Body mass index and waist circumference predict health-related quality of life, but not satisfaction with life, in the elderly

Association of sleep duration with obesity in older adults: A systematic review and meta-analysis

BACKGROUND

Research on sleep duration and obesity is extensive in children and young individuals but limited and inconsistent for older adults. Our study aims to clarify the current status of this association in the elderly population.

METHODS

We searched six English and four Chinese databases up to January 25, 2024, for observational studies on sleep duration and obesity in older adults. Two researchers independently conducted the literature search and data extraction. Study quality was assessed using the Newcastle-Ottawa Scale for cohort studies and the Agency for Healthcare Research and Quality for cross-sectional studies. Meta-analyses were performed using Stata 15.0 software, using both random-effects and fixed-effects models to calculate pooled odds ratios with 95% confidence intervals (CIs).

RESULTS

The meta-analysis of 15 studies found a correlation between short sleep duration and obesity in older individuals (pooled odds ratio, 1.40 [95% CI: 1.12-1.73]; P = 0.003). However, no significant correlation was found between long sleep duration and obesity among the elderly (pooled odds ratio, 1.04 [95% CI, 0.95-1.13]; P = 0.426).

CONCLUSIONS

Short sleep duration in the elderly was associated with obesity. More prospective studies need to be included in the future to improve the reliability of the conclusions. Geriatr Gerontol Int 2024; 24: 1269-1282.

Health-Related Quality of Life among Elderly Patients in Urban Bangladesh: A Cross-Sectional Study

Quality of life (QoL) focuses on a person's ability to live a fulfilling life. It helps in determining successful aging in the elderly population. Because of a scarcity of information regarding predictors of QoL in the elderly population in developing countries, this study was undertaken to assess the overall QoL and its predictors in the elderly population in an urban setting of Bangladesh. In this cross-sectional study, 275 participants were enrolled by systematic sampling at the outpatient department of a tertiary care hospital in Dhaka, Bangladesh. Data were collected by using a pretested semi-structured standard questionnaire for QoL (OPQOL-35). Pearson's correlation was used to assess the association between QoL and sociodemographic factors. Multivariate linear regression was conducted to identify predictors of QoL, after controlling for potential confounders. The median age of the participants (n = 275) was 65 years (range, 60 to 85; 25th and 75th percentile, 60 and 68, respectively). The majority (78%) of them were married, and 20% were widowed or divorced. The median score of QoL was 113 (25th and 75th percentile, 101 and 124, respectively). Most of the participants had very poor (bad as can be) or poor (bad) QoL. Only 7.3% were observed to have "good" QoL (scores 140 or more). Females had significantly poorer QoL scores compared to males (p < 0.001). Age, gender, educational status, smoking, and sleep duration significantly predicted QoL in a multiple regression analysis. In conclusion, the QoL of the elderly individuals in Bangladesh was very poor or poor. Future research should focus on service-oriented interventions, especially targeting women. Counseling elderly people to enhance their quality of life may include improving sleep patterns, healthy diets, regular exercise, and caring for their mental health.

Psychological determinants of the effectiveness of conjugated linoleic acid supplementation in overweight and obese women-a randomized controlled trial

Introduction

Previous studies investigating the effectiveness of conjugated linoleic acid (CLA) supplementation in body weight reduction provided unequivocal results. We hypothesized that psychological factors such as self-efficacy, locus of control or dispositional optimism can affect the success of the intervention. Therefore, this study aimed to determine the psychological factors that modulate the effectiveness of CLA supplementation in overweight or obese women and affect the ability to successfully complete the study.

Methods

In total, 74 subjects were recruited into this three-month randomized trial and divided into intervention and control groups receiving, respectively, capsules containing 3 g 80% CLA per day and capsules containing 3 g of sunflower oil. The following psychological tests were performed before the intervention: Multidimensional Health Locus of Control scale, Acceptance of Illness Scale, Satisfaction with Life Scale (SWLS), General Self Efficacy Scale (GSES), Health Behavior Inventory scale and Life Orientation Test (LOT-R).

