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Protective and high-risk social activities associated with homebound status among older adults in rural Japan. Prev Med Rep 2022; 30:102037. [DOI: 10.1016/j.pmedr.2022.102037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 09/25/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022] Open
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Ko Y, Noh W. A Scoping Review of Homebound Older People: Definition, Measurement and Determinants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3949. [PMID: 33918712 PMCID: PMC8069440 DOI: 10.3390/ijerph18083949] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022]
Abstract
Being homebound (HB) can affect people's physical and mental health by decreasing movement, which can itself be exacerbated by the deterioration of people's health. To break this vicious cycle of HB and being in poor health, it is necessary to identify and address the factors influencing HB status. Thus, we used a scoping review to identify an HB trend, focusing on the definition, measurements, and determinants of HB status. We analyzed 47 studies according to the five-stage methodological framework for scoping reviews. The common attribute of definitions of HB status was that the boundaries of daily life are limited to the home. However, this varied according to duration and causes of becoming HB; thus, the understanding of HB shifted from the presence or absence of being HB to the continuum of daily activity. Various definitions and measurements have been used to date. Many studies have focused on individual factors to analyze the effect of HB. In the future, it will be necessary to develop a standardized measurement that reflects the multidimensional HB state. In addition, it is necessary to utilize a theoretical framework to explore the social and environmental factors affecting HB.
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Affiliation(s)
| | - Wonjung Noh
- College of Nursing, Gachon University, Incheon 21936, Korea;
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The joint associations of weight status and physical activity with mobility disability: The NIH-AARP Diet and Health Study. Int J Obes (Lond) 2018; 43:1830-1838. [PMID: 30575803 DOI: 10.1038/s41366-018-0294-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/26/2018] [Accepted: 11/02/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVES The purpose of this study was to determine the joint associations of weight status and physical activity with mobility disability in older men and women. SUBJECTS/METHODS We analyzed prospective data from 135,220 participants in the NIH-AARP Diet and Health Study between 1995-1996 and 2004-2005. METHODS Height and weight, as well as light- and moderate-to-vigorous-intensity physical activity typical of the past 10 years (h/week) were self-reported at baseline, and body mass index (BMI: kg/m2) was categorized into normal weight (BMI 18 to <25 kg/m2); overweight (BMI 25 to <30 kg/m2); and obese (BMI ≥ 30 kg/m2). Mobility was assessed by self-report at follow-up and mobility disability was defined as reporting "unable to walk" or an "easy usual walking pace (<2 mph)". Multivariable logistic regression determined the independent and joint associations of weight status and total physical activity with the odds of mobility disability. RESULTS Twenty-one percent of men and 37% of women reported a mobility disability at follow-up. We observed a curvilinear dose-response association between increasing categories of weight status and mobility disability within each tertile of physical activity, with the highest odds experienced by men and women with overweight (OR = 2.45; 95%CI: 2.25, 2.67 for men and OR = 2.99; 95%CI: 2.78, 3.22 for women) and obesity (OR = 3.93; 95%CI: 3.58, 4.32 for men and OR = 5.08; 95% CI: 4.65, 5.54 for women) in combination with low physical activity. Moreover, among those reporting 7 or fewer hours/week of total physical activity, being of normal body weight did not eliminate the excess odds of mobility disability. CONCLUSIONS These findings highlight the combined importance of obesity prevention and physical activity promotion to mobility in older age. Given aging demographics and the global economic burden associated with aging- and disuse-related disability, there is tremendous public health benefit to understanding how various modifiable determinants of mobility disability can interact in older age.
