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Yao J, Steinberg D, Turner EL, Cai GY, Cameron JR, Hybels CF, Eagle DE, Milstein G, Rash JA, Proeschold-Bell RJ. When Shepherds Shed: Trajectories of Weight-Related Behaviors in a Holistic Health Intervention Tailored for US Christian Clergy. JOURNAL OF RELIGION AND HEALTH 2024; 63:1849-1866. [PMID: 37709979 PMCID: PMC11061022 DOI: 10.1007/s10943-023-01910-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/16/2023]
Abstract
Maintaining healthy behaviors is challenging. Based upon previous reports that in North Carolina (NC), USA, overweight/obese clergy lost weight during a two-year religiously tailored health intervention, we described trajectories of diet, physical activity, and sleep. We investigated whether behavior changes were associated with weight and use of health-promoting theological messages. Improvements were observed in sleep, calorie-dense food intake, and physical activity, with the latter two associated with weight loss. While theological messages were well-retained, their relationship with behaviors depended on the specific message, behavior, and timing. Findings offer insights into weight loss mechanisms, including the role of theological messages in religiously tailored health interventions.
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Affiliation(s)
- Jia Yao
- Global Health Institute and Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA.
| | - Dori Steinberg
- School of Nursing and Global Health Institute, Duke University, Durham, NC, USA
| | - Elizabeth L Turner
- Department of Biostatistics and Bioinformatics and Global Health Institute, Duke University, Durham, NC, USA
| | - Grace Y Cai
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
| | - Jacqueline R Cameron
- Department of Internal Medicine, Section of Palliative Medicine, Department of Preventive Medicine, Department of Religion, Health and Human Values, Rush University, Chicago, IL, USA
| | - Celia F Hybels
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - David E Eagle
- Global Health Institute and Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
| | - Glen Milstein
- Department of Psychology, The City College of New York, New York, NY, USA
| | - Joshua A Rash
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Rae Jean Proeschold-Bell
- Global Health Institute and Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
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Jia H, Lubetkin EI. Association between self-reported body mass index and active life expectancy in a large community-dwelling sample of older U.S. adults. BMC Geriatr 2022; 22:310. [PMID: 35397523 PMCID: PMC8994875 DOI: 10.1186/s12877-022-03021-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 04/01/2022] [Indexed: 11/26/2022] Open
Abstract
Background Obesity may have a protective effect (greater survival) in older adults, a finding known as the “obesity paradox.” This study examined the association between self-reported body mass index (BMI) and active life expectancy (ALE) among older U.S. adults. Methods Using the Medicare Health Outcomes Survey Cohort 15 (2012 baseline, 2014 follow-up), we estimated life expectancy and ALE by participants’ baseline BMI and age using multi-state models. A participant was classified as in an active state if this person reported having no difficulty for any of these six activities of daily living (ADLs). Results Small differences in life expectancy were noted among persons in normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2), and obesity ranges (BMI 30 kg/m2 and higher). However, persons with obesity had a significantly lower ALE. ALE at age 65 was 11.1 (11.0–11.2) years for persons with obesity, 1.2 (1.1–1.3) years less than that for the normal weight and overweight persons (12.3 years for both, 12.2–12.4). Persons with class III obesity had a significantly lower life expectancy and ALE than normal weight persons. Although persons with class I or II obesity had a similar life expectancy as normal weight persons, they have a shorter ALE. Conclusions Although older adults with obesity have a similar life expectancy as normal weight persons, they have a significantly shorter ALE. Given the complex relationship of BMI and ALE, a “one size fits all” approach to weight management is not advisable. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03021-7.
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Bennett HQ, Kingston A, Lourida I, Robinson L, Corner L, Brayne C, Matthews FE, Jagger C. A comparison over 2 decades of disability-free life expectancy at age 65 years for those with long-term conditions in England: Analysis of the 2 longitudinal Cognitive Function and Ageing Studies. PLoS Med 2022; 19:e1003936. [PMID: 35290368 PMCID: PMC8923437 DOI: 10.1371/journal.pmed.1003936] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 02/03/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous research has examined the improvements in healthy years if different health conditions are eliminated, but often with cross-sectional data, or for a limited number of conditions. We used longitudinal data to estimate disability-free life expectancy (DFLE) trends for older people with a broad number of health conditions, identify the conditions that would result in the greatest improvement in DFLE, and describe the contribution of the underlying transitions. METHODS AND FINDINGS The Cognitive Function and Ageing Studies (CFAS I and II) are both large population-based studies of those aged 65 years or over in England with identical sampling strategies (CFAS I response 81.7%, N = 7,635; CFAS II response 54.7%, N = 7,762). CFAS I baseline interviews were conducted in 1991 to 1993 and CFAS II baseline interviews in 2008 to 2011, both with 2 years of follow-up. Disability was measured using the modified Townsend activities of daily living scale. Long-term conditions (LTCs-arthritis, cognitive impairment, coronary heart disease (CHD), diabetes, hearing difficulties, peripheral vascular disease (PVD), respiratory difficulties, stroke, and vision impairment) were self-reported. Multistate models estimated life expectancy (LE) and DFLE, stratified by sex and study and adjusted for age. DFLE was estimated from the transitions between disability-free and disability states at the baseline and 2-year follow-up interviews, and LE was estimated from mortality transitions up to 4.5 years after baseline. In CFAS I, 60.8% were women and average age was 75.6 years; in CFAS II, 56.1% were women and average age was 76.4 years. Cognitive impairment was the only LTC whose prevalence decreased over time (odds ratio: 0.6, 95% confidence interval (CI): 0.5 to 0.6, p < 0.001), and where the percentage of remaining years at age 65 years spent disability-free decreased for men (difference CFAS II-CFAS I: -3.6%, 95% CI: -8.2 to 1.0, p = 0.12) and women (difference CFAS II-CFAS I: -3.9%, 95% CI: -7.6 to 0.0, p = 0.04) with the LTC. For men and women with any other LTC, DFLE improved or remained similar. For women with CHD, years with disability decreased (-0.8 years, 95% CI: -3.1 to 1.6, p = 0.50) and DFLE increased (2.7 years, 95% CI: 0.7 to 4.7, p = 0.008), stemming from a reduction in the risk of incident disability (relative risk ratio: 0.6, 95% CI: 0.4 to 0.8, p = 0.004). The main limitations of the study were the self-report of health conditions and the response rate. However, inverse probability weights for baseline nonresponse and longitudinal attrition were used to ensure population representativeness. CONCLUSIONS In this study, we observed improvements to DFLE between 1991 and 2011 despite the presence of most health conditions we considered. Attention needs to be paid to support and care for people with cognitive impairment who had different outcomes to those with physical health conditions.
