Obesity Paradox in Caucasian Seniors: Results of the PolSenior Study

Abstract

Objectives To investigate the influence of overweight and obesity on general performance and mortality in seniors. Design Cross-sectional multidisciplinary study on ageing of the Polish population. Setting Community-dwelling individuals aged 65 years or older, selected using three-stage stratified, proportional draw. Participants 4944 Polish Caucasian seniors, aged 65 years or older recruited between October 2007 and October 2010. Measurements All study subjects underwent measurement of body mass index (BMI), waist circumference (WC), and arm circumference (AC). The physical and cognitive performance was evaluated using the Katz Activities of Daily Living (ADL) score and Mini-Mental State Examination (MMSE), respectively. Morbidity data were obtained from a medical questionnaire. Mortality data were obtained from the Population Register of Poland between October 2015 and October 2018. Results Increasing age was associated with a decreased prevalence of obesity (all p<0.001). Higher BMI, WC and AC values were associated with higher ADL and MMSE scores (all p<0.001). On multivariate analysis, all three body measurements in women remained independent predictors of the ADL score (BMI p=0.002, WC p=0.005, AC p<0.001) and MMSE score (p<0.001, p=0.003, p<0.001). In men, physical functioning was associated with AC (p=0.003), and cognitive status was associated with AC (p<0.001) and BMI (p=0.013). There was no association between general obesity, abdominal obesity, or AC with several aging-related adverse conditions. Kaplan-Meier survival curves showed that overweight and obesity were associated with the lowest mortality. On multivariate analysis, BMI and AC values remained independent predictors of mortality. In successfully aging individuals, neither BMI, WC, nor AC remained such predictors. Conclusions Overweight and obesity in Caucasian seniors are not associated with deterioration of physical and cognitive function or with increased mortality.

BMI, functional and cognitive status in a cohort of nonagenarians: results from the Mugello study

“…In the present study, nonagenarians with a high BMI, without reporting a significant prevalence of sarcopenia and despite having a higher risk of falling and of functional disabilities, presented better MMSE scores. These results are in line with several papers reporting the so-called "obesity paradox" hypothesis [22,23], that is a reduced risk of cognitive decline associated with overweight in late life, even if the issue remain controversial [24]. A very recent observational study investigating the relationship between obesity and cognitive impairment in 1100 patients aged 60-98 years has shown that overweight was associated with a lower risk of cognitive impairment [25], and the results of a prospective study revealed that older people with higher BMI had a lower risk of dementia than their counterparts with lower BMI [26].…”

“…The mini-mental state examination (MMSE) was used to tests 5 areas of cognitive function: orientation, registration, attention and calculation, recall and language [13]. The global score ranges from 0 to 30, with a score of 23 or less indicating severe (≤ 9 points), moderate (10-18 points) or mild (19)(20)(21)(22)(23) dementia. Depressive symptoms were investigated by the 15-item Geriatric Depression Scale (GDS) [14].…”

BMI Trajectory In Relation to Cause-Specific Mortality In Taiwan’s Adult Population.

“…Older populations tend to have a reverse J-shaped association of BMI with all-cause mortality, which indicates that underweight and obesity are both important risk factors of mortality (25)(26)(27). This so-called "obesity paradox"-higher BMI has protective association with all-cause mortality in older population (6,28)-was also found in our sample of Taiwanese populations. Combining our nding of obesity as not being a protective factor for mid-aged adults in our sample, one possible mechanism may be selection bias.…”

Body weight-dependent foot loads, assessed in terms of BMI and adiposity, in school-aged children: a cross sectional study

“…The effect of excessive body weight is appreciably instrumental in developing various ailments within the musculoskeletal system, alterations in gait, the foot structure itself, as well as the altered load on the plantar part of the foot 36 – 39 . As evidenced throughout our own study, there was a fundamental difference in the biomechanics of foot loading.…”