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De-Rosende Celeiro I, Santos-Del-Riego S, Muñiz García J. Homebound status among middle-aged and older adults with disabilities in ADLs and its associations with clinical, functional, and environmental factors. Disabil Health J 2016; 10:145-151. [PMID: 27461941 DOI: 10.1016/j.dhjo.2016.06.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 06/15/2016] [Accepted: 06/18/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Homebound status is associated with poor health, comorbidity, and mortality and represents a major challenge for health systems. However, its prevalence among people with disabilities in the basic activities of daily living (ADLs) is unknown. OBJECTIVES The objectives were to: (1) examine the prevalence of the homebound status among middle-aged and older adults with disabilities in ADLs, and (2) identify its clinical, functional, and environmental determinants. METHODS This study included 221 community-dwelling subjects, aged ≥50 years, who applied for long-term care services at the Office for Legal Certification of Long-term Care Need of Coruña (Spain). Each subject had a disability in ADLs and was interviewed by a trained examiner in the subject's home. The participants were considered homebound if they remained inside their home during the previous week. MEASURES Demographic, clinical, functional, and environmental factors. Multiple logistic regression was used to determine the factors associated with homebound status. RESULTS The prevalence of homebound status was 39.8%. A multivariate analysis revealed that the presence of architectural barriers at the home entrance (stairs [OR: 6.67, p < 0.001] or a heavy door [OR: 2.83, p = 0.023]), walking ability limitations (OR: 3.26, p = 0.006), and higher age (OR: 1.05, p = 0.04) were associated with homebound status. CONCLUSIONS Homebound status is a highly prevalent problem among middle-aged and older adults with disabilities in ADLs. Architectural factors in the home and walking ability limitations seem to be important predictors, suggesting that health care interventions should target home adaptations and mobility skills as a means to preventing or decreasing homebound status.
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Affiliation(s)
- Iván De-Rosende Celeiro
- Department of Health Sciences, University of A Coruña, A Coruña, Spain; Service of Dependence and Personal Autonomy, Xunta de Galicia, A Coruña, Spain.
| | | | - Javier Muñiz García
- University Institute of Health Sciences, University of A Coruña, A Coruña, Spain; Biomedical Research Institute of A Coruña, A Coruña, Spain
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Specific versus general self-reported health indicators predicting mortality among older adults in Europe: disparities by gender employing SHARE longitudinal data. Int J Public Health 2014; 59:665-78. [PMID: 24846530 DOI: 10.1007/s00038-014-0563-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 04/17/2014] [Accepted: 05/01/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES The study aims at assessing the relative importance of specific versus general self-reported indicators of health and disability in predicting mortality among older adults and at exploring the potential value of the global activity limitation indicator (GALI), a recently validated general measure of activity restrictions, as predictor of death. METHODS Longitudinal data from two waves (2004 and 2006-2007) of the Survey of Health, Ageing and Retirement in Europe were employed. The sample comprises 17,941 persons aged 50+ at baseline, representing 11 countries. Associations were estimated by sex using Cox's proportional hazards regression models. RESULTS Most specific and general indicators of health and disability are strong and independent predictors. There are disparities by sex; among general measures, controlling for all indicators under consideration, self-rated health (SRH) only remains significantly associated with mortality among males and GALI among females. CONCLUSIONS A combination of specific and general measures is more efficient in predicting mortality than either of these alone. SRH and GALI seem to share some traits, adding health and disability dimensions over specific measures, representing though different aspects by gender.
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Ellis A, Crowe K, Lawrence J. Obesity-related inflammation: implications for older adults. J Nutr Gerontol Geriatr 2014; 32:263-90. [PMID: 24224937 DOI: 10.1080/21551197.2013.842199] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The combination of age-related increases in obesity and inflammation can lead to chronic disease, decreased strength, and physical disability. Lifestyle interventions that include moderate caloric restriction along with aerobic and resistance exercise have shown improvements in metabolic outcomes, strength, and physical function in obese older adults. Although few weight loss studies have addressed diet quality, evidence summarized in this review suggests that encouraging intake of antioxidant-rich fruits and vegetables, high-quality protein, low-glycemic index carbohydrates, and omega-3 fatty acids may further ameliorate obesity-related inflammation. Future controlled trials are indicated to examine the effects of incorporating these foods into multimodal weight loss interventions.
