1
|
Görres C, Hoßbach J, Pabst A, Luppa M, Stein J, Welzel FD, Jung FU, Hussenoeder FS, Engel C, Kirsten T, Reyes N, Wirkner K, Riedel-Heller SG, Löbner M. [The relationship between obesity, social isolation, and mental health-results from the LIFE adult study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:1121-1130. [PMID: 39190150 DOI: 10.1007/s00103-024-03940-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 07/17/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Population-based studies on the relationship between social isolation and obesity, which also include younger adults, are still lacking in Germany. The aim of this study is to investigate the prevalence of social isolation in people with and without obesity. In addition, socially isolated people with and without obesity are examined with regard to socio-demographic and socio-economic factors as well as with regard to depressive symptoms. METHODS This study was based on baseline data from the LIFE Adult Study (18-79 years) from the 2011-2014 study period. The sample comprised n = 8350 participants. In addition to socio-demographic characteristics and socio-economic status (SES), data on social isolation (LSNS-6), depression (ADS), and body mass index (BMI) were collected. Evaluations were carried out using inferential statistical analyses. RESULTS Overall, 13.1% of the total sample were affected by social isolation. Participants with obesity (20.4%) had a significantly (p < 0.001) higher prevalence compared to those without obesity (11.4%). A better social integration was significantly associated with younger age (p < 0.001), female sex (p < 0.001), being married (and cohabiting) (p < 0.001), higher socioeconomic status (p < 0.001), and lower depressive symptoms (p < 0.001). DISCUSSION A higher BMI was not associated per se with poorer social integration. However, the present study showed that socially isolated people with obesity represent a special risk group for impaired mental health and had twice the prevalence of social isolation compared to those without obesity.
Collapse
Affiliation(s)
- Charlyn Görres
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - Jana Hoßbach
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - Alexander Pabst
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - Melanie Luppa
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - Janine Stein
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - Franziska D Welzel
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - Franziska U Jung
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - Felix S Hussenoeder
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - Christoph Engel
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
- LIFE - Leipziger Forschungszentrum für Zivilisationserkrankungen, Universität Leipzig, Leipzig, Deutschland
| | - Toralf Kirsten
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
- Medizininformatikzentrum - Abteilung Medical Data Science, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland
- LIFE - Leipziger Forschungszentrum für Zivilisationserkrankungen, Universität Leipzig, Leipzig, Deutschland
| | - Nigar Reyes
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
| | - Kerstin Wirkner
- LIFE - Leipziger Forschungszentrum für Zivilisationserkrankungen, Universität Leipzig, Leipzig, Deutschland
| | - Steffi G Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
- LIFE - Leipziger Forschungszentrum für Zivilisationserkrankungen, Universität Leipzig, Leipzig, Deutschland
| | - Margrit Löbner
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland.
| |
Collapse
|
2
|
Qiao Z, Wang Z, Qiu J, Zhang J, Cao W. Analysis of the effect of BMI on depression and anxiety among older adults in China: the mediating role of ADL and IADL. Front Public Health 2024; 12:1387550. [PMID: 39296846 PMCID: PMC11408477 DOI: 10.3389/fpubh.2024.1387550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 08/26/2024] [Indexed: 09/21/2024] Open
Abstract
Background Anxiety and depression are serious psychological and public health issues among the older adults. Currently, there is a lack of understanding of the relationship between Body Mass Index (BMI) and anxiety or depression symptoms in the older adult population in China. Therefore, the purpose of this study is to investigate the impact of BMI on anxiety and depression through correlation analysis in different subgroups and to examine the potential chain mediating effects of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) between BMI and symptoms of anxiety and depression. Methods From the CLHLS database conducted in 2017-2018, data regarding height, weight, anxiety symptoms, depression symptoms, as well as demographic, socioeconomic, behavioral, and health-related characteristics were collected. Multivariate logistic regression analysis was used to explore the impact of BMI on anxiety and depression symptoms. Finally, the SPSS macro process was utilized to test the multiple mediating effects of ADL and IADL between BMI and anxiety or depression symptoms. Results After screening, a final sample of 9,098 Chinese older adult individuals aged 65 and above was selected. Among them, 1,074 cases (11.8%) exhibited anxiety symptoms, 1,458 cases (16.0%) exhibited depressive symptoms. Compared to normal BMI, the adjusted analysis showed that underweight in Chinese older adult individuals was significantly associated with anxiety (OR = 1.316, p = 0.004) and depression (OR = 1.232, p = 0.013). This relationship was found to be more significant in males, individuals aged 80 and above, unmarried individuals, and those residing in town. ADL and IADL played a chain-mediated role between BMI and anxiety symptoms in the older adult. BMI not only had a direct effect on anxiety symptoms in the older adult (effect = -0.0159; SE = 0.0066; 95%CI: LL = -0.0288, UL = -0.0031), but also influenced them indirectly through two pathways: the independent mediating role of IADL (effect = -0.0010; SE = 0.0005; 95%CI: LL = -0.0018, UL = -0.0003) and the chain-mediated role of ADL and IADL (effect = -0.0012; SE = 0.0004; 95%CI: LL = -0.0020, UL = -0.0006). Conclusion In the older adult individuals in China, underweight is associated with an increased risk of anxiety and depression symptoms. Improving the underweight condition of Chinese older adult individuals can reduce their ADL and IADL limitations, thereby benefiting their mental health.