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Affiliation(s)
- Holly Q. Bennett
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
- * E-mail:
| | - Andrew Kingston
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Ilianna Lourida
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Louise Robinson
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Lynne Corner
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Fiona E. Matthews
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Carol Jagger
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
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CD34 +THY1 + synovial fibroblast subset in arthritic joints has high osteoblastic and chondrogenic potentials in vitro. Arthritis Res Ther 2022; 24:45. [PMID: 35168627 PMCID: PMC8845288 DOI: 10.1186/s13075-022-02736-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/02/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Synovial fibroblasts (SFs) in rheumatoid arthritis (RA) and osteoarthritis (OA) play biphasic roles in joint destruction and regeneration of bone/cartilage as mesenchymal stem cells (MSCs). Although MSCs contribute to joint homeostasis, such function is impaired in arthritic joints. We have identified functionally distinct three SF subsets characterized by the expression of CD34 and THY1 as follows: CD34+THY1+, CD34−THY1−, and CD34−THY1+. The objective of this study was to clarify the differentiation potentials as MSCs in each SF subset since both molecules would be associated with the MSC function. Methods SF subsets were isolated from synovial tissues of 70 patients (RA: 18, OA: 52). Expressions of surface markers associated with MSCs (THY1, CD34, CD73, CD271, CD54, CD44, and CD29) were evaluated in fleshly isolated SF subsets by flow cytometry. The differentiation potentials of osteogenesis, chondrogenesis, and adipogenesis were evaluated with histological staining and a quantitative polymerase chain reaction of differentiation marker genes. Small interfering RNA was examined to deplete THY1 in SFs. Results The expression levels of THY1+, CD73+, and CD271+ were highest and those of CD54+ and CD29+ were lowest in CD34+THY1+ among three subsets. Comparing three subsets, the calcified area, alkaline phosphatase (ALP)-stained area, and cartilage matrix subset were the largest in the CD34+THY1+ subset. Consistently, the expressions of differentiation markers of the osteoblasts (RUNX2, ALPL, and OCN) or chondrocytes (ACAN) were the highest in the CD34+THY1+ subset, indicating that the CD34+THY1+ subset possessed the highest osteogenic and chondrogenic potential among three subsets, while the differentiation potentials to adipocytes were comparable among the subsets regarding lipid droplet formations and the expression of LPL and PPARγ. The knockdown of THY1 in bulk SFs resulted in impaired osteoblast differentiation indicating some functional aspects in this stem-cell marker. Conclusion The CD34+THY1+ SF subset has high osteogenic and chondrogenic potentials. The preferential enhancement of MSC functions in the CD34+THY1+ subset may provide a new treatment strategy for regenerating damaged bone/cartilage in arthritic joints. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02736-7.
