Adult Obesity and the Burden of Disability throughout Life

Peeters, Anna; Bonneux, Luc; Nusselder, Wilma; Laet, Chris De; Barendregt, Jan J.

doi:10.1038/oby.2004.143

Cited by 108 publications

(87 citation statements)

References 32 publications

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“…Noteworthy, a 6-y lesser life expectancy in obese subjects aged 30-49 y has been observed 87 as well as a reduction of life expectancy free of disability compared with normal-weight subjects. 88 Thus, these findings suggest that the increased prevalence of obesity in middle-age as in older age may counteract the expected increase of life expectancy of normal-weight subjects.…”

Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 78%

Health consequences of obesity in the elderly: a review of four unresolved questions

et al. 2005

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Obesity prevalence is growing progressively even among older age groups. Controversy exists about the potential harms of obesity in the elderly. Debate persists about the relation between obesity in old age and total or disease-specific mortality, the definition of obesity in the elderly, its clinical relevance, and about the need for its treatment. Knowledge of age-related body composition and fat distribution changes will help us to better understand the relationships between obesity, morbidity and mortality in the elderly. Review of the literature supports that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages. Weight gain or fat redistribution in older age may still confer adverse health risks (for earlier mortality, comorbidities conferring independent adverse health risks, or for functional decline). Evaluation of comorbidity and weight history should be performed in the elderly in order to generate a comprehensive assessment of the potential adverse health effects of overweight or obesity. The risks of obesity in the elderly have been underestimated by a number of confounders such as survival effect, competing mortalities, relatively shortened life expectancy in older persons, smoking, weight change and unintentional weight loss. Identification of elderly subjects with sarcopenic obesity is probably clinically relevant, but the definition of sarcopenic obesity, the benefits of its clinical identification, as well as its relation to clinical consequences require further study. Studies on the effect of voluntary weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5-10% of initial body weight) may be beneficial. In older as well as in younger adults, voluntary weight loss may help to prevent the adverse health consequences of obesity.

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Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 78%

Health consequences of obesity in the elderly: a review of four unresolved questions

et al. 2005

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“…The onset of obesity in young and middle adulthood may result in lower physical activity contributing to decreased muscle strength and cardiovascular fitness and greater declines in physical performance because of longer duration of excess body weight and earlier onset of chronic disease. Peeters et al 27 found that obesity at ages 30-49 was associated with 5-6 fewer years free of limitations in ADLs after age 50 compared to those who were normal weight. In the ARIC study, participants who were obese at age 25 had approximately a twofold or higher prevalence of limitations in self-reported physical function and ADLs at ages 52-75.…”

Section: Discussionmentioning

confidence: 99%

The association between weight history and physical performance in the Health, Aging and Body Composition study

et al. 2007

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Objective: Although the association between current obesity and physical disability is well known, the cumulative effect of obesity is unknown. Using data from the Health, Aging and Body Composition study, we examined the association between weight history in young and middle adulthood and weight status in late adulthood with physical performance in late adulthood. Design: Longitudinal cohort study. Subjects: White and black men and women aged 70-79 years at study baseline (n ¼ 2803). Measures: Body mass index (BMI; kg/m 2 ) was calculated using recalled height at age 25 and weight at age 25 and 50 and measured height and weight at ages 70-79. Physical performance at ages 70-79 was assessed using a short physical performance battery (SPPB) and a 400-m walk test. Results: In this well-functioning cohort, approximately 24% of men and 8% of women reported being overweight or obese (BMI X25 kg/m 2 ) at age 25, 51% of men and 37% of women reported being overweight or obese at age 50, and 69% of men and 66% of women were overweight or obese at ages 70-79. Men and women who were obese (BMI X30 kg/m 2 ) at ages 25, 50 and 70-79 had significantly worse SPPB scores and 400-m walk times than those who were normal weight. Women who were overweight (BMI 25-29.9 kg/m 2 ) at ages 25, 50 and 70-79 also had significantly worse physical performance. Furthermore, men and women who had a history of being overweight or obese at ages 25 or 50 had worse physical performance compared to those who were normal weight throughout or who were overweight or obese at ages 70-79 but not in midlife or earlier.Conclusions: Maintaining a healthy body weight throughout adulthood may play a role in preventing or delaying the onset of physical disability.

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“…This is likely due to the higher proportion of smokers in the normal weight group who are at a greater risk of disability, and highlights the need to stratify by smoking status when assessing BMI as a risk factor for ill health. 7,14 The moderating effect of smoking was not evident in females, likely due to the lower prevalence of smoking among females.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, such cohorts need comprehensive measures of disability and to have evaluated possible confounders and effect modifiers. Although several studies have analysed the relationship between mid-life BMI and disability, [10][11][12][13][14] data of this kind are lacking. With the prevalence of overweight and obesity increasing across all age groups, it is important to know to what extent excess weight prior to old age is associated with disability in old age.…”

Section: Introductionmentioning

confidence: 99%

The relationship between body mass index prior to old age and disability in old age

et al. 2012

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OBJECTIVES: To analyse the relationship between body mass index (BMI) in middle-age and disability status in old-age using data from the Melbourne Collaborative Cohort Study (MCCS). METHODS: A total of 41 514 participants enroled in the MCCS between 1990-1994. Height and weight were measured at baseline and disability, defined as limitations to self-care activities of daily living (ADLs) and self-care plus mobility activities, was identified at follow-up (2003-2007). In all, 6300 participants were o65 years at baseline, X70 years at follow-up and not missing BMI at baseline or ADLs at follow-up. The association between BMI in six categories (30)(31)(32)(33)(34)(35); 35 þ ) and disability status was analysed using logistic regression. Models were stratified by sex, and sequentially adjusted for age, education, country of birth, then smoking, alcohol, fruit and vegetable intake, and physical activity. RESULTS: Adjusted odds ratios for composite self-care ADL and mobility limitations compared with BMI 18.5-22.5 kg m À 2 were 1.73 (95%CI 1.14-2.64) for BMI 30-35 kg m À 2 and 3.46 (1.78-6.73) for BMI 35 þ kg m À 2 in males. In females, adjusted odds ratios were 1.29 (1.00-1.68) for BMI 22.5-25 kg m À 2 , 1.74 (1.35-2.24) for BMI 25-27.5 kg m À 2 , 2.58 (1.98-3.36) for BMI 27.5-30 kg m À 2 , 2.74 (2.10-3.58) for BMI 30-35 kg m À 2 and 4.21 (3.12-5.88) for BMI 35 þ kg m À 2 . CONCLUSION: A graded relationship was observed between BMI and disability in males and females, across the continuum of BMI. These results highlight the importance of a healthy body weight at middle age in order to reduce the risk of disability in old age.

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Adult Obesity and the Burden of Disability throughout Life

Cited by 108 publications

References 32 publications

Health consequences of obesity in the elderly: a review of four unresolved questions

Health consequences of obesity in the elderly: a review of four unresolved questions

The association between weight history and physical performance in the Health, Aging and Body Composition study

The relationship between body mass index prior to old age and disability in old age

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