Joint Association of Obesity and Metabolic Syndrome With Incident Mobility Limitation in Older Men and Women--Results From the Health, Aging, and Body Composition Study

Stenholm, Sari; Koster, Annemarie; Alley, Dawn E.; Houston, Denise K.; Kanaya, Alka M.; Lee, Jung Sun; Newman, Anne B.; Satterfield, Suzanne; Simonsick, Eleanor M.; Visser, Marjolein; Harris, Tamara B.; Ferrucci, Luigi

doi:10.1093/gerona/glp150

Cited by 48 publications

(32 citation statements)

References 39 publications

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“…Obesity had an independent effect on the onset of impairment in strength, lower body mobility, and activities of daily living (Jenkins, 2004). However, discrepant to our findings, they found physical activity to be a protective factor in reducing impaired physical functioning despite weight category, thus adding to the evidence suggesting that being physically active as an obese or overweight older adult is beneficial (Brach et al, 2003; Stenholm et al, 2010). Stenholm et al, 2007 in a Finnish population of predominately middle-aged adults, also examined the combined effects of BMI and fitness and found that being overweight and physically active provided protection against future disability among older adults.…”

Section: Discussioncontrasting

confidence: 99%

Impact of Obesity and Physical Activity on Functional Outcomes in the Elderly

et al. 2014

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Objectives (1) to examine whether the association between obesity and physical functioning among older adults is moderated by physical activity; and (2) to test whether this moderating effect varies by gender. Methods Data from adults ≥60 who participated in the National Health and Nutrition Examination Surveys (2005–2010) were analyzed. Using multivariate logistic regression, we estimated the prevalence ratio of functional limitations and activities of daily living (ADL/IADL) impairment, by body mass index (BMI) and physical activity, while adjusting for age, educational level and a co-morbidity index. Results The sample included 5,304 subjects, mean age 70.4 years and 50.5% were female. Overweight and obesity was associated with higher levels of functional limitations when compared to normal weight individuals regardless of PA status (PR 1.47 (1.17–1.85) and 2.71 (2.00–3.67) even after adjustment for confounders. Discussion Overweight and obesity is associated with impairment in functional outcomes irrespective of physical activity.

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Section: Discussioncontrasting

confidence: 99%

Impact of Obesity and Physical Activity on Functional Outcomes in the Elderly

et al. 2014

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“…In addition, obesity is associated with substantial excess disability and mobility limitations (24,25). Stenholm and colleagues reported that obese (BMI ≥ 30kg/m 2 ) men and women aged 70–79 years from the Health, Aging and Body Composition Study had an increased risk of mobility limitation during a 6.5-year follow-up period (26). Obese men and women aged 65 years and older from the English Longitudinal Study of Ageing were reported to have an increased risk of self-reported difficulties with activities of daily living and with a measure of functional impairment during a 5-year follow-up period (27).…”

Section: Discussionmentioning

confidence: 99%

Obesity in Older People With and Without Conditions Associated With Weight Loss: Follow-up of 955,000 Primary Care Patients

Bowman

Delgado

Henley

et al. 2016

GERONA

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Background:Moderate obesity in later life may improve survival, prompting calls to revise obesity control policies. However, this obesity paradox may be due to confounding from smoking, diseases causing weight-loss, plus varying follow-up periods. We aimed to estimate body mass index (BMI) associations with mortality, incident type 2 diabetes, and coronary heart disease in older people with and without the above confounders.Methods:Cohort analysis in Clinical Practice Research Datalink primary care, hospital and death certificate electronic medical records in England for ages 60 to more than 85 years. Models were adjusted for age, gender, alcohol use, smoking, calendar year, and socioeconomic status.Results:Overall, BMI 30–34.9 (obesity class 1) was associated with lower overall death rates in all age groups. However, after excluding the specific confounders and follow-up less than 4 years, BMI mortality risk curves at age 65–69 were U-shaped, with raised risks at lower BMIs, a nadir between 23 and 26.9 and steeply rising risks above. In older age groups, mortality nadirs were at modestly higher BMIs (all <30) and risk slopes at higher BMIs were less marked, becoming nonsignificant at age 85 and older. Incidence of diabetes was raised for obesity-1 at all ages and for coronary heart disease to age 84.Conclusions:Obesity is associated with shorter survival plus higher incidence of coronary heart disease and type 2 diabetes in older populations after accounting for the studied confounders, at least to age 84. These results cast doubt on calls to revise obesity control policies based on the claimed risk paradox at older ages.

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“…(74) But it is also known that inflammation only partially explains observed mobility limitations. (75)…”

Section: Discussionmentioning

confidence: 99%

Obesity and Physical Frailty in Older Adults: A Scoping Review of Lifestyle Intervention Trials

Starr

McDonald

Bales

2014

Journal of the American Medical Directors Association

152

105

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Many frail older adults are thin, weak, and undernourished; this component of frailty remains a critical concern in the geriatric field. However, there is also strong evidence that excessive adiposity contributes to frailty by reducing the ability of older adults to perform physical activities and increasing metabolic instability. Our scoping review explores the impact of being obese on physical frailty in older adults by summarizing the state of the science for both clinical markers of physical function and biomarkers for potential underlying causes of obesity-related decline. We used the five-stage methodological framework of Arksey and O’Malley to conduct a scoping review of randomized trials of weight loss and/or exercise interventions for obesity (BMI ≥ 30 kg/m2) in older adults (aged > 60 yrs), examining the outcomes of inflammation, oxidative stress, and lipid accumulation in muscle, as well as direct measures of physical function. Our initial search yielded 212 articles; exclusion of cross-sectional and observational studies, cell culture and animal studies, disease-specific interventions, and articles published before 2001 led to a final result of 21 articles. Findings of these trials included the following major points: The literature consistently confirmed benefits of lifestyle interventions to physical function assessed at the clinical level. Generally speaking, weight loss alone produced a greater effect than exercise alone and the best outcomes were achieved with a combination of weight loss and exercise, especially exercise programs that combined aerobic, resistance, and flexibility training. Weight loss interventions tended to reduce markers of inflammation and/or oxidative damage when more robust weight reduction was achieved and maintained over time, whereas exercise did not change markers of inflammation. However, participation in a chronic exercise program did reduce the oxidative stress induced by an acute bout of exercise. Weight loss interventions consistently reduced lipid accumulation in the muscle; however, in response to exercise, three studies showed an increase and two a decrease in muscle lipid infiltration. In summary, this scoping review identified strong clinical evidence that weight reduction and/or exercise interventions can improve physical function and biomarkers of physical dysfunction among overweight/obese older adults, supporting the suggestion that excessive adiposity contributes to physical frailty. However, the evidence also suggests a complexity of metabolic influences, both systemically and within muscle, which has not been elucidated to date. Considerable further study is needed to examine the mechanisms by which lifestyle interventions influence physical frailty before the net impact of such interventions can be fully understood.

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Joint Association of Obesity and Metabolic Syndrome With Incident Mobility Limitation in Older Men and Women--Results From the Health, Aging, and Body Composition Study

Abstract: Obesity itself, independent of its metabolic consequences, is a risk factor for mobility limitation among obese older adults. In addition, having the MetS increases the risk of functional decline in older nonobese women but not in men.

Cited by 48 publications

References 39 publications

Impact of Obesity and Physical Activity on Functional Outcomes in the Elderly

Impact of Obesity and Physical Activity on Functional Outcomes in the Elderly

Obesity in Older People With and Without Conditions Associated With Weight Loss: Follow-up of 955,000 Primary Care Patients

Obesity and Physical Frailty in Older Adults: A Scoping Review of Lifestyle Intervention Trials

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