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Lourida I, Bennett HQ, Beyer F, Kingston A, Jagger C. The impact of long-term conditions on disability-free life expectancy: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000745. [PMID: 36962577 PMCID: PMC10021208 DOI: 10.1371/journal.pgph.0000745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/14/2022] [Indexed: 11/18/2022]
Abstract
Although leading causes of death are regularly reported, there is disagreement on which long-term conditions (LTCs) reduce disability-free life expectancy (DFLE) the most. We aimed to estimate increases in DFLE associated with elimination of a range of LTCs. This is a comprehensive systematic review and meta-analysis of studies assessing the effects of LTCs on health expectancy (HE). MEDLINE, Embase, HMIC, Science Citation Index, and Social Science Citation Index were systematically searched for studies published in English from July 2007 to July 2020 with updated searches from inception to April 8, 2021. LTCs considered included: arthritis, diabetes, cardiovascular disease including stroke and peripheral vascular disease, respiratory disease, visual and hearing impairment, dementia, cognitive impairment, depression, cancer, and comorbidity. Studies were included if they estimated HE outcomes (disability-free, active or healthy life expectancy) at age 50 or older for individuals with and without the LTC. Study selection and quality assessment were undertaken by teams of independent reviewers. Meta-analysis was feasible if three or more studies assessed the impact of the same LTC on the same HE at the same age using comparable methods, with narrative syntheses for the remaining studies. Studies reporting Years of Life Lost (YLL), Years of Life with Disability (YLD) and Disability Adjusted Life Years (DALYs = YLL+YLD) were included but reported separately as incomparable with other HE outcomes (PROSPERO registration: CRD42020196049). Searches returned 6072 unique records, yielding 404 eligible for full text retrieval from which 30 DFLE-related and 7 DALY-related were eligible for inclusion. Thirteen studies reported a single condition, and 17 studies reported on more than one condition (two to nine LTCs). Only seven studies examined the impact of comorbidities. Random effects meta-analyses were feasible for a subgroup of studies examining diabetes (four studies) or respiratory diseases (three studies) on DFLE. From pooled results, individuals at age 65 without diabetes gain on average 2.28 years disability-free compared to those with diabetes (95% CI: 0.57-3.99, p<0.01, I2 = 96.7%), whilst individuals without respiratory diseases gain on average 1.47 years compared to those with respiratory diseases (95% CI: 0.77-2.17, p<0.01, I2 = 79.8%). Eliminating diabetes, stroke, hypertension or arthritis would result in compression of disability. Of the seven longitudinal studies assessing the impact of multiple LTCs, three found that stroke had the greatest effect on DFLE for both genders. This study is the first to systematically quantify the impact of LTCs on both HE and LE at a global level, to assess potential compression of disability. Diabetes, stroke, hypertension and arthritis had a greater effect on DFLE than LE and so elimination would result in compression of disability. Guidelines for reporting HE outcomes would assist data synthesis in the future, which would in turn aid public health policy.
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Affiliation(s)
- Ilianna Lourida
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Holly Q Bennett
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fiona Beyer
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Andrew Kingston
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Carol Jagger
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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Bennett HQ, Kingston A, Lourida I, Robinson L, Corner L, Brayne CEG, Matthews FE, Jagger C. The contribution of multiple long-term conditions to widening inequalities in disability-free life expectancy over two decades: Longitudinal analysis of two cohorts using the Cognitive Function and Ageing Studies. EClinicalMedicine 2021; 39:101041. [PMID: 34386756 PMCID: PMC8342913 DOI: 10.1016/j.eclinm.2021.101041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND : Disability-free life expectancy (DFLE) inequalities by socioeconomic deprivation are widening, alongside rising prevalence of multiple long-term conditions (MLTCs). We use longitudinal data to assess whether MLTCs contribute to the widening DFLE inequalities by socioeconomic deprivation. METHODS : The Cognitive Function and Ageing Studies (CFAS I and II) are large population-based studies of those ≥65 years, conducted in three areas in England. Baseline occurred in 1991 (CFAS I, n=7635) and 2011 (CFAS II, n=7762) with two-year follow-up. We defined disability as difficulty in activities of daily living, MLTCs as the presence of at least two of nine health conditions, and socioeconomic deprivation by area-level deprivation tertiles. DFLE and transitions between disability states and death were estimated from multistate models. FINDINGS : For people with MLTCs, inequalities in DFLE at age 65 between the most and least affluent widened to around 2.5 years (men:2.4 years, 95% confidence interval (95%CI) 0.4-4.4; women:2.6 years, 95%CI 0.7-4.5) by 2011. Incident disability reduced for the most affluent women (Relative Risk Ratio (RRR):0.6, 95%CI 0.4-0.9), and mortality with disability reduced for least affluent men (RRR:0.6, 95%CI 0.5-0.8). MLTCs prevalence increased only for least affluent men (1991: 58.8%, 2011: 66.9%) and women (1991: 60.9%, 2011: 69.1%). However, DFLE inequalities were as large in people without MLTCs (men:2.4 years, 95%CI 0.3-4.5; women:3.1 years, 95% CI 0.8-5.4). INTERPRETATION : Widening DFLE inequalities were not solely due to MLTCs. Reduced disability incidence with MLTCs is possible but was only achieved in the most affluent.
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Affiliation(s)
- Holly Q Bennett
- Population Health Sciences Institute, Faculty of Medical Sciences, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Andrew Kingston
- Population Health Sciences Institute, Faculty of Medical Sciences, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Ilianna Lourida
- Population Health Sciences Institute, Faculty of Medical Sciences, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Louise Robinson
- Population Health Sciences Institute, Faculty of Medical Sciences, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Lynne Corner
- Population Health Sciences Institute, Faculty of Medical Sciences, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Carol EG Brayne
- Cambridge Institute of Public Health, Forvie site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical campus, Cambridge CB2 0SR, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Faculty of Medical Sciences, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Carol Jagger
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Edwardson Building, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK
- Corresponding author.
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Wu H. How do Co- and Non-Residential Children Impact your Subjective Life Expectancy: An Empirical Study on CHARLS Data? Int J Health Plann Manage 2019; 35:532-544. [PMID: 31679156 DOI: 10.1002/hpm.2946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Existing studies conclude SLE predicts decision-making in the future. This paper studied how contacts with children influence subjective life expectancy (SLE) of the mid-age and elderly in China. We also investigated the moderation effect of living arrangement preference (LAP). A better understanding of impact factors that contribute to the mid-age and elderly's thoughts about their lifetime is essential for the late-career financial planning and health interventions. METHODS Our study examines the relationship between co- and non-residential children and SLE by using two waves of data from China Health and Retirement Longitudinal Study (CHARLS). RESULTS Our findings suggest that contacts with children help older people construct positive SLE. However, with an increased number of non-residential children, older people will become pessimistic about their SLE. When older people prefer living alone, it decreases the impact of the number of non-residential children on SLE. CONCLUSION Our results encourage children to live with their parents and contact their parents from time to time. Interventions that change their ideas about living arrangement preference may actually be useful for mid-age and elderly. The best living arrangement should take the living arrangement preference of older people into consideration and give them the best arrangement according to their preference.