Results

A total of 60 women completed the study and the subjects who dropped out obtained higher scores in the GSES (p = 0.0490) and the LOT-R (p = 0.0087) tests than subjects who completed the trial. Besides, multivariate linear regression demonstrated that the SWLS test (p = 0.0345) results were independent predictors of body weight changes.

Conclusion

In conclusion, psychological factors like self-efficacy and optimism may be associated with a higher risk of withdrawal from the study, while satisfaction with life may have an impact on the effectiveness of body weight reduction.Clinical trial registration: [https://drks.de/search/en], identifier [DRKS00010462].

Multicomponent Training Improves the Quality of Life of Older Adults at Risk of Frailty

Achieving a high quality of life in older adults can be difficult if they have limited physical function. The aims of this study were to evaluate the relationship between baseline values and variations in body composition, fitness, and nutritional status on health-related quality of life (HRQoL) and to describe the effects of a 6-month multicomponent training (MCT) programme and a 4-month detraining period on HRQoL. A total of 106 participants with limited physical function were included in this study (age: 80.8 ± 5.9 years; 74 females) and were divided into two groups: control (CON) and intervention (TRAIN). HRQoL was measured using the EQ-5D-3L questionnaire and a visual analogue scale (EQ-VAS). Information on body composition, physical fitness, Mediterranean diet adherence, and nutritional status were obtained. Healthier baseline values for body composition, fitness and nutritional status were associated with better HRQoL (explaining 23.7-55.4%). The TRAIN group showed increased HRQoL during this 6-month MCT, showing group-by-time interaction (p < 0.05) and a deleterious effect of detraining. Changes in weight, arm strength, and aerobic capacity contributed to explaining 36% of the HRQoL changes obtained with MCT (all p < 0.05). This MCT improved HRQoL in older adults with limited physical function. However, HRQoL returned to baseline values after detraining. This study highlights the importance of performing ongoing programs in this population.

Non-linear relationship between body mass index and self-rated health in older Korean adults: body image and sex considerations

OBJECTIVES

The purpose of this study was to investigate the association between body mass index (BMI) and self-rated health (SRH) in older adults aged over 65 years while examining the influence of self-perceived body image (SBI) and sex.

METHODS

Raw data were obtained from the Korea Community Health Survey, which included BMI measurements of Koreans aged over 65 years (n=59,628). Non-linear relationships between BMI and SRH were analyzed separately for each sex using restricted cubic splines while controlling for SBI and other confounding variables.

RESULTS

Men showed a reverse J-shaped association, while women showed a J-shaped association between BMI and poor SRH. However, including SBI in the model changed this association for men to an inverted U-shape showing a negative direction, with the highest risk of poor SRH observed in the underweight to overweight range. For women, a nearly linear positive relationship was observed. Regardless of BMI, those who perceived their weight as not "exactly the right weight" had a higher risk of poor SRH than those who perceived their weight as "exactly the right weight" in both men and women. Older men who thought they were much too fat or too thin had similar highest risks of poor SRH, whereas older women who thought they were too thin had the highest risk of poor SRH.

CONCLUSIONS

The findings of this study emphasize the importance of considering sex and body image perceptions when assessing the relationship between BMI and SRH in older adults, especially in men.

Oral health and depressive symptoms among older adults in urban China: a moderated mediation model analysis

BACKGROUND

This study explored the association between oral health and depression occurs via daily dietary satisfaction as a mediator, and that body mass index could moderate the path between daily dietary satisfaction and depression.

METHODS

Data for this research were derived from a community survey adopting quota sampling in the cities of Tianjin and Shijiazhuang in mainland China in 2020 (N = 781). The moderated mediation model was tested by using bootstrapping with resampling strategies, and the Johnson-Neyman technique was used to visualize the moderating effect of body mass index.

RESULTS

A significant negative association between oral health and depression has been indicated (B = -0.22, SE = 0.11, 95%CI [- 0.44, - 0.01]), and dietary satisfaction partially mediated the relationship between oral health and depression (B = -0.04, SE = 0.02, 95%CI [- 0.09, - 0.002]). The path was moderated by body mass index, and the effect of dietary satisfaction on depression was much greater in people with relatively low body mass index.