Collapse
Affiliation(s)
- Ziqing Qiao
- Nanqiao Town Community Health Service Center, Shanghai, China
| | - Zichun Wang
- Shanghai Fengxian District Center for Disease Control and Prevention, Shanghai, China
| | - Jiaping Qiu
- Nanqiao Town Community Health Service Center, Shanghai, China
| | - Jie Zhang
- Nanqiao Town Community Health Service Center, Shanghai, China
| | - Weiyi Cao
- Nanqiao Town Community Health Service Center, Shanghai, China
| |
Collapse
|
3
|
Prates Freitas B, Martins Cândido L, Jakovljevic Pudla Wagner K, Rodrigues Lacerda AC, Amaral Mendonça V, De Micheli R, Sartorio A, Carelli Pereira de Avelar N, Danielewicz AL. Sedentary Behavior, Obesity, and Disabilities in Community-Dwelling Older Adults: Analysis of the Brazilian National Health Survey 2019. Healthcare (Basel) 2024; 12:1625. [PMID: 39201183 PMCID: PMC11353341 DOI: 10.3390/healthcare12161625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 08/03/2024] [Accepted: 08/13/2024] [Indexed: 09/02/2024] Open
Abstract
Research suggests that sedentary behavior (SB) and obesity are associated with disabilities in basic activities (BADL) and instrumental (IADL) activities of daily living. However, there is a lack of studies investigating this association in community-dwelling older adults. Thus, the aim of this study was to investigate the association between different SB typologies, isolated and in conjunction with obesity, and their associations with BADL and IADL disabilities in community-dwelling Brazilian older adults. This was a cross-sectional study using data from older adults (≥60 years) who participated in the Brazilian National Health Survey (2019). The exposures were obesity (BMI > 27 kg/m2) and the amount of time spent daily on SB watching television (SB TV < 3 and ≥3 h/day) and engaging in leisure activities (SB leisure < 3 and ≥3 h/day), analyzed both separately and jointly. The outcomes were BADL and IADL disabilities. The main results showed that isolated SB TV ≥ 3 h/day (OR: 1.26; 95% CI: 1.14; 1.39) and SB TV ≥ 3 h/day combined with obesity (OR: 1.55; 95% CI: 1.37; 1.75) increased the odds of BADL and IADL disabilities. Obesity alone (OR: 1.21; 95% CI: 1.07; 1.36) increased only the odds of BADL disabilities. Moreover, SB leisure ≥ 3 h/day without obesity reduced the odds of IADL disabilities (OR: 0.56; 95% CI: 0.41; 0.76). Ideally, older adults should be encouraged to prevent obesity, reduce excessive periods spent in SB watching TV, and increase the daily periods spent in leisure activities, thus minimizing the likelihood of disabilities in functional activities.
Collapse
Affiliation(s)
- Bruno Prates Freitas
- Department of Health Sciences, Laboratory of Aging, Resources and Rheumatology, Universidade Federal de Santa Catarina, Araranguá 88906-072, SC, Brazil (N.C.P.d.A.)
| | - Letícia Martins Cândido
- Postgraduate Program in Public Health, Universidade Federal de Santa Catarina, Florianópolis 88040-900, SC, Brazil;
| | - Katia Jakovljevic Pudla Wagner
- Coordination of Biosciences and Unified Health, Universidade Federal de Santa Catarina, Curitibanos 89520-000, SC, Brazil;
| | - Ana Cristina Rodrigues Lacerda
- Departament of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina 39100-000, MG, Brazil; (A.C.R.L.)
| | - Vanessa Amaral Mendonça
- Departament of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina 39100-000, MG, Brazil; (A.C.R.L.)
| | - Roberta De Micheli
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy
| | - Núbia Carelli Pereira de Avelar
- Department of Health Sciences, Laboratory of Aging, Resources and Rheumatology, Universidade Federal de Santa Catarina, Araranguá 88906-072, SC, Brazil (N.C.P.d.A.)
| | - Ana Lúcia Danielewicz
- Department of Health Sciences, Laboratory of Aging, Resources and Rheumatology, Universidade Federal de Santa Catarina, Araranguá 88906-072, SC, Brazil (N.C.P.d.A.)