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Affiliation(s)
- Amy Ellis
- a Department of Human Nutrition , University of Alabama , Tuscaloosa , Alabama , USA
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Buys DR, Roth DL, Ritchie CS, Sawyer P, Allman RM, Funkhouser EM, Hovater M, Locher JL. Nutritional risk and body mass index predict hospitalization, nursing home admissions, and mortality in community-dwelling older adults: results from the UAB Study of Aging with 8.5 years of follow-up. J Gerontol A Biol Sci Med Sci 2014; 69:1146-53. [PMID: 24589863 DOI: 10.1093/gerona/glu024] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Nutritional risk and low BMI are common among community-dwelling older adults, but it is unclear what associations these factors have with health services utilization and mortality over long-term follow-up. The aim of this study was to assess prospective associations of nutritional risk and BMI with all-cause, nonsurgical, and surgical hospitalization; nursing home admission; and mortality over 8.5 years. METHODS Data are from 1,000 participants in the University of Alabama at Birmingham Study of Aging, a longitudinal, observational study of older black and white residents of Alabama aged 65 and older. Nutritional risk was assessed using questions associated with the DETERMINE checklist. BMI was categorized as underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9), class I obese (30.0-34.9), and classes II and III obese (≥35.0). Cox proportional hazards models were fit to assess risk of all-cause, nonsurgical, and surgical hospitalization; nursing home admission; and mortality. Covariates included social support, social isolation, comorbidities, and demographic measures. RESULTS In adjusted models, persons with high nutritional risk had 51% greater risk of all-cause hospitalization (95% confidence interval: 1.14-2.00) and 50% greater risk of nonsurgical hospitalizations (95% confidence interval: 1.11-2.01; referent: low nutritional risk). Persons with moderate nutritional risk had 54% greater risk of death (95% confidence interval: 1.19-1.99). BMI was not associated with any outcomes in adjusted models. CONCLUSIONS Nutritional risk was associated with all-cause hospitalizations, nonsurgical hospitalizations, and mortality. Nutritional risk may affect the disablement process that leads to health services utilization and death. These findings point to the need for more attention on nutritional assessment, interventions, and services for community-dwelling older adults.
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Affiliation(s)
| | - David L Roth
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Patricia Sawyer
- Division of Gerontology, Geriatrics and Palliative Care, Comprehensive Center for Healthy Aging, and
| | - Richard M Allman
- Division of Gerontology, Geriatrics and Palliative Care, Comprehensive Center for Healthy Aging, and Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center Alabama
| | | | | | - Julie L Locher
- Department of Health Care Organizations and Policy, University of Alabama at Birmingham
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Williams ED, Eastwood SV, Tillin T, Hughes AD, Chaturvedi N. The effects of weight and physical activity change over 20 years on later-life objective and self-reported disability. Int J Epidemiol 2014; 43:856-65. [PMID: 24562419 PMCID: PMC4052138 DOI: 10.1093/ije/dyu013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Weight and health behaviours are known to affect physical disability; however the evidence exploring the impact of changes to these lifestyle factors over the life course on disability is inconsistent. We aimed to explore the roles of weight and activity change between mid and later life on physical disability. Methods: Baseline and 20-year clinical follow-up data were collected from1418 men and women, aged 58–88 years at follow-up, as part of a population-based observational study based in north-west London. At clinic, behavioural data were collected by questionnaire and anthropometry measured. Disability was assessed using a performance-based locomotor function test and self-reported questionnaires on functional limitation and basic activities of daily living (ADLs). Results: At follow-up, 39% experienced a locomotor dysfunction, 24% a functional limitation and 17% an impairment of ADLs. Weight gain of 10–20% or >20% of baseline, but not weight loss, were associated with increased odds of a functional limitation [odds ratio (OR) 1.69, 95% confidence interval (CI) 1.14-2.49 and OR 2.74, 1.55-4.83, respectively], after full adjustment for covariates. The same patterns were seen for the other disability outcomes. Increased physical activity reduced, and decreased physical activity enhanced the likelihood of disability, independent of baseline behaviours and adiposity. The adverse effects of weight gain appeared to be lessened in the presence of increased later-life physical activity. Conclusion: Weight and activity changes between mid and later life have strong implications for physical functioning in older groups. These findings reinforce the importance of the maintenance of healthy weight and behaviour throughout the life course, and the need to promote healthy lifestyles across population groups.