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Affiliation(s)
- Hong Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, China
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Years of life with and without limitation in physical function and in activities of daily living by body mass index among older adults. Int J Obes (Lond) 2019; 43:2244-2253. [PMID: 31068661 DOI: 10.1038/s41366-019-0370-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 03/19/2019] [Accepted: 03/25/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND While older adults with pre-obesity and Class I obesity have similar or lower mortality risk versus those with normal weight, a heavier body mass index (BMI) may not translate into more healthy life years. Utilizing longitudinal data on 3452 older (≥60 years) Singaporeans, we assessed the association between BMI and years of remaining life overall with and without limitation in physical function and in activities of daily living (ADLs). METHODS Difficulty in any of nine tasks involving upper or lower extremities was considered as limitation in physical function, and health-related difficulty in any basic ADL or instrumental ADL as limitation in ADLs. We utilized multistate life tables, including BMI as a time-varying covariate. RESULTS At age 60, life expectancy (LE) was similar for those with normal weight, pre-obesity and obesity. However, those with obesity, versus normal weight, had 6.3 [95% confidence interval: 3.4-9.2] more years with limitation in physical function and 4.9 [3.4-6.5] less years without limitation in physical function. Those with pre-obesity, versus normal weight, also had 3.7 [1.9-5.3] more years with limitation in physical function. The same pattern across BMI categories was observed for years of life with and without limitation in ADLs. In stratified analyses, similar associations of BMI with years of life with and without limitation in physical function and in ADLs were observed across gender, ethnicity, and educational status. CONCLUSIONS The increasing global prevalence of obesity may result in an increase in years of life with limitation in physical function and in ADLs at older ages. Older adults, their families and healthcare systems should be cognizant of this issue.
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Moreno X, Albala C, Lera L, Leyton B, Angel B, Sánchez H. Gender, nutritional status and disability-free life expectancy among older people in Santiago, Chile. PLoS One 2018; 13:e0194074. [PMID: 29590148 PMCID: PMC5874002 DOI: 10.1371/journal.pone.0194074] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 02/23/2018] [Indexed: 12/20/2022] Open
Abstract
Background This study was aimed to estimate life expectancy (LE), disability-free life expectancy (DFLE) and disabled life expectancy (DLE) among older adults from Santiago, Chile, and to determine the existence of differences by gender and by body mass index (BMI) categories in these indicators. Methods A sample of 1216 people aged 60 or more, from the Chilean cohort of the Study of Health, Ageing and Well-Being was recruited in 2000; two follow-up assessments were carried out in a 10-year period. Functional limitation was assessed through self-report of difficulties in activities of daily living, instrumental activities of daily living and mobility. BMI was determined with measured weight and height. Multistate life tables were employed to estimate LE and healthy life expectancy (HLE). Results At 60 years, women could expect to live on average an additional 20.4 years (95% CI 19.0–21.6), and men an additional 16.4 years (95% CI 14.9–17.7). Total LE was longer among women at all ages, but they had a higher proportion of disabled years to be lived compared to men, with a difference of 14% at 60 years, and 10% at 90 years. There were no significant differences in LE, DFLE and DLE between BMI categories. Discussion Despite a longer LE, Chilean older women expect to live a higher proportion of years with disabilities, compared to men. Public health programs should address factors affecting LE of older men, and those associated with disability among older women.
