Regular readers may recall previous posts on the issue of obesity (or excess weight) in the elderly and how the well-known obesity paradox, namely that skinny people with chronic diseases die first, confounds the interpretation of finding in this age group.
This topic is now extensively reviewed by Decaria and colleagues front the Lawson Health Research Institute, London, Ontario, in a paper just published by the International Journal of Obesity.
The authors identified almost 500 relevant research articles and came to the following main conclusions:
1) The current WHO (World Health Organization)-recommended body mass index, waist circumference and waist-to-hip ratio obesity thresholds for the general adult population may not be appropriate for older adults.
2) Weight change or physical fitness may be more useful measures of mortality and health risk in obese older adults.
3) Although, obesity in older adults is associated with several disorders that increase functional disability, epidemiological evidence suggests that obesity is protective against mortality in seniors.
4) As a result of point 3, the trend toward increasing prevalence of obesity in older adults will lead to an increase in unhealthy life years and health-care costs.
Based on their finding, the authors propose that
“…treatment strategies for obese older adults should focus on maintaining body weight and improving physical fitness and function rather than weight loss, and that a combination of aerobic and resistance exercise appears to be the most effective strategy.”
Overall, an important message to clinicians with overweight and obese elderly clients: focus on fitness and function not on weight loss!
Medicine Hat, Alberta
Decaria JE, Sharp C, & Petrella RJ (2012). Scoping review report: obesity in older adults. International journal of obesity (2005) PMID: 22410960