Prevalence of Moderate to Severe Obesity Among U.S. Nursing Home Residents, 2000–2010

Felix, Holly C.; Bradway, Christine; Chisholm, Latarsha; Pradhan, Rohit; Weech‐Maldonado, Robert

doi:10.3928/19404921-20150223-01

Cited by 27 publications

(27 citation statements)

References 19 publications

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“…The obesity epidemic is an alarming worldwide public health problem [81]. Obesity predicts various health outcomes such as diabetes, cardiovascular and metabolic diseases, and mortality [82].…”

Section: Association Between Obesity Osas and Hypercoagulabilitymentioning

confidence: 99%

Obstructive sleep apnea syndrome: coagulation anomalies and treatment with continuous positive airway pressure

et al. 2015

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Further studies are required to determine the precise role of hypercoagulability in the cardiovascular pathogenesis of OSAS, particularly its interaction with oxidative stress, thrombotic tendency and endothelial dysfunction. Nasal continuous positive airway pressure (nCPAP), the gold standard treatment for OSAS, not only significantly reduced apnea-hypopnoea indices but also markers of hypercoagulability, thus representing a potential mechanisms by which CPAP reduces the rate of cardiovascular morbidity and mortality in OSAS patients.

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Section: Association Between Obesity Osas and Hypercoagulabilitymentioning

confidence: 99%

Obstructive sleep apnea syndrome: coagulation anomalies and treatment with continuous positive airway pressure

et al. 2015

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“…Understanding how reported need for assistance varies as BMI increases (for example, between a resident with a BMI of 30 kg/m 2 and a resident with a BMI of 50 kg/m 2 ) will help to define the problem of obesity care in nursing homes in terms of who is most affected, how increasing BMI affects staffing and equipment needs, and what level of BMI should be the focus of policy interventions. 9,17,18 …”

Section: Introductionmentioning

confidence: 99%

Obesity and intensive staffing needs of nursing home residents

2018

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The objective of this study is to examine how increasing body mass index (BMI) among nursing home residents affects the amount of staffing assistance needed for activities of daily living (ADL). We analyzed 1,627,141 US nursing home residents reported in the 2013 Minimum Data Set in seven BMI categories, from underweight (BMI < 18.5 kg/m2) to obesity Class IIIB (≥50 kg/m2). Logistic regression models estimated the odds of nursing home-reported need for extensive (≥2 staff member) assistance needed for ADLs. The adjusted odds increased from 1.07 (95% Confidence Interval (95%CI) 1.06–1.08) for Class I, 1.16 (95%CI 1.14–1.17) for Class II, 1.33 (95%CI 1.31–1.35) for Class IIIA, and 1.90 (95%CI 1.86–1.95) for Class IIIB obesity residents compared to residents of normal weight. As a nursing home resident’s BMI increases, especially for BMI ≥40 kg/m2, the need for extensive staffing assistance with ADLs also increases substantially.

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“…10 Our findings are an important addition to the literature because we use recent data for the entire country and separately examine the effects of moderate and severe obesity, which are becoming more prevalent among nursing home residents. 8 …”

Section: Discussionmentioning

confidence: 99%

“…In one study of individuals admitted to nursing homes in Arkansas between 1999 and 2004, obesity was associated with needing assistance from 2 or more persons to complete activities of daily living (ADLs). 10 The prevalence of obesity since this time has increased substantially, 8 including rates of moderate and severe obesity, which were not examined in the prior study. Thus, our goal was to estimate how different levels of obesity (mild, moderate, and severe) impact the need for extensive ADL assistance in a contemporary, comprehensive sample of nursing home residents.…”

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confidence: 98%

“…1 Individuals with obesity are more likely to become disabled at an early age, 2–4 which has led to higher rates of obesity in the nursing home population. 5–8 Obesity places nursing home residents at risk for poor outcomes 9 and may impact the delivery of long-term care, for instance, through placing a greater physical burden on facility staff. 6,10,11 In response, nursing homes may need to invest in specialized equipment such as motorized lifts or devote more staffing resources to their residents with obesity.…”

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Higher Level of Obesity Is Associated with Intensive Personal Care Assistance in the Nursing Home

Kosar

Thomas

Gozalo

et al. 2018

Journal of the American Medical Directors Association

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Objectives: To examine whether higher obesity level was associated with extensive staffing assistance (from 2 or more persons) for completing activities of daily living (ADL) among older nursing home residents. Design: Retrospective cross-sectional study. Setting: US government–certfied nursing homes. Participants: Medicare beneficiaries residing in a nursing home on April 1, 2015. Exclusion criteria were age less than 65 years and body mass index (BMI) below 18.5 (underweight). Measures: Residents were divided by obesity level according to established BMI cutoffs, as follows: nonobese (BMI = 18.5–29.9) or mild (BMI = 30.0–34.9), moderate (BMI = 35.0–39.9), or severe (BMI ≥40) obesity. Level of staffing assistance for completing each of 10 ADL (bed mobility, transfer, walking in room, walking in corridor, on- and off-unit locomotion, dressing, eating, toileting, and personal hygiene) was dichotomized as below 2 and 2 or more. Robust Poisson regression was used to test whether obesity conferred excess risk for needing 2 or more staff to complete each ADL. Adjusted models included individual-level covariates and nursing home fixed effects. Results: A total of 1,063,383 nursing home residents were identified, including 309,263 (29.0%) with obesity. Adjusted relative risks (95% confidence intervals) for 2-person assistance with bed mobility associated with mild, moderate, and severe obesity were 1.17 (1.15, 1.18), 1.28 (1.25, 1.31), and 1.40 (1.36, 1.43), respectively. Adjusted relative risks for 2-person assistance with transferring associated with mild, moderate, and severe obesity were 1.15 (1.13, 1.17), 1.24 (1.22, 1.27), and 1.36 (1.33, 1.39), respectively. Obesity was associated with 2-person assistance for all other ADL except for eating. Conclusions: Higher obesity level was significantly associated with assistance from 2 or more staff for completing 9 of 10 ADL. Given increasing obesity rates in nursing homes, payment mechanisms that do not adjust for obesity or comprehensively account for excess ADL assistance may need revision to prevent adverse impacts on the long-term care system.

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Prevalence of Moderate to Severe Obesity Among U.S. Nursing Home Residents, 2000–2010

Cited by 27 publications

References 19 publications

Obstructive sleep apnea syndrome: coagulation anomalies and treatment with continuous positive airway pressure

Obstructive sleep apnea syndrome: coagulation anomalies and treatment with continuous positive airway pressure

Obesity and intensive staffing needs of nursing home residents

Higher Level of Obesity Is Associated with Intensive Personal Care Assistance in the Nursing Home

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