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Affiliation(s)
- Ximena Moreno
- Institute of Nutrition and Food Technology, University of Chile. ElLíbano, Macul, Santiago, Chile
| | - Cecilia Albala
- Institute of Nutrition and Food Technology, University of Chile. ElLíbano, Macul, Santiago, Chile
- * E-mail:
| | - Lydia Lera
- Institute of Nutrition and Food Technology, University of Chile. ElLíbano, Macul, Santiago, Chile
| | - Bárbara Leyton
- Institute of Nutrition and Food Technology, University of Chile. ElLíbano, Macul, Santiago, Chile
| | - Bárbara Angel
- Institute of Nutrition and Food Technology, University of Chile. ElLíbano, Macul, Santiago, Chile
| | - Hugo Sánchez
- Institute of Nutrition and Food Technology, University of Chile. ElLíbano, Macul, Santiago, Chile
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Rosenberg DE, Lee AK, Anderson M, Renz A, Matson TE, Kerr J, Arterburn D, McClure JB. Reducing Sedentary Time for Obese Older Adults: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e23. [PMID: 29434012 PMCID: PMC5826980 DOI: 10.2196/resprot.8883] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/05/2017] [Accepted: 12/06/2017] [Indexed: 01/12/2023] Open
Abstract
Background Older adults have high rates of obesity and are prone to chronic health conditions. These conditions are in part due to high rates of sedentary time (ST). As such, reducing ST could be an innovative strategy for improving health outcomes among obese older adults. To test this theory, we developed a novel, technology-enhanced intervention to reduce sitting time (I-STAND) and pilot tested it to assess the feasibility, acceptability, and preliminary effects of the intervention on ST and biometric outcomes. Objective The current paper aims to describe the rationale, design, and methods of the I-STAND sitting reduction pilot trial. Methods Older adults with obesity (n=60) were recruited from a large health care system and randomized to receive I-STAND or a healthy living intervention. I-STAND combined personal coaching with a technology-enhanced intervention (Jawbone UP band) to cue breaks from sitting. Participants completed self-report and biometric assessments at baseline and 3 months. Additional qualitative results were collected from a subset of I-STAND participants (n=22) to further inform the feasibility and acceptability of the interventions. The primary outcome was total hours of daily sitting time measured by the activPAL device. Secondary outcomes included sit-to-stand transitions, bouts of sitting longer than 30 minutes, physical function, blood pressure, fasting glucose, cholesterol, and depressive symptoms. Results Study enrollment has ended and data processing is underway. Conclusions Data from randomized trials on sitting reduction are needed to inform novel approaches to health promotion among older adults with obesity. Our trial will help fill this gap. The methods used in our study can guide future research on using technology-based devices to assess or prompt sedentary behavior reduction, or those interested in behavioral interventions targeting obese older adults with novel approaches Trial Registration ClinicalTrials.gov: NCT02692560; https://clinicaltrials.gov/ct2/show/NCT02692560 (Archived by WebCite at http://www.webcitation.org/6wppLTWAl)
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Affiliation(s)
- Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Amy K Lee
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Melissa Anderson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Anne Renz
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Theresa E Matson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Jacqueline Kerr
- University of California San Diego, San Diego, CA, United States
| | - David Arterburn
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Jennifer B McClure
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
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Lisko I, Tiainen K, Raitanen J, Jylhävä J, Hurme M, Hervonen A, Jylhä M, Stenholm S. Body Mass Index and Waist Circumference as Predictors of Disability in Nonagenarians: The Vitality 90+ Study. J Gerontol A Biol Sci Med Sci 2017; 72:1569-1574. [DOI: 10.1093/gerona/glx032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
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Cao B. Future healthy life expectancy among older adults in the US: a forecast based on cohort smoking and obesity history. Popul Health Metr 2016; 14:23. [PMID: 27408607 PMCID: PMC4941025 DOI: 10.1186/s12963-016-0092-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 06/23/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In the past three decades, the elderly population in the United States experienced increase in life expectancy (LE) and disability-free life expectancy (LE(ND)), but decrease in life expectancy with disability (LE(D)). Smoking and obesity are two major risk factors that had negative impacts on these trends. While smoking prevalence continues to decline in recent decades, obesity prevalence has been growing and is currently at a high level. This study aims to forecast the healthy life expectancy for older adults aged 55 to 85 in the US from 2011 to 2040, in relation to their smoking and obesity history. METHODS First, population-level mortality data from the Human Mortality Database (HMD) and individual-level disability data from the US National Health Interview Survey (NHIS) were used to estimate the transition rates between different health states from 1982 to 2010, using a multi-state life table (MSLT) model. Second, the estimated transition rates were fitted and projected up to 2040, using a modified Lee-Carter model that incorporates cohort smoking and obesity history from NHIS. RESULTS Mortality and morbidity for both sexes will continue to decline in the next decades. Relative to 2010, men are expected to have 3.2 years gain in LE(ND) and 0.8 years loss in LE(D). For women, there will be 1.8 years gain in LE(ND) and 0.8 years loss in LE(D). By 2040, men and women are expected to spend respectively 80 % and 75 % of their remaining life expectancy between 55 and 85 disability-free. CONCLUSIONS Smoking and obesity have independent negative impacts on both the survival and disability of the US older population in the coming decades, and are responsible for the present and future gender disparity in mortality and morbidity. Overall, the US older population is expected to enjoy sustained health improvements and compression of disability, largely due to decline in smoking.
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Affiliation(s)
- Bochen Cao
- Population Studies Center, University of Pennsylvania, McNeil Building, 3718 Locust Walk, Philadelphia, PA 19104 USA
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Corica F, Bianchi G, Corsonello A, Mazzella N, Lattanzio F, Marchesini G. Obesity in the Context of Aging: Quality of Life Considerations. PHARMACOECONOMICS 2015; 33:655-672. [PMID: 25420750 DOI: 10.1007/s40273-014-0237-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The progressive increase in the prevalence of obesity and aging in the population is resulting in increased healthcare and disability spending. The burden of obesity is particularly relevant in old age, due to accumulating co-morbidities and changes in body composition. Sarcopenic obesity, a mix of over- and under-nutrition, causes frailty, disability, and problems in social and psychological areas, impacting overall health-related quality of life (HR-QOL). The relationship between obesity, aging, and HR-QOL is, however, much more complex than generally acknowledged and is difficult to disentangle. The impact of obesity on HR-QOL is particularly strong in young people, who are free of co-morbidities. It progressively attenuates, compared with the general population, with advancing age, when co-morbid conditions are diffusely present and reduce the perceived health status, independent of obesity. However, even this apparent 'obesity paradox' should not minimize the importance of obesity on HR-QOL, as other obesity-associated limitations and disabilities do impact HR-QOL in older age. A patient-centered approach aimed at reducing the disability and social isolation of advancing age is mandatory to improve HR-QOL in any class of obesity.