- Postgraduate Program in Public Health, Universidade Federal de Santa Catarina, Florianópolis 88040-900, SC, Brazil;
| |
Collapse
|
4
|
Scott IC, Bajpai R, Hider SL, Helliwell T, Mallen CD, Muller S. The relationship between obesity and patient-reported outcome measures in people with polymyalgia rheumatica. Rheumatol Adv Pract 2024; 8:rkae081. [PMID: 39006539 PMCID: PMC11239789 DOI: 10.1093/rap/rkae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/29/2024] [Indexed: 07/16/2024] Open
Abstract
Objective To examine the association between obesity and patient-reported outcome measures (PROMs) in a primary care-based cohort of people with PMR. Methods The PMR Cohort Study recruited people with incident PMR from 382 general practices. Self-completed questionnaires (0, 12, 24 months) captured a range of PROMs for pain, stiffness, anxiety, depression, fatigue, function and quality of life, alongside data on BMI. People were categorized as underweight/normal weight (BMI < 25kg/m2), overweight (25-29.99 kg/m2) or obese (≥30 kg/m2). Piecewise, multilevel, linear mixed-effects regression models examined relationships between BMI categories and PROMs over time, adjusting for confounding variables. Chi-squared tests examined the relationship between obesity and glucocorticoid persistence. Results 644 people with PMR were included. At baseline, 33.9% were normal/underweight, 40.6% overweight and 25.5% obese. Compared with normal/underweight people, those with obesity had significantly worse scores for the following: pain and stiffness at 12 months; fatigue at 12 and 24 months; depression at baseline; physical function at all time points; and quality of life at baseline and 12 months. They also had significantly smaller improvements in stiffness (1.13 units on an 11-point numeric rating scale; P = 0.001) and physical function (0.14 units measured using the modified Health Assessment Questionnaire; P = 0.025) between 0 and 12 months. BMI categories did not relate to persistent glucocorticoid use at 12 months (P = 0.110) or 24 months (P = 0.166). Conclusion Obesity associates with poorer outcomes for a range of PROMs in people with PMR. Consideration should be given to providing weight management support to people with PMR and obesity.
Collapse
Affiliation(s)
- Ian C Scott
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership University NHS Foundation Trust, Staffordshire, UK
| | - Ram Bajpai
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Samantha L Hider
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership University NHS Foundation Trust, Staffordshire, UK
| | - Toby Helliwell
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Centre for Academic Social Care, Public Health, Community and Primary Care (COSMIC), Midlands Partnership University NHS Foundation Trust, Staffordshire, UK
| | - Christian D Mallen
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership University NHS Foundation Trust, Staffordshire, UK
| | - Sara Muller
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| |
Collapse
|
5
|
Pau M, Cerfoglio S, Capodaglio P, Marrone F, Grugni G, Porta M, Leban B, Galli M, Cimolin V. Cyclogram-based evaluation of inter-limb gait symmetry in Prader-Willi Syndrome. Gait Posture 2024; 112:167-172. [PMID: 38805861 DOI: 10.1016/j.gaitpost.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/13/2023] [Accepted: 05/23/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is characterized by a complex clinical condition, whose typical features lead to impaired motor and functional skills. To date, limited data is available as regards symmetry of gait in PWS. RESEARCH QUESTION The aim of this study was to characterize lower-limb asymmetry during gait in a group of Prader-Willi Syndrome (PWS) individuals by using the synchronized cyclograms and to compare it with those of two different control groups, a normal-weight group and an obese group. METHODS A total of 18 PWS, 30 normal weight (NW) and 28 obese individuals (OG) matched for age, sex and height were assessed via 3D gait analysis. Gait spatio-temporal parameters were computed together with angle-angle diagrams, characterized in terms of their geometric features (i.e. area, orientation, and trend symmetry index). RESULTS Individuals with PWS exhibit reduced speed, stride length and cadence and increased duration of both stance and double support phase than the other groups. OG was characterized by the same pattern when compared to NW. With respect to inter-limb symmetry, individuals with PWS exhibited significantly larger cyclogram areas at hip joint with respect to the other two groups (203.32 degrees2 vs. 130.73 degrees2 vs. 111.59 degrees2) and significantly higher orientation angle (4.17° vs. 2.11° vs. 1.22°) and Trend Symmetry (3.72 vs. 2.02 vs. 1.21) with respect to the other two groups at knee joint; no differences were found at ankle joint. Both individuals with PWS and those of OG exhibited reduced ROM at knee and ankle joints with respect with normal weight, but no statistically significant differences were observed between PWS and OG. SIGNIFICANCE The obtained results may provide novel and useful insights to understand better the impairments in motor control associated with this pathological state, supporting clinics in the identification of the best rehabilitation program for this rare pathological state, aimed to improve stability and motor control.
