity1 (HRs of 0.80 [0.65-0.99], p  =  0.042, and 0.77 [0.60-0.99], p  =  0.044, respectively) compared to normal-weight; the 1-unit increase in BMI reduced the risk of @entity204 (23% reduction) only in underweight @entity1 . CONCLUSIONS: This study showed that the presence of @entity303 amplifies the @entity28 paradox in very old and functionally limited NH residents. Therefore, weight loss in NH residents, particularly in @entity1 with @entity303 , should be considered with extreme caution even for @entity28 @entity1 .

The prognostic value of body-mass index on mortality in older adults with XXXX living in nursing homes.

@entity303 :: ('MESH:D003704', 'Disease') :: ['Dementia', 'dementia'] @entity1 :: ('9606', 'Species') :: ['people'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity28 :: ('MESH:D009765', 'Disease') :: ['obese', 'obesity']
@entity303 :: (MESH:D003704,Disease) :: ['dementia']