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Affiliation(s)
- Francesco Corica
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Pongiglione B, De Stavola BL, Ploubidis GB. A Systematic Literature Review of Studies Analyzing Inequalities in Health Expectancy among the Older Population. PLoS One 2015; 10:e0130747. [PMID: 26115099 PMCID: PMC4482630 DOI: 10.1371/journal.pone.0130747] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 05/23/2015] [Indexed: 11/21/2022] Open
Abstract
Aim To collect, organize and appraise evidence of socioeconomic and demographic inequalities in health and mortality among the older population using a summary measure of population health: Health Expectancy. Methods A systematic literature review was conducted. Literature published in English before November 2014 was searched via two possible sources: three electronic databases (Web of Science, Medline and Embase), and references in selected articles. The search was developed combining terms referring to outcome, exposure and participants, consisting in health expectancy, socioeconomic and demographic groups, and older population, respectively. Results Of 256 references identified, 90 met the inclusion criteria. Six references were added after searching reference lists of included articles. Thirty-three studies were focused only on gender-based inequalities; the remaining sixty-three considered gender along with other exposures. Findings were organized according to two leading perspectives: the type of inequalities considered and the health indicators chosen to measure health expectancy. Evidence of gender-based differentials and a socioeconomic gradient were found in all studies. A remarkable heterogeneity in the choice of health indicators used to compute health expectancy emerged as well as a non-uniform way of defining same health conditions. Conclusions Health expectancy is a useful and convenient measure to monitor and assess the quality of ageing and compare different groups and populations. This review showed a general agreement of results obtained in different studies with regard to the existence of inequalities associated with several factors, such as gender, education, behaviors, and race. However, the lack of a standardized definition of health expectancy limits its comparability across studies. The need of conceiving health expectancy as a comparable and repeatable measure was highlighted as fundamental to make it an informative instrument for policy makers.
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Affiliation(s)
- Benedetta Pongiglione
- Medical Statistics Department, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Bianca L De Stavola
- Medical Statistics Department, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - George B Ploubidis
- Centre for Longitudinal Studies, Institute of Education, London, United Kingdom
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Laditka JN, Laditka SB. Associations of multiple chronic health conditions with active life expectancy in the United States. Disabil Rehabil 2015; 38:354-61. [DOI: 10.3109/09638288.2015.1041614] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- James N. Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Sarah B. Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
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Yin Z, Shi X, Kraus VB, Brasher MS, Chen H, Liu Y, Lv Y, Zeng Y. Gender-dependent association of body mass index and waist circumference with disability in the Chinese oldest old. Obesity (Silver Spring) 2014; 22:1918-1925. [PMID: 24777985 PMCID: PMC4114995 DOI: 10.1002/oby.20775] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 03/23/2014] [Accepted: 04/13/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To explore associations of BMI and waist circumference (WC) with disability among the Chinese oldest old. METHODS The 5,495 oldest old in the sixth wave of Chinese Longitudinal Healthy Longevity Study conducted in 2011 were included in this study. Disability was assessed by activities of daily living (ADL); height and weight for BMI and WC were measured; information including socio-demographics, lifestyles, and health status was collected. RESULTS Generalized additive models analysis showed that the association of BMI/WC with ADL disability was nonlinear. Among the males, logistic regression results supported a "J" shape association between ADL disability with BMI/WC-the highest tertile group in BMI or WC was significantly associated with an increased risk of ADL disability: odds ratio 1.78 (95% confidence interval (CI): 1.26-2.52) for BMI and 2.01 (95% CI: 1.44-2.82) for WC. Among females, an inverse "J" shape association was found, only the lowest tertile group before the cutoff point had an increased risk of ADL disability: odds ratio 1.42 (95%CI: 1.02-1.97) for BMI and 1.47 (95% CI:1.06-2.04) for WC. CONCLUSIONS Associations of BMI and WC with ADL disability are significant even in the oldest old, but differ between the genders.
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Affiliation(s)
- Zhaoxue Yin
- Division of Non-communicable Diseases Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoming Shi
- Division of Non-communicable Diseases Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Corresponding Authors: Xiaoming Shi, NO.155 Changbai Road, Changping District, Beijing 102206, China, Tel. +86-10-58900215, Fax. +86-10-58900247, Yi Zeng, Box 3003, Room 1506, BUSSE Building, Durham, NC27710, USA, Tel. 919-660-7554, Fax: 919-668-0453,
| | - Virginia B. Kraus
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Huashuai Chen
- Center for the study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC, USA
| | - Yuzhi Liu
- Center for Study of Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
| | - Yuebin Lv
- Division of Non-communicable Diseases Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zeng
- Center for the study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC, USA
- Center for Study of Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
- Corresponding Authors: Xiaoming Shi, NO.155 Changbai Road, Changping District, Beijing 102206, China, Tel. +86-10-58900215, Fax. +86-10-58900247, Yi Zeng, Box 3003, Room 1506, BUSSE Building, Durham, NC27710, USA, Tel. 919-660-7554, Fax: 919-668-0453,
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We are ageing. BIOMED RESEARCH INTERNATIONAL 2014; 2014:808307. [PMID: 25045704 PMCID: PMC4090574 DOI: 10.1155/2014/808307] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 05/27/2014] [Accepted: 05/27/2014] [Indexed: 02/01/2023]
Abstract
Ageing and longevity is unquestioningly complex. Several thoughts and mechanisms of ageing such as pathways involved in oxidative stress, lipid and glucose metabolism, inflammation, DNA damage and repair, growth hormone axis and insulin-like growth factor (GH/IGF), and environmental exposure have been proposed. Also, some theories of ageing were introduced. To date, the most promising leads for longevity are caloric restriction, particularly target of rapamycin (TOR), sirtuins, hexarelin and hormetic responses. This review is an attempt to analyze the mechanisms and theories of ageing and achieving longevity.