CONCLUSIONS

This study present evidence for policymakers and researchers that strategies to enhance oral health and daily dietary satisfaction could be important for preventing depression in Chinese older adults, and especially for the relatively fitter older groups with lower body mass index.

Gender-Specific Factors Associated with Health-Related Quality of Life in Obese Korean Older Adults: Evidence from the 2020 Korean National Health and Nutrition Examination Survey

Given the increasing aging population in South Korea, the quality of life of older adults must be ensured. This cross-sectional descriptive study investigated the gender-specific factors associated with health-related quality of life in obese older adults aged 65 years and above based on Korean National Health and Nutrition Examination Survey (KNHNES) 2020 data. In total, 507 obese Korean older adults participated in the 8th KNHNES. Chi-square tests and logistic regression analysis were performed to determine the variation in health-related quality of life according to socioeconomic and health-related factors and assess their inter-relationships. The influencing factors of health-related quality of life in obese Korean older adults were national health insurance (odds ratio (OR) = 1.02, 95% confidence interval (CI): 0.40–2.21), private health insurance (OR = 0.36, 95% CI: 0.28–0.75), arthritis (OR = 6.64, 95% CI: 2.57–17.14), and good dietary lifestyle (OR = 0.07, 95% CI: 0.05–0.93) in men; and private health insurance (OR = 2.66, 95% CI: 1.05–6.72), arthritis (OR = 2.81, 95% CI: 1.44–5.51), and physical activity (OR = 4.33, 95% CI: 1.71–10.94) affected health-related quality of life in women. The importance of health behaviors should be considered in the development of health programs and interventions for improving the quality of life of older adults.

Central Obesity Is Associated With an Increased Rate of Multisite Pain in Older Adults

Objective

Central obesity has been associated with several adverse health events, but little research exists about the longitudinal effects of central obesity on multisite pain. The purpose of this study was to assess if central obesity, as measured by waist circumference measurement, was associated with an increased rate of having multisite pain among older adults aged 65 years and older.

Design

The National Health and Aging Trends Study is a longitudinal cohort study initiated in 2011 and intended to be representative of Medicare beneficiaries in the contiguous United States.

Methods

There were 7,145 community-dwelling participants included in this study. Data for this study were collected annually between 2011 and 2018. Researchers assessed if waist circumference risk level was associated with an increased rate ratio of multisite pain. Weighted data were used in a multivariable generalized estimating equation model that used a log link specified with a Poisson distribution.

Results

Participants with high-risk waist circumferences (98 cm or greater for women and 109 cm or greater for men) had a 11% higher rate of multisite pain than those with low-risk waist circumferences [rate ratio (RR) 1.11, 95% CI: 1.07–1.15] adjusting for gender, age, race, education, probable major depression, arthritis, and multimorbidity count.

Conclusion

As measured by waist circumference, central adiposity is associated with multisite pain in older adults. While more research is needed, reducing waist circumference may prove beneficial in reducing the burden of multisite pain.

Relationship of domain-specific quality of life with body mass index and waist circumference in a Korean elderly population

BACKGROUND

Obesity affects health-related quality of life (QoL); however, their relationship among elderly Asians is not well known.

AIMS

Relationship of domain-specific QoL with body mass index (BMI) and waist circumference and the sex differences were investigated using a nationally representative sample of elderly Korean population.

METHODS

In the Korea National Health and Nutrition Examination Survey phase VII (2016-2018), 3659 adults aged ≥ 65 years (1551 men and 2108 women) participated. BMI and waist circumference were classified according to Asian- and Korean-specific criteria. QoL was evaluated using the European Quality of Life Scale-Five Dimensions (EQ-5D). Multivariable logistic regressions were used to examine the relationship of QoL with BMI and waist circumference.

