Article

Obesity, Physical Function, and Mortality in Older Adults

Epidemiology and Public Health Group, Peninsula Medical School, Exeter, United Kingdom.
Journal of the American Geriatrics Society (Impact Factor: 4.22). 07/2008; 56(8):1474-8. DOI: 10.1111/j.1532-5415.2008.01813.x
Source: PubMed

ABSTRACT To estimate the effects of excess body weight on objective and subjective physical function and mortality risks in noninstitutionalized older adults.
Population-based cohort study.
The English Longitudinal Study of Ageing (ELSA).
Three thousand seven hundred ninety-three participants in the ELSA aged 65 and older followed up for 5 years.
Analyses compared the risks of impaired physical function and mortality for subjects who were at the recommended weight (body mass index (BMI)=20.0-24.9) with those who were overweight (BMI=25.0-29.9), obese (BMI=30.0-34.9) or severely obese (BMI>or=35.0). Outcome measures were difficulties with activities of daily living (ADLs), score on the Short Physical Performance Battery, and mortality.
Participants in higher BMI categories had greater risk of impaired physical function at follow-up but little or no greater risk of mortality. For example, compared with men of recommended weight, obese men (BMI=30.0-34.9) had relative risk ratios of difficulties with ADLs of 1.99 (95% confidence interval (CI)=1.42-2.78), of measured functional impairment of 1.51 (95% CI=1.05-2.16), and of mortality of 0.99 (95% CI=0.60-1.61). Findings were robust when excluding those who lost weight, smoked, or had poor self-rated health.
Excess body weight in people aged 65 and older is associated with greater risk of impaired physical function but not with greater mortality risk. Societies with growing numbers of overweight and obese older people are likely to face increasing burdens of disability-associated health and social care costs.

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    • "Accordingly, as compared to non-diabetic older adults, diabetic older adults reportedly experience a 9-year reduction in disability-free life expectancy (Andrade, 2010). Similarly, the relationship between obesity and physical function has been widely examined (Vincent et al., 2010; Coakley et al., 1998; Lang et al., 2008; Rejeski et al., 2010; Alley et al., 2008), and data show that high body weight and high BMI are associated with increased risk for functional impairment and disability. Functional impairments and disabilities in older adults can lead to a loss of independence (Mor et al., 1994), increased use of support services (Branch and Jette, 1982), hospitalization (Branch and Jette, 1981; Ostir et al., 2001), and mortality (Manton, 1988; Reuben and Siu, 1990). "
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    • "A total possible score of 12 was created using the sum of four possible points for tests of chair stands, gait speed, and standing balance. Functional limitation was defined as an SPPB score of less than 9 (21, 22). Subjects were first asked to balance in a standing position with their feet side by side, semi-tandem, and fully tandem for 10 sec each. "
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