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Mo F, Morrison H, Neutel IC. Population attributable risk from obesity to arthritis in the Canadian Population Health Longitudinal Survey 1994-2006. Int J Rheum Dis 2014; 17:628-34. [DOI: 10.1111/1756-185x.12372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Frank Mo
- Social Determinants and Science Integration Directorate; Public Health Agency of Canada; Ottawa Ontario Canada
| | - Howard Morrison
- Social Determinants and Science Integration Directorate; Public Health Agency of Canada; Ottawa Ontario Canada
| | - Ineke C. Neutel
- The R. Samuel McLaughlin Centre; Institute of Population Health; University of Ottawa; Ottawa Ontario Canada
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Murphy RA, Reinders I, Register TC, Ayonayon HN, Newman AB, Satterfield S, Goodpaster BH, Simonsick EM, Kritchevsky SB, Harris TB. Associations of BMI and adipose tissue area and density with incident mobility limitation and poor performance in older adults. Am J Clin Nutr 2014; 99:1059-65. [PMID: 24522448 PMCID: PMC3985211 DOI: 10.3945/ajcn.113.080796] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Obesity is a risk factor for disability, but risk of specific adipose depots is not completely understood. OBJECTIVE We investigated associations between mobility limitation, performance, and the following adipose measures: body mass index (BMI) and areas and densities of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and intermuscular adipose tissue (IMAT) in older adults. DESIGN This was a prospective population-based study of men (n = 1459) and women (n = 1552) initially aged 70-79 y and free from mobility limitation. BMI was determined from measured height and weight. Adipose tissue area and density in Hounsfield units were measured in the thigh and abdomen by using computed tomography. Mobility limitation was defined as 2 consecutive reports of difficulty walking one-quarter mile or climbing 10 steps during semiannual assessments over 13 y. Poor performance was defined as a gait speed <1 m/s after 9 y of follow-up (n = 1542). RESULTS In models adjusted for disability risk factors, BMI, and areas of VAT, abdominal SAT, and IMAT were positively associated with mobility limitation in men and women. In women, thigh SAT area was positively associated with mobility limitation risk, whereas VAT density was inversely associated. Associations were similar for poor performance. BMI and thigh IMAT area (independent of BMI) were particularly strong indicators of incident mobility limitation and poor performance. For example, in women, the HR (95% CI) and OR (95% CI) associated with an SD increment in BMI for mobility limitation and poor performance were 1.31 (1.21, 1.42) and 1.41 (1.13, 1.76), respectively. In men, the HR (95% CI) and OR (95% CI) associated with an SD increment in thigh IMAT for mobility limitation and poor performance were 1.37 (1.27, 1.47) and 1.54 (1.18, 2.02), respectively. CONCLUSIONS Even into old age, higher BMI is associated with mobility limitation and poor performance. The amount of adipose tissue in abdominal and thigh depots may also convey risk beyond BMI.
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Affiliation(s)
- Rachel A Murphy
- Laboratory of Epidemiology, and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, MD (RAM, IR, and TBH); the Sections on Comparative Medicine Pathology, Radiology (TCR), and Gerontology and Geriatrics (SBK), Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC; the Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (HNA); the Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA (ABN); the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (SS); the Center for Aging and Population Health, Department of Medicine, University of Pittsburgh, Pittsburgh, PA (BHG); and the Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, Baltimore, MD (EMS)
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Haas MC, Bodner EV, Brown CJ, Bryan D, Buys DR, Keita AD, Flagg LA, Goss A, Gower B, Hovater M, Hunter G, Ritchie CS, Roth DL, Wingo BC, Ard J, Locher JL. Calorie restriction in overweight seniors: response of older adults to a dieting study: the CROSSROADS randomized controlled clinical trial. J Nutr Gerontol Geriatr 2014; 33:376-400. [PMID: 25424512 PMCID: PMC4248142 DOI: 10.1080/21551197.2014.965993] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We conducted a study designed to evaluate whether the benefits of intentional weight loss exceed the potential risks in a group of community-dwelling obese older adults who were at increased risk for cardiometabolic disease. The CROSSROADS trial used a prospective randomized controlled design to compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition and adipose tissue deposition (Specific Aim #1: To compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition, namely visceral adipose tissue), cardiometabolic disease risk (Specific Aim #2: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on cardiometabolic disease risk), and functional status and quality of life (Specific Aim #3: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on functional status and quality of life). Participants were randomly assigned to one of three groups: Exercise Only (Control) Intervention, Exercise + Diet Quality + Weight Maintenance Intervention, or Exercise + Diet Quality + Weight Loss Intervention. CROSSROADS utilized a lifestyle intervention approach consisting of exercise, dietary, and behavioral components. The development and implementation of the CROSSROADS protocol, including a description of the methodology, detailing specific elements of the lifestyle intervention, assurances of treatment fidelity, and participant retention; outcome measures and adverse event monitoring; as well as unique data management features of the trial results, are presented in this article.