RESULTS

Men with BMI < 18.5 kg/m² and ≥ 25.0 kg/m² had a significant association with poor QoL in mobility and self-care, but no relationship was found with the other domains. Women with BMI ≥ 25.0 kg/m² had poor QoL in mobility and self-care, and those with BMI ≥ 30.0 kg/m² had poor QoL in usual activities and pain/discomfort. There was no significant association with anxiety/depression. Both elderly men and women with abdominal obesity had a significant association with poor QoL in mobility, self-care, usual activities, and pain/discomfort; however, there was no significant relationship with waist circumference and anxiety/depression.

CONCLUSIONS

The association between QoL and BMI was different according to sex and the domains of QoL. Domain-specific QoL should be considered in the management of body weight of the elderly.

Measuring What Matters: Beyond Quality Performance Measures in Caring for Adults with Obesity

Obesity is a chronic disease that poses serious health and societal burdens. Although guidelines exist for obesity management in primary care, evaluating the success of obesity treatment programs is hampered by lack of established, robust quality measures. This study aimed to develop, and test for feasibility, measures for operational tracking, quality performance, and patient-centered care in the context of a national collaborative to develop a model for obesity management in the US primary care setting. The authors developed and evaluated 7 measures used to track the care of patients with overweight or obesity (n = 226,727 at baseline) receiving care within 10 health care organizations (HCOs). Measure categories included: (1) operational tracking (obesity/overweight prevalence and prevalence of obesity-related complications); (2) quality performance (obesity diagnosis, change in weight over time, anti-obesity medication prescriptions, and assessment of obesity-related complications); and (3) patient-centered care (patient-reported outcomes). Measures were tested for feasibility, variability across HCOs, ability to detect differences over time, and value to the HCOs. All measures were feasible to collect, provided value to the participating HCOs, and demonstrated variation and ability to detect differences over time (eg, rates of documented diagnosis of obesity classes 1, 2, and 3 increased from 29%, 46%, and 66%, respectively, at baseline to 35%, 53%, and 71% at study end). This study confirmed the feasibility and perceived value of 7 operational, performance, and patient-centered measures collected in primary care practices in 10 HCOs over an 18-month period.

BMI and dissatisfaction with life: contextual factors and socioemotional costs of obesity

Purpose

In this study, we investigate whether individuals’ BMI categories are associated with being dissatisfied with one’s life, how this association is affected by the social comparison that individuals make, and what the role of the overall BMI levels in this process is.

Methods

We use data for 21,577 men and 27,415 women, collected in 2016 by the European Bank for Reconstruction and Development, from 34 countries in Europe, the Middle East, and Central Asia. To understand the moderating effect of contextual environment, we use multilevel mixed effect logistic regression models and data for national, regional, and cohort-specific BMI levels.

Result

We find that the association of BMI and dissatisfaction with life differs by gender, with overweight men being less likely to be dissatisfied with life than men with normal weight and obese women being more likely to be dissatisfied with life compared to women with normal weight. For contextual effects, we find that obese women in regions with low BMI levels are more likely to be dissatisfied with life. The effect of obesity on female life dissatisfaction is not observed in regions with high BMI levels. As for men, regional BMI levels affect the levels of life dissatisfaction but only for underweight men.

Conclusions

Our study adds additional nuance to the quality-of-life research by showing that the association between BMI and decreased life satisfaction is, at least partially, moderated by the contextual environment, and that the character of these effects differs by gender.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11136-021-02912-3.

Utility Decrements Associated with Adult Overweight and Obesity in Australia: A Systematic Review and Meta-Analysis

OBJECTIVE

The aim was to conduct a systematic review and meta-analysis of health state utility decrements associated with overweight and obesity in adults 18 years and over, for use in modelled economic evaluations in Australia.

METHODS

A systematic review was conducted in nine databases to identify studies that reported health state utility values by weight status. Random-effects meta-analysis was used to synthesise average utility decrements (from healthy weight) associated with overweight, all obesity and obesity classes 1, 2 and 3. Heterogeneity surrounding utility decrements was assessed via sub-group analysis, random-effects meta-regression and sensitivity analyses.