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Affiliation(s)
- Emily D Williams
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Sophie V Eastwood
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Therese Tillin
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Alun D Hughes
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Nishi Chaturvedi
- International Centre for Circulatory Health, Imperial College London, London, UK
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Fowler-Brown A, Wee CC, Marcantonio E, Ngo L, Leveille S. The mediating effect of chronic pain on the relationship between obesity and physical function and disability in older adults. J Am Geriatr Soc 2013; 61:2079-2086. [PMID: 24329819 DOI: 10.1111/jgs.12512] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To determine the extent to which bodily pain mediates the effect of obesity on disability and physical function. DESIGN Cross-sectional analysis. SETTING Population-based sample of residents in the greater Boston area. PARTICIPANTS Community-dwelling adults aged 70 and older (N=736). MEASUREMENTS Body mass index (BMI), obtained from measured height and weight, was categorized as normal weight (19.0-24.9 kg/m2), overweight (25.0-29.9 kg/m2), or obese (≥30.0 kg/m2). Main outcome measures were the Physical Component Summary of the Medical Outcomes Study 12-item Short-Form Survey (PCS), activity of daily living (ADL) disability, and Short Physical Performance Battery (SPPB) score. Chronic pain was assessed according to the number of weight-bearing joint sites that had pain (hips, knees, feet and pain all over). RESULTS Older obese adults had greater ADL disability and lower SPPB and PCS scores than their nonobese counterparts, although in sex-stratified adjusted analyses, obesity was adversely associated with outcomes only in women. Obesity was associated with greater number of pain sites; and more pain sites were associated with greater odds of disability. Mediation analysis suggests that pain is a significant mediator (22-44%) of the adverse effect of obesity on disability and physical function in women. CONCLUSION Bodily pain may be an important treatable mediator of the adverse effect of obesity on disability and physical function in women.
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Affiliation(s)
- Angela Fowler-Brown
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Christina C Wee
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Edward Marcantonio
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.,Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Long Ngo
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Suzanne Leveille
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts, Boston, Massachusetts
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Bonutti PM, Goddard MS, Zywiel MG, Khanuja HS, Johnson AJ, Mont MA. Outcomes of unicompartmental knee arthroplasty stratified by body mass index. J Arthroplasty 2011; 26:1149-53. [PMID: 21256695 DOI: 10.1016/j.arth.2010.11.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 11/21/2010] [Indexed: 02/01/2023] Open
Abstract
Patients who have high body mass indices can have disabling medial compartment knee osteoarthritis, which might benefit from unicompartmental knee arthroplasty (UKA). The purpose of this study was to compare clinical and radiographic outcomes of UKAs in patients with body mass indices (BMIs) greater and less than 35 kg/m(2). Thirty-four patients (40 knees) had BMIs of 35 kg/m(2) or greater, whereas the remaining 33 patients (40 knees) had BMIs below 35 kg/m(2), with 2-year minimum follow-up. In the high-BMI group, 5 knees were revised to total knee arthroplasty, compared with none in the lower BMI group. Knee Society scores were lower in the surviving high-BMI knees. All surviving components were radiographically stable. The results suggest that UKA should be approached with caution in patients who have high BMIs.
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Kouvonen A, Swift JA, Stafford M, Cox T, Vahtera J, Väänänen A, Heponiemi T, De Vogli R, Griffiths A, Kivimäki M. Social participation and maintaining recommended waist circumference: prospective evidence from the English Longitudinal Study of Aging. J Aging Health 2011; 24:250-68. [PMID: 21956100 DOI: 10.1177/0898264311421960] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To investigate whether older adults participating in social activities are more likely to maintain or achieve recommended waist circumference (WC) levels. METHOD A total of 4,280 older adults who participated in Wave 2 (baseline) and Wave 4 (follow-up) of the English Longitudinal Study of Ageing. WC was measured by a nurse in both study waves. RESULTS Participation in education, arts, music groups, evening classes, and in charitable associations was associated with maintaining recommended WC only in those men whose WC was in the recommended range at baseline. Participation in social activities was not associated with achieving recommended WC in women or men with initially large waist. DISCUSSION Participation in cultural and charitable activities may help in maintaining a recommended level of WC in older men with WC originally in the recommended range.
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Affiliation(s)
- Anne Kouvonen
- Warsaw School of Social Sciences and Humanities, Wroclaw, Poland.