Collapse
Affiliation(s)
- Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari 09123, Italy
| | - Serena Cerfoglio
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, Milano 20133, Italy; Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, Piancavallo 28824, Italy
| | - Paolo Capodaglio
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, Piancavallo 28824, Italy; Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, Turin 10126 , Italy
| | - Flavia Marrone
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, Milano 20133, Italy; Department of of Mechanical Engineering, Politecnico di Milano, via La Masa 1, Milano 20156, Italy
| | - Graziano Grugni
- Unit of Auxology, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, Piancavallo 28824, Italy
| | - Micaela Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari 09123, Italy
| | - Bruno Leban
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari 09123, Italy
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, Milano 20133, Italy
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, Milano 20133, Italy; Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, Piancavallo 28824, Italy.
| |
Collapse
|
6
|
MacNeil A, Cottagiri SA, Villeneuve PJ, Jiang Y, de Groh M, Fuller-Thomson E. Incident Functional Limitations Among Older Adults With Diabetes During the COVID-19 Pandemic: An Analysis of Prospective Data From the Canadian Longitudinal Study on Aging. Can J Diabetes 2024; 48:290-298.e2. [PMID: 38639706 DOI: 10.1016/j.jcjd.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 01/26/2024] [Accepted: 02/25/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES The objectives of this study were 1) to examine and compare changes in functional limitations during the COVID-19 pandemic among older adults with and without diabetes; and 2): to identify key risk factors associated with developing functional limitations among older adults with and without diabetes during the pandemic. METHODS We analyzed data collected from the Canadian Longitudinal Study on Aging. The analysis was restricted to those with no functional limitations in the follow-up 1 wave (2015 to 2018) (final sample N=6,045). Regression models were used to describe associations between diabetes status and functional limitation outcomes. We conducted stratified analyses to evaluate whether these associations varied by sociodemographic indicators. We also predicted the probability of the development of ≥1 functional limitation among those with and without diabetes for various patient profiles. RESULTS Older adults with diabetes were 1.28-fold (95% confidence interval 1.02 to 1.60) more likely to develop ≥1 functional limitation than older adults without diabetes after controlling for relevant sociodemographic and health covariates. Risk factors for incident functional limitations among older adults, both with and without diabetes, include increasing age, low socioeconomic status, obesity, multimorbidity, and physical inactivity. CONCLUSIONS Our findings indicate that older adults with diabetes were at an increased risk of developing functional limitations during the pandemic when compared with older adults without diabetes, even when controlling for several key risk factors. Targetting modifiable risk factors, such as physical activity, may help to reduce the risk of functional limitations among older adults with diabetes.