RESULTS

Twelve studies were found for which data were used to synthesise utility decrements, estimated as overweight = 0.020 (95% confidence interval 0.010-0.030), all obesity = 0.055 (0.034-0.076), obesity class 1 = 0.047 (0.017-0.077), class 2 = 0.072 (0.028-0.116) and class 3 = 0.084 (0.039-0.130). There was considerable heterogeneity in our results, which could be accounted for by the different ages and utility instruments used in the contributing studies.

CONCLUSIONS

Our results demonstrate that elevated weight status is associated with small but statistically significant reductions in utility compared with healthy weight, which will result in reduced quality-adjusted life years when extrapolated across time and used in economic evaluations.

Aerobic, Resistance, and Combination Training on Health-Related Quality of Life: The STRRIDE-AT/RT Randomized Trial

Purpose: The main purpose of this study was to determine the differential effects of aerobic training (AT), resistance training (RT), and a combination of aerobic and resistance training (AT/RT) on changes in self-rated HrQoL measures, including the Short-Form 36 (SF-36) survey and Satisfaction with Physical Function and Appearance survey. We also sought to determine if combination training (AT/RT) has a more or less additive effect compared to AT or RT alone on self-rated HrQoL measures. Materials and Methods: Participants (n = 137) completed one of three 8-month exercise interventions: (1) AT: 14 kcal exercise expenditure per kg of body weight per week (KKW; equivalent to roughly 12 miles/week) at 65-80% of peak oxygen consumption; (2) RT: 3 days per week, 8 exercises, 3 sets per exercise, 8-12 repetitions per set; (3) AT/RT: full combination of the AT and RT interventions. The SF-36 survey, Satisfaction with Physical Function and Appearance survey, physical fitness, and anthropometrics were assessed at baseline and post-intervention. Paired t-tests determined significant pre- vs. post-intervention scores within groups (p < 0.05). Analyses of covariance determined differences in change scores among groups (p < 0.05). Results: On average, participants were 49.0 ± 10.6 years old, obese (BMI: 30.6 ± 3.2 kg/m²), female (57.7%), and Caucasian (84.7%). Following the 8-month intervention, exercise groups improved peak VO₂ (all groups), strength (RT and AT/RT), and anthropometric measures (AT and AT/RT). For the SF-36, RT (p = 0.03) and AT/RT (p < 0.001) significantly improved their physical component score; only AT/RT (p < 0.001) significantly improved their mental component score. Notably, all groups significantly improved both their satisfaction with physical function and appearance scores (All Groups: p < 0.001 for both outcomes). Conclusions: We found that aerobic, resistance, or combination exercise training improves several components of self-rated HrQoL, including physical function, appearance, and mental well-being. Clinical Trial Registration: No. NCT00275145.

The association between obesity and chronic pain among community-dwelling older adults: a systematic review and meta-analysis

OBJECTIVES

To systematically review studies and explore the association between obesity and chronic pain among community-dwelling older adults.

METHODS

A comprehensive literature search was conducted in 9 databases and the Pubmed search engine from their inception to March 19, 2020. Studies that investigated the associations between overweight/obesity and chronic pain among older people were obtained. Comprehensive Meta-analysis was used to meta-analyze the eligible studies.

RESULTS

Totally 14 studies with 40,999 participants were included in this review, and 8 of these studies were meta-analyzed. The meta-analyses showed that both overweight (pooled OR = 1.166, 95% CI: 1.104-1.232, p < 0.01) and obesity (pooled OR = 1.786, 95% CI: 1.530-2.085, p < 0.01) had significant associations with chronic pain among older adults.

CONCLUSIONS

Overweight and obesity are both associated with chronic pain among older adults. It is suggested that body weight control strategies might be incorporated into the pain management program for older adults with obesity.

Association of midlife body composition with old-age health-related quality of life, mortality, and reaching 90 years of age: a 32-year follow-up of a male cohort

BACKGROUND

Overweight and obesity increase the risk of morbidity and mortality. The relations between body composition at midlife, health-related quality of life (HRQoL) in old age, and longevity are, however, less studied.