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Cohen-Mansfield J, Shmotkin D, Hazan H. Homebound older persons: prevalence, characteristics, and longitudinal predictors. Arch Gerontol Geriatr 2011; 54:55-60. [PMID: 21420181 DOI: 10.1016/j.archger.2011.02.016] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 02/20/2011] [Accepted: 02/21/2011] [Indexed: 12/22/2022]
Abstract
The current study examines the prevalence and correlates of homebound status aiming to elucidate the predictors and implications of being homebound. Analyzed sample was drawn from two representative cohorts of older persons in Israel, including 1191 participants (mean age=83.10 ± 5.3 years) of the first wave of the Cross-Sectional and Longitudinal Aging Study (CALAS) and 418 participants (mean age=83.13 ± 5.2 years) of the Israeli Multidisciplinary Aging Study (IMAS). Cross-sectional and longitudinal analyses were conducted. Homebound prevalence rates of 17.7-19.5% were found. Homebound participants tended to be older, female, have obese or underweight body mass index (BMI), poorer health, lower functional status, less income, higher depressed affect, were significantly lonelier (in CALAS), and more likely to have stairs and no elevators, than their counterparts. Predictors of becoming homebound include low functional IADL status, having stairs and no elevator (in both cohorts), old age, female gender, and being obese or underweight (in CALAS). The study shows that homebound status is a prevalent problem in old-old Israelis. Economic and socio-demographic resources, environment, and function play a role in determining the older person's homebound status. Implications for preventing homebound status and mitigating its impact with regards to the Israeli context are discussed.
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Affiliation(s)
- Jiska Cohen-Mansfield
- The Herczeg Institute on Aging, Tel Aviv University, P.O.B. 39040, Ramat Aviv, Tel Aviv 69978, Israel.
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Abstract
OBJECTIVE To test the association between obesity and specific types and anatomical sites of unintentional injuries in older adults. METHODS Participants consisted of 52,857 men and women aged ≥65 years from the 2003 and 2005 Canadian Community Health Survey. Weight, height, and details on injuries occurring in the past year were obtained by survey. RESULTS Obese individuals had a higher risk for sprains/strains occurring at any anatomical site (odds ratio, 95% confidence interval: men 1.48, 1.48-1.62; women 1.14, 1.10-1.27). Conversely, obese individuals were less likely to have a fracture at any anatomical location (men 0.56, 0.50-0.63; women 0.66, 0.51-0.92) or at the hip (men 0.31, 0.12-0.53; women 0.42, 0.29-0.92). Finally, obese older adults did not experience more superficial injuries than normal-weight individuals. CONCLUSION Among this large sample of older adults, obesity provided some protection against fractures but was associated with higher odds for sprains/strains.
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Affiliation(s)
- Danielle R Bouchard
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.
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Abstract
We examine obesity, intentional weight loss and physical disability in older adults. Based on prospective epidemiological studies, body mass index exhibits a curvilinear relationship with physical disability; there appears to be some protective effect associated with older adults being overweight. Whereas the greatest risk for physical disability occurs in older adults who are ≥class II obesity, the effects of obesity on physical disability appears to be moderated by both sex and race. Obesity at age 30 years constitutes a greater risk for disability later in life than when obesity develops at age 50 years or later; however, physical activity may buffer the adverse effects obesity has on late life physical disability. Data from a limited number of randomized clinical trials reinforce the important role that physical activity plays in weight loss programmes for older adults. Furthermore, short-term studies have found that resistance training may be particularly beneficial in these programmes as this mode of exercise attenuates the loss of fat-free mass during caloric restriction. Multi-year randomized clinical trials are needed to examine whether weight loss can alter the course of physical disablement in aging and to determine the long-term feasibility and effects of combining resistance exercise with weight loss in older adults.
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Affiliation(s)
- W J Rejeski
- Departments of Health and Exercise Science and Geriatric Medicine, Wake Forest University School of Medicine, Wake Forest University, Winston-Salem, NC, USA
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Abstract
PURPOSE OF REVIEW The present review is intended to provide a critical overview of recent investigations of obesity among older persons with emphasis upon associated functional limitations, potential for intervention, and a future research agenda. RECENT FINDINGS Obesity is growing in prevalence among older persons. The association between obesity and functional decline is well documented. Recent findings suggest possible contributions of obesity-associated inflammatory milieu, sarcopenia, and impairment of muscle function/strength to adverse functional outcomes. A growing body of literature supports consideration of moderate weight reduction to secure improved metabolic and functional parameters for obese older persons. SUMMARY Obesity is associated with an unfortunate burden of chronic disease, functional limitation, and poor life quality. In view of the growing numbers of afflicted older individuals, there must be research priority to discern how obesity impacts function so that appropriate prevention and treatment strategies may be adopted.
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Affiliation(s)
- Gordon L Jensen
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania 16802, USA.
