Objective: To determine (1) whether obese older adults had higher prevalence of falls and ambulatory stumbling, impaired balance and lower health-related quality of life (HRQL) than their normal weight counterparts, and (2) whether the falls and balance measures were associated with HRQL in obese adults. Methods:Subjects who had a body mass index (BMI) greater than 30 kg/m 2 were classified into an obese group (n = 128) while those with BMI between 18.5 and 24.9 kg/m 2 were included into a normal weight group (n = 88). Functional tests were performed to assess balance, and questionnaires were administered to assess history of falls, ambulatory stumbling, and HRQL. Results:The obese group reported a higher prevalence of falls (27% vs. 15%), and ambulatory stumbling (32% vs. 14%) than the normal weight group. Furthermore, the obese group had lower HRQL, (p ≤ 0.05) for physical function (63 ± 27 vs. 75 ± 26; mean ± SD), role-physical (59 ± 40 vs. 74 ± 37), vitality (58 ± 23 vs. 66 ± 20), bodily pain (62 ± 25 vs. 74 ± 21) and general health (64 ± 19 vs. 70 ± 18). In the obese group, a history of falls was related (p ≤ 0.05) to lower scores in 4 domains of HRQL, and ambulatory stumbling was related (p ≤ 0.01) to 7 domains. Conclusion:In middle-aged and older adults, obesity was associated with a higher prevalence of falls and stumbling during ambulation, as well as lower values in multiple domains of HRQL. Furthermore, a history of falls and ambulatory stumbling were related to lower measures of HRQL in obese adults.

Background: Physical activity is associated with health-related quality of life (HRQL) in clinical populations, but less is known whether this relationship exists in older men and women who are healthy. Thus, this study determined if physical activity was related to HRQL in apparently healthy, older subjects.

Abstract:The objective of this study was to determine whether differences in large and small arterial compliance existed among normal weight, overweight, and obese older men and women, and whether large and small arterial compliance were associated with abdominal, hip, and subcutaneous fat distribution. A total of 134 individuals who were 40 years of age and older (age ϭ 62 Ϯ 11 years; mean Ϯ SD) were grouped into normal weight (BMI: 18.5-24.9 kg/m 2 ; n ϭ 33), overweight (BMI: 25.0-29.9 kg/m 2 ; n ϭ 48), or obese (BMI: Ն30.0 kg/m 2 ; n ϭ 53) categories. The hemodynamic and arterial compliance measurements were obtained using the HDI/PulseWave CR-2000 CardioVascular Profiling System (Hypertension Diagnostics, Inc). Body mass index, nine-site sum of skinfolds, and circumference measures around the hip and waist were used for analysis. Large and small arterial compliance was lower (p Ͻ 0.001) in the obese group (12.4 Ϯ 4.8 ml/mmHg ϫ 10 vs 4.6 Ϯ 2.5 ml/mmHg ϫ 100, respectively) than the normal weight (16.2 Ϯ 4.9 ml/mmHg ϫ 10 vs 5.5 Ϯ 2.7 ml/mmHg ϫ 100) and overweight (15.2 Ϯ 4.3 ml/mmHg ϫ 10 vs 5.0 Ϯ 2.2 ml/mmHg ϫ 100) groups. This difference remained (p Ͻ 0.001) after adjusting for body surface area, sex, hyperlipidemia, and hypertension. Additionally, large arterial compliance correlated (p Ͻ 0.05) with sum of skinfolds (r ϭ Ϫ 0.209), while small arterial compliance correlated with hip circumference (r ϭ Ϫ 0.189). Arterial compliance measures were not related (p Ͼ 0.05) to waist circumference or waist-to-hip ratio. In conclusion, obesity was associated with a decrease in large and small arterial compliance independent of conventional risk factors. Additionally, subcutaneous fat and fat around the hips were inversely related to arterial compliance.

The effects of acute exercise on arterial compliance in older adults are unknown. Large and small arterial compliance were assessed during and 24 h following a 30 min bicycle ergometer test, and on a non-exercise, control condition. The change in large artery compliance was similar between the exercise and non-exercise conditions (p = 0.876). Small artery compliance during the exercise day was higher than the non-exercise day at 45, 60, and 75 min following exercise (p < 0.001), was 17% higher 30 min post-exercise than at rest (p < 0.001), and decreased by 20% between 30 min (4.5 ± 0.4 ml/mmHg x 100) and 120 min (3.6 ± 0.3 ml/mmHg x 100) after exercise (p = 0.027). The current study shows 30 min of moderate-intensity exercise transiently increases small arterial compliance 30 min after exercise, but does not elicit more sustained increases in either large or small arterial compliance.

The purpose of this study was to examine the effects of metabolic syndrome (MS) features on arterial elasticity of the large and small arteries in apparently healthy adults, to examine the effect of clustered features of MS, and to determine which features are most predictive of large and small artery elasticity. The subjects for this study consisted of 126 men and women, age 45 years and older. The subjects rested supine while pulse contour analysis was measured from the radial artery by using an HDI/Pulsewave CR-2000 instrument (Hypertension Diagnostic, Inc) to assess arterial elasticity in the large and small arteries. Medical history was obtained along with body mass index, waist circumference, body surface area, and blood pressure. Large artery elasticity was lower (p = 0.002) in subjects with hypertension (12.7 ±4.3 mL/mm Hg × 10) than in those with normotension (15.0 ±4.2 mL/mm Hg × 10; mean ± SD), and small artery elasticity was lower (p = 0.001) as well (3.9 ±2.3 mL/mm Hg × 100 vs 5.3 ±2.5 mL/mm Hg × 100). Large artery elasticity was lower (p = 0.02) in obese subjects (12.2 ±4.9 mL/mm Hg × 10) than in nonobese subjects (14.2 ±4.5 mL/mm Hg × 10), and large artery elasticity was lower (p = 0.04) in subjects with abdominal obesity (12.2 ±4.5 mL/mm Hg × 10) than in those without (14.5 ±4.8 mL/mm Hg × 10). Large artery elasticity decreased as the number of features of MS increased (p <0.01). Multiple regression showed that body mass index and the presence of hypertension were predictors of large artery elasticity (R = 0.61, R 2 = 0.37, p = 0.003, SEE = 3.60 mL/mm Hg × 10), and hypertension was a predictor of small artery elasticity (R = 0.53, R 2 = 0.28, p = 0.001, SEE = 2.12 mL/mm Hg × 100). Hypertension and obesity are the features of MS that are most predictive of impairment in large and small artery elasticity in apparently healthy middle-aged and older adults. Furthermore, impairment in large artery elasticity is more evident in subjects with at least three features of MS.