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Affiliation(s)
- Marilyn C Haas
- a Division of Gerontology, Geriatrics, and Palliative Care , University of Alabama at Birmingham , Birmingham , Alabama , USA
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22
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Proeschold-Bell RJ, McDevitt PJ. An Overview of the History and Current Status of Clergy Health. J Prev Interv Community 2012; 40:177-9. [DOI: 10.1080/10852352.2012.680407] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Diehr P, Thielke S, O'Meara E, Fitzpatrick AL, Newman A. Comparing years of healthy life, measured in 16 ways, for normal weight and overweight older adults. J Obes 2012; 2012:894894. [PMID: 22778920 PMCID: PMC3388309 DOI: 10.1155/2012/894894] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 02/17/2012] [Accepted: 03/07/2012] [Indexed: 11/22/2022] Open
Abstract
Introduction. The traditional definitions of overweight and obesity are not age specific, even though the relationship of weight to mortality is different for older adults. Effects of adiposity on aspects of health beside mortality have not been well investigated. Methods. We calculated the number of years of healthy life (YHL) in the 10 years after baseline, for 5,747 older adults. YHL was defined in 16 different ways. We compared Normal and Overweight persons, classified either by body mass index (BMI) or by waist circumference (WC). Findings. YHL for Normal and Overweight persons differed significantly in 25% of the comparisons, of which half favored the Overweight. Measures of physical health favored Normal weight, while measures of mental health and quality of life favored Overweight. Overweight was less favorable when defined by WC than by BMI. Obese persons usually had worse outcomes. Discussion. Overweight older adults averaged as many years of life and years of healthy life as those of Normal weight. There may be no outcome based reason to distinguish Normal from Overweight for older adults. Conclusion. The "Overweight paradox" appears to hold for nonmortality outcomes. New adiposity standards are needed for older adults, possibly different by race and sex.
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Affiliation(s)
- Paula Diehr
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
- Department of Health Services, University of Washington, Seattle, WA 98195, USA
| | - Stephen Thielke
- Department of Psychiatry, University of Washington, Seattle, WA 98195, USA
- Geriatric Research, Education, and Clinical Center, Puget Sound VA Medical Center, Seattle, WA 98195, USA
| | - Ellen O'Meara
- Group Health Research Institute, Seattle, WA 98195, USA
| | | | - Anne Newman
- Department of Epidemiology and Center for Aging and Population Research, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Obesity in older adults: epidemiology and implications for disability and disease. ACTA ACUST UNITED AC 2011; 22:10-34. [DOI: 10.1017/s0959259811000190] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
SummaryObesity is a worldwide problem with increasing prevalence and incidence in both developed and developing countries. In older adults, excess weight is associated with a higher prevalence of cardiovascular disease, metabolic disease, several important cancers, and numerous other medical conditions. Obesity has also been associated with increased functional limitations, disability, and poorer quality of life. Additionally, obesity has been independently associated with all-cause mortality. The obesity epidemic has important social and economic implications, representing an important source of increased public health care costs. The aim of this review is to report the epidemiology of obesity worldwide, and the implications of obesity on disability and chronic diseases in older adults.
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Proeschold-Bell RJ, LeGrand SH. High rates of obesity and chronic disease among United Methodist clergy. Obesity (Silver Spring) 2010; 18:1867-70. [PMID: 20448538 DOI: 10.1038/oby.2010.102] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We used self-reported data from United Methodist clergy to assess the prevalence of obesity and having ever been told certain chronic disease diagnoses. Of all actively serving United Methodist clergy in North Carolina (NC) 95% (n = 1726) completed self-report height and weight items and diagnosis questions from the Behavioral Risk Factor Surveillance Survey (BRFSS). We calculated BMI categories and diagnosis prevalence rates for the clergy and compared them to the NC population using BRFSS data. The obesity rate among clergy aged 35-64 years was 39.7%, 10.3% (95% CI = 8.5%, 12.1%) higher than their NC counterparts. Clergy also reported significantly higher rates of having ever been given diagnoses of diabetes, arthritis, high blood pressure, angina, and asthma compared to their NC peers. Health interventions that address obesity and chronic disease among clergy are urgently needed.
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Affiliation(s)
- Rae Jean Proeschold-Bell
- Duke Global Health Institute, Duke University Center for Health Policy, Durham, North Carolina, USA.
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Riebe D, Blissmer BJ, Greaney ML, Garber CE, Lees FD, Clark PG. The relationship between obesity, physical activity, and physical function in older adults. J Aging Health 2009; 21:1159-78. [PMID: 19897781 DOI: 10.1177/0898264309350076] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This study investigated the relationship between overweight and obesity, age, and gender with physical activity and physical function in community-dwelling older men and women. METHOD Multivariate analysis of covariance was used to analyze differences between normal weight, overweight, and obese adults (n = 821) above the age of 60 years. RESULTS Obesity but not overweight was associated with lower levels of physical activity and physical function. Within BMI groups, individuals who were physically active were less likely to have abnormal physical function scores compared to those who were sedentary. Compared to men, obese women had lower physical function scores, placing them at higher risk for future disability. Aging was associated with lower levels of physical activity and physical function. DISCUSSION The study illustrates the importance of avoiding obesity and participating in regular physical activity to prevent or slow down the loss of functioning in older age.
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Affiliation(s)
- Deborah Riebe
- Department of Kinesiology, The University of Rhode Island, 210 Flagg Road Kingston, RI 02881, USA.
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