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Houston DK, Nicklas BJ, Zizza CA. Weighty Concerns: The Growing Prevalence of Obesity among Older Adults. ACTA ACUST UNITED AC 2009; 109:1886-95. [PMID: 19857630 DOI: 10.1016/j.jada.2009.08.014] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Accepted: 06/02/2009] [Indexed: 02/08/2023]
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Impact of resistance training with or without caloric restriction on physical capacity in obese older women. Menopause 2009; 16:66-72. [PMID: 18779759 DOI: 10.1097/gme.0b013e31817dacf7] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate the specific impact of resistance training (RT) with or without caloric restriction (CR) on physical capacity in obese older women. DESIGN Forty-eight postmenopausal obese women, physically independent and between the ages of 55 and 75 years were recruited. The women were randomly assigned to one of four groups (1: RT [n = 12], 2: CR [n = 12], 3: CR + RT [n = 12], or 4: control group [C; n = 12]) for 3 months. CR and CR + RT groups participated in a weekly group session on nutrition, and RT and CR + RT groups took part in a resistance training program. Physical capacity was measured with 11 different performance tests. A global physical capacity score (range, 0-44) was then computed using quartiles of each test. Body composition was measured by dual-energy x-ray absorptiometry. RESULTS Body weight, total fat mass, percentage of fat mass, and body mass index (kg/m) significantly decreased in the CR and CR + RT groups (P < 0.01), whereas only the CR group showed a significant decrease in lean body mass (P < 0.05) after the 3-month program. The global physical capacity score significantly improved in the RT group (10.0 +/- 8.8%; P < 0.01), compared with the C group after 3 months. CONCLUSION Overall, the 3-month RT program alone had a greater effect on physical capacity than CR or CR + RT. Thus, a 3-month RT could help prevent long-term decreases in physical capacity in obese older women.
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Affiliation(s)
- Gordon L. Jensen
- From the Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania
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Tsimbos C, Verropoulou G. A multivariate analysis of factors associated with physical functioning limitations in the Greek elderly population. JOURNAL OF STATISTICS & MANAGEMENT SYSTEMS 2008. [DOI: 10.1080/09720510.2008.10701365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jarosz PA, Bellar A. Age-appropriate obesity treatment. Nurse Pract 2008; 33:24-32. [PMID: 18458625 DOI: 10.1097/01.npr.0000317485.58038.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Xiang H, Kidwell K, Wheeler K. Role of disability in the association between obesity and unintentional injuries. Disabil Health J 2008; 1:99-107. [DOI: 10.1016/j.dhjo.2008.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Revised: 01/17/2008] [Accepted: 02/06/2008] [Indexed: 01/22/2023]
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Sachs-Ericsson N, Burns AB, Gordon KH, Eckel LA, Wonderlich SA, Crosby RD, Blazer DG. Body mass index and depressive symptoms in older adults: the moderating roles of race, sex, and socioeconomic status. Am J Geriatr Psychiatry 2007; 15:815-25. [PMID: 17804833 DOI: 10.1097/jgp.0b013e3180a725d6] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Although the long-term health risks associated with obesity in older adults have been well documented, less is known about the psychological consequences. The current study examined the relationship between body mass index (BMI) and subsequent depressive symptoms. The authors anticipated that BMI would predict depressive symptoms, and that this relationship would be greater among women, individuals of higher socioeconomic status (SES), and white subjects. METHODS A three-year longitudinal epidemiological design was employed. Participants were obtained from a biracial sample of community-dwelling older adults (N = 2,406) and were interviewed in their home by trained interviewers. A comprehensive survey assessed age, gender, race, SES (education and income), and health functioning variables. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. BMI was derived from self-reported weight and height. RESULTS BMI was found to predict depressive symptoms. Contrary to predictions, the influence of BMI on depressive symptoms was greater for African Americans than whites and, in particular, African Americans with less education. There were no sex differences. CONCLUSION Among older adults, BMI was associated with depressive symptoms although the effect size was small. Factors contributing to this relationship may differ from those observed in younger populations, for example, health functioning may play a larger role. Obesity appears to have the most adverse impact on those who are most likely to be overweight, lower SES African Americans.
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Affiliation(s)
- Natalie Sachs-Ericsson
- Department of Psychology, Florida State University, Tallahassee, FL 32306, USA. sachs @psy.fsu.edu
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