Collapse
Affiliation(s)
- Andie MacNeil
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada
| | - Susanna Abraham Cottagiri
- Department of Public Health Sciences, School of Medicine, Queens University, Kingston, Ontario, Canada
| | - Paul J Villeneuve
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; CHAIM Research Centre, Carleton University, Ottawa, Ontario, Canada
| | - Ying Jiang
- Applied Research Division, Center for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Margaret de Groh
- Applied Research Division, Center for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
7
|
Smith L, López Sánchez GF, Rahmati M, Tully MA, Pizzol D, Veronese N, Soysal P, Kostev K, Yon DK, Butler L, Shin JI, Koyanagi A. Association between sedentary behavior and dynapenic abdominal obesity among older adults from low- and middle-income countries. Aging Clin Exp Res 2024; 36:109. [PMID: 38730062 PMCID: PMC11087302 DOI: 10.1007/s40520-024-02763-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Sedentary behavior, or time spent sitting, may increase risk for dynapenic abdominal obesity (DAO), but there are currently no studies on this topic. AIMS Therefore, we investigated the association between sedentary behaviour and DAO in a nationally representative sample of older adults from six low- and middle-income countries. METHODS Cross-sectional data from the Study on Global AGEing and Adult Health were analysed. Dynapenia was defined as handgrip strength < 26 kg for men and < 16 kg for women. Abdominal obesity was defined as waist circumference of > 88 cm (> 80 cm for Asian countries) for women and > 102 cm (> 90 cm) for men. DAO was defined as having both dynapenia and abdominal obesity. Self-reported sedentary behavior was categorized as ≥ 8 h/day (high sedentary behaviour) or < 8 h/day. Multivariable multinomial logistic regression was conducted. RESULTS Data on 20,198 adults aged ≥ 60 years were analyzed [mean (SD) age 69.3 (13.1) years; 54.1% females]. In the overall sample, ≥ 8 h of sedentary behavior per day (vs. <8 h) was significantly associated with 1.52 (95%CI = 1.11-2.07) times higher odds for DAO (vs. no dynapenia and no abdominal obesity), and this was particularly pronounced among males (OR = 2.27; 95%CI = 1.42-3.62). Highly sedentary behavior was not significantly associated with dynapenia alone or abdominal obesity alone. DISCUSSION High sedentary behaviour may increase risk for DAO among older adults. CONCLUSIONS Interventions to reduce sedentary behaviour may also lead to reduction of DAO and its adverse health outcomes, especially among males, pending future longitudinal research.
Collapse
Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Masoud Rahmati
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireland, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
| |
Collapse
|
8
|
Fayosse A, Dumurgier J, Dugravot A, Landré B, Singh-Manoux A, Sabia S. Cross-sectional and longitudinal associations of obesity with disability between age 50 and 90 in the SHARE study. Arch Gerontol Geriatr 2024; 119:105320. [PMID: 38171031 DOI: 10.1016/j.archger.2023.105320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/12/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Obesity is associated with disability but whether age and ageing modify this association remains unclear. We examined whether this association changes between 50 and 90 years, and whether change in disability rates over 14 years differs by body mass index (BMI) categories. METHODS BMI and ADL-disability data on 28,453 individuals from 6 waves (2004-2018, SHARE study) were used to examine the cross-sectional absolute and relative associations, extracted at age 50, 60, 70, 80, and 90 years using logistic mixed models. Then baseline BMI and change in disability rates over 14-years were examined using logistic-mixed models. RESULTS At age 50, the probabilities of ADL disability in individuals with BMI 30-34.9 and ≥35 kg/m² were 0.07 (0.06, 0.09) and 0.11 (0.09, 0.12), increasing to 0.47 (0.44, 0.50) and 0.55 (0.50, 0.60) at age 90; the increase in both these groups was greater than that in the normal-weight group (p for increase with age<0.001). On the relative scale the OR at age 50 in these obesity groups was 2.37 (1.79, 3.13) and 5.03 (3.38, 7.48), decreasing to 1.51 (1.20, 1.89) and 2.19 (1.50, 3.21) at age 90; p for decrease with age=0.05 and 0.02 respectively. The 14-year increase in probability of disability was greatest in those with BMI≥35 kg/m² at age 50, 60, and 70 at baseline: differences in increase compared to normal weight were 0.08 (0.02, 0.14), 0.11 (0.07, 0.15), and 0.09 (0.02, 0.16) respectively. CONCLUSIONS ADL disability is increasingly prevalent with age in individuals with obesity. Relative measures of change obscure the association between obesity and disability due to age-related increase in disability rates in all groups.
Collapse
Affiliation(s)
- Aurore Fayosse
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris 75010, France
| | - Julien Dumurgier
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris 75010, France; Cognitive Neurology Center, Saint Louis, Lariboisiere - Fernand Widal Hospital, AP-HP; Université Paris Diderot, France
| | - Aline Dugravot
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris 75010, France
| | - Benjamin Landré
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris 75010, France
| | - Archana Singh-Manoux
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris 75010, France; Faculty of Brain Sciences, Division of Psychiatry, University College London, United Kingdom.
