Quality of Life and Mental Health in Older Adults with Obesity and Frailty: Associations with a Weight Loss Intervention

Abstract

Objective: To examine the bi-directional associations of a weight loss intervention with quality of life and mental health in obese older adults with functional limitations. Design: Combined-group analyses of secondary variables from the MEASUR-UP randomized controlled trial. Setting: Academic medical center. Participants: Obese community-dwelling men and women (N = 67; age ≥60; BMI ≥30) with functional limitations (Short Physical Performance Battery [SPPB] score of 4–10 out of 12). Intervention: Six-month reduced calorie diet at two protein levels Measurements: Weight, height, body composition, physical function, medical history, and mental health and quality of life assessments (Center for Epidemiologic Studies Depression Scale [CES-D]; Profile of Mood States [POMS], Pittsburgh Sleep Quality Index [PSQI]; Perceived Stress Scale [PSS]; Satisfaction with Life Scale [SWLS]; and Short Form Health Survey [SF-36]) were acquired at 0, 3 and 6 months Results: Physical composite quality of life (SF-36) improved significantly at 3 months (β = 6.29, t2,48 = 2.60, p = 0.012) and 6 months (β = 10.03, t2,48 = 4.83, p < 0.001), as did several domains of physical quality of life. Baseline depression symptoms (CES-D and POMS) were found to predict lower amounts of weight loss; higher baseline sleep latency (PSQI) and anger (POMS) predicted less improvement in physical function (SPPB). Conclusion: The significant bi-directional associations found between a weight loss intervention and mental health/quality of life, including substantial improvements in physical quality of life with obesity treatment, indicate the importance of considering mental health and quality of life as part of any weight loss intervention for older adults.

Factors Associated with Health-Related Quality of Life in Community-Dwelling Older Adults: A Multinomial Logistic Analysis

“…It seems clear that overweight and obese patients perceive a poorer physical health [40,45,46,47]. This is corroborated by the fact that interventions aimed at achieving weight loss have been shown to improve the physical quality of life [48].…”

Quality of life during the epidemic of COVID-19 and its associated factors among enterprise workers in East China

“…During the nationwide lockdown, people were socially isolated (8), and experienced negative emotions such as fear and stress (9)(10)(11) and lifestyle changes including reduced physical activity and increased sedentary time (12)(13)(14). The lockdown due to the epidemic of COVID-19 had a negative effect on mental health for both patients with COVID-19 (15)(16)(17) and general populations (17)(18)(19)(20)(21), also re ected by the health-related quality of life (HRQoL) (22,23).…”

Care home staff's experiences and views of supporting the dietary management and choices of older residents with obesity

“…The 'obesity paradox' (Souto Barreto et al, 2017) suggests that being overweight reduces mortality risk, a concept that some participants in this study also recognised (overweight residents having something in reserve). These factors influence nutrition Chau et al (2008) and Payne et al (2018), weight loss interventions for older people should be individualised and supported by nutrition experts in order to ensure safety and effectiveness. However, expert dietitian input is difficult to access because CCGs do not commission and fund dietetic services to support care home RWO unless they have diabetes or are malnourished due to acute weight loss.…”

“…Finding a solution that accounts for both the ‘obesity paradox’, and supporting quality of life and health status for care home RWO is problematic. A number of studies propose that weight management interventions should be considered despite the ‘obesity paradox’ as they can improve function, cognition and mental health (Chau, Cho, Jani, & St Jeor, 2008; Napoli et al., 2014; Payne et al., 2018). It should be noted that all these authors stress weight management programmes for older people should be developed by experts in nutrition to maximise safe practice.…”