OBJECTIVES

We examined the association of midlife body composition with successful aging, defined as high HRQoL and reaching 90 y of age, during 32 y follow-up.

METHODS

Participants were 1354 men from the Helsinki Businessmen Study, born 1919-1934. In 1985/1986 (mean age: 60 y) various health measurements were performed. Percentages of body fat (BF) and skeletal muscle mass (SM) were calculated using validated formulas (including waist and hip circumferences, weight, and age) and divided into quartiles. In 2000 and 2007 (mean ages: 74 and 80 y, respectively), HRQoL was assessed using RAND-36/Short Form-36 scales. Mortality was retrieved from registers through 2018, and longevity determined by calculating the proportion of participants reaching 90 y. Logistic regression was used to assess ORs with 95% CIs.

RESULTS

Higher SM% at midlife in 1985/1986 was associated (P < 0.05) with higher scores in the RAND-36 scales of physical functioning, role limitations caused by physical health problems, vitality, social functioning, and general health in old age in 2000. In 2007 only the association with physical domain (physical functioning, role limitations caused by physical health problems) remained statistically significant (P < 0.01). BF% quartiles in 1985/1986 were inversely associated with several RAND-36 scales in 2000 and 2007. During the 32-y follow-up, 982 participants died and 281 reached 90 y of age. Being in the highest SM% quartile at midlife increased (adjusted OR: 2.32; 95% CI: 1.53, 3.53; lowest SM% quartile as reference) and being in the highest BF% quartile decreased (OR: 0.43; 95% CI: 0.28, 0.66; lowest BF% quartile as reference) the odds of reaching 90 y.

CONCLUSIONS

Desirable body composition in terms of both fat and skeletal muscle mass at midlife was associated with successful aging in men.This trial was registered at clinicaltrials.gov as NCT02526082.

Dietary weight-loss interventions for the management of obesity in older adults

The obesity epidemic has reached old age in most industrialized countries, but trials elucidating the benefits and risks of weight reduction in older adults above 70 years of age with obesity remain scarce. While some findings demonstrate a reduced risk of mortality and other negative health outcomes in older individuals with overweight and mild obesity (i.e. body mass index (BMI) < 35 kg/m²), other recent research indicates that voluntary weight loss can positively affect diverse health outcomes in older individuals with overweight and obesity (BMI > 27 kg/m²), especially when combined with exercise. However, in this age group weight reduction is usually associated with a reduction of muscle mass and bone mineral density. Since uncertainty persists as to which level overweight or obesity might be tolerable (or even beneficial) for older persons, current recommendations are to consider weight reducing diets only for older persons that are obese (BMI ≥ 30 kg/m²) and have weight-related health problems. Precise treatment modalities (e.g. appropriate level of caloric restriction and indicated dietary composition, such as specific dietary patterns or optimal protein content) as well as the most effective and safest way of adding exercise are still under research. Moreover, the long-term effects of weight-reducing interventions in older individuals remain to be clarified, and dietary concepts that work for older adults who are unable or unwilling to exercise are required. In conclusion, further research is needed to elucidate which interventions are effective in reducing obesity-related health risks in older adults without causing relevant harm in this vulnerable population.

Waist-Calf Circumference Ratio Is an Independent Risk Factor of HRQoL in Centenarians

PURPOSE

To analyze the associations between waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), calf circumference, waist-calf circumference ratio (WCR), and quality of life in Hainan centenarians.

PATIENTS AND METHODS

A total of 1002 centenarians in Hainan were selected by a full sample survey. The EQ-5D visual analogue scale (EQ-5D-VAS) was used to investigate the quality of life. Restricted cubic splines were used to analyze and visualize the linear relationships.

RESULTS

After adjustment, the standard β values for BMI, WC, WHR, WHtR, calf circumference, and WCR associated with EQ-5D score were 0.101, 0.126, -0.018, 0.100, 0.302, and -0.219, respectively; all associations except for WHR were significant (P < 0.01). With increasing BMI, WC, and calf circumference, the risk of EQ-5D score <1 decreased (odds ratios [ORs] 0.91 [95% confidence interval (CI): 0.86-0.97), 0.97 [95% CI: 0.95-0.99], and 0.87 [95% CI: 0.82-0.92] after adjustment, respectively). With increasing WCR, the risk also increased (OR 2.70 [95% CI: 1.54-4.75]).

CONCLUSION

After excluding nutritional and muscle retention factors, fat central distribution negatively impacted the health-related quality of life of the oldest old population.

A Review of the Development and Application of Generic Preference-Based Instruments with the Older Population

Older people (aged 65 years and over) are the fastest growing age cohort in the majority of developed countries, and the proportion of individuals defined as the oldest old (aged 80 years and over) living with physical frailty and cognitive impairment is rising. These population changes put increasing pressure on health and aged care services, thus it is important to assess the cost effectiveness of interventions targeted for older people across health and aged care sectors to identify interventions with the strongest capacity to enhance older peoples' quality of life and provide value for money. Cost-utility analysis (CUA) is a form of economic evaluation that typically uses preference-based instruments to measure and value health-related quality of life for the calculation of quality-adjusted life-years (QALYS) to enable comparisons of the cost effectiveness of different interventions. A variety of generic preference-based instruments have been used to measure older people's quality of life, including the Adult Social Care Outcomes Toolkit (ASCOT); Health Utility Index Mark 2 (HUI2); Health Utility Index Mark 3 (HUI3); Short-Form-6 Dimensions (SF-6D); Assessment of Quality of Life-6 dimensions (AQoL-6D); Assessment of Quality of Life-8 dimensions (AQoL-8D); Quality of Wellbeing Scale-Self-Administered (QWB-SA); 15 Dimensions (15D); EuroQol-5 dimensions (EQ-5D); and an older person specific preference-based instrument-the Investigating Choice Experiments Capability Measure for older people (ICECAP-O). This article reviews the development and application of these instruments within the older population and discusses the issues surrounding their use with this population. Areas for further research relating to the development and application of generic preference-based instruments with populations of older people are also highlighted.

Associations between Body Mass Index and Subjective Health Outcomes among Older Adults: Findings from the Yilan Study, Taiwan

Previous findings on the associations between body mass index (BMI) and subjective health outcomes among older adults are inconsistent. The aims of this study were to explore the associations of BMI with health-related quality of life (HRQoL), self-rated health (SRH) and happiness among older adults. This study was part of the Yilan study, which was a community-based survey conducted in the Yilan city in Taiwan. A total of 3722 older adults were randomly recruited during 2012–2016. HRQoL was measured using the Short Form-12 Health Survey physical component summary (PCS) and mental component summary (MCS) scores and SRH and happiness were also evaluated. By hierarchical regression, after adjusting for covariates, compared with normal-weight participants, overweight did not have significantly different PCS scores (B = 0.20, 95% confidence interval [CI]: −0.45 to 0.85, p = 0.546) but obese had significantly lower PCS scores (B = −0.97, 95% CI: −1.68 to −0.26, p < 0.0001); overweight and obese participants had significantly better MCS scores (B = 1.00, 95% CI: 0.40 to 1.61, p = 0.001 and B = 1.22, 95% CI: 0.60 to 1.88, p < 0.0001, respectively); overweight participants had significantly higher SRH scores (B = 1.08, 95% CI: 0.16 to 2.00, p = 0.022) but underweight had significantly lower SRH scores (B = −2.88, 95% CI: −4.81 to −0.95, p = 0.003); overweight and obese participants had better happiness scores (B = 1.55, 95% CI: 0.45 to 2.66, p = 0.006 and B = 1.68, 95% CI: 0.49 to 2.88, p = 0.006, respectively). In conclusion, compared with normal-weight individuals, overweight individuals had better mental HRQoL, SRH and happiness but underweight older people reported poorer SRH and obese reported poorer physical HRQOL but better mental HRQoL and self-rated happiness.