| | - Séverine Sabia
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris 75010, France; Faculty of Brain Sciences, Division of Psychiatry, University College London, United Kingdom
| |
Collapse
|
9
|
Luo J, Zhao D, Gao T, Sun J, Li P, Wang X, Wang X, Chai S, Li J, Zhou C. Activities of daily living limitations and family doctor contract services among overweight and obese older adults: is there a rural-urban difference? BMC PRIMARY CARE 2023; 24:223. [PMID: 37891472 PMCID: PMC10612158 DOI: 10.1186/s12875-023-02177-4] [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] [Received: 04/07/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate the relationship between activities of daily living (ADL) limitations and family doctor contract services among overweight and obese older adults, as well as to examine whether this association varies by urban-rural residence. METHODS Data for the present study were obtained from the sixth Health Service of Shandong province, China. A total of 4,249 overweight and obese older adults were included in this study. Binary logistic regression models were used to evaluate the relationship between ADL limitations and family doctor contract services, to examine the potential differences between urban and rural areas. RESULTS Of 4,249 overweight and obese older adults, the prevalence of limitations in ADL and family doctor service contracting rate in Shandong province were 12.47% and 66.46%, respectively. The results of the regression analyses revealed that overweight and obese older adults with ADL limitations were more likely to sign up for family doctor services than those without ADL limitations (OR = 1.27, 95%CI: 1.02-1.58, P = 0.033). Only among rural overweight and obese older adults, the relationship between ADL limitations and family doctor contract services was statistically significant (OR = 1.50, 95%CI: 1.13-1.99, P = 0.005). CONCLUSIONS Our study found a significant association between ADL limitations and family doctor contract services among overweight and obese older adults in Shandong, China. This relationship differed by urban-rural residence. To promote the positive development of the family doctor contract service system, the government should increase publicity, provide personalized contracted services, and prioritize the healthcare needs of overweight and obese older adults with ADL limitations, with special attention to rural areas.
Collapse
Affiliation(s)
- Jingjing Luo
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, 250012, Jinan, China
- Institute of Health and Elderly Care, Shandong University, 250012, Jinan, China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, 250012, Jinan, China
- Institute of Health and Elderly Care, Shandong University, 250012, Jinan, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, 250012, Jinan, China
- Institute of Health and Elderly Care, Shandong University, 250012, Jinan, China
| | - Jingjie Sun
- Shandong Health Commission Medical Management Service Center, 250012, Jinan, China
| | - Peilong Li
- Shandong Health Commission Medical Management Service Center, 250012, Jinan, China
| | - Xuehong Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, 250012, Jinan, China
- Institute of Health and Elderly Care, Shandong University, 250012, Jinan, China
| | - Xueqing Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, 250012, Jinan, China
- Institute of Health and Elderly Care, Shandong University, 250012, Jinan, China
| | - Shujun Chai
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, 250012, Jinan, China
- Institute of Health and Elderly Care, Shandong University, 250012, Jinan, China
| | - Jiayan Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, 250012, Jinan, China
- Institute of Health and Elderly Care, Shandong University, 250012, Jinan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, 250012, Jinan, China.
- Institute of Health and Elderly Care, Shandong University, 250012, Jinan, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University), 250012, Jinan, China.
| |
Collapse
|
10
|
Smith L, López Sánchez GF, Tully MA, Veronese N, Soysal P, Yon DK, Pizzol D, López-Gil JF, Barnet Y, Butler L, Shin JI, Koyanagi A. Sex differences in the association between dynapenic abdominal obesity and onset of disability in activities of daily living among adults aged ≥50 years: A prospective analysis of the Irish Longitudinal Study on Ageing. Maturitas 2023; 176:107763. [PMID: 37393660 DOI: 10.1016/j.maturitas.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/18/2023] [Accepted: 04/14/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Sex differences in the longitudinal relationship between dynapenic abdominal obesity, i.e., impairment in muscle strength and high waist circumference, and disability in activities of daily living have not been investigated to date. Therefore, we aimed to examine sex differences in the longitudinal association between dynapenic abdominal obesity at baseline and the onset of disability in activities of daily living during a four-year follow-up period among Irish adults aged ≥50 years. METHODS Data from Wave 1 (2009-2011) and Wave 3 (2014-2015) of the Irish Longitudinal Study on Ageing survey were analyzed. Dynapenia was defined as handgrip strength of <26 kg for men and <16 kg for women. Abdominal obesity was defined as waist circumference of >88 cm for women and >102 cm for men. Dynapenic abdominal obesity was defined as having both dynapenia and abdominal obesity. Disability was defined as having difficulty with at least one of six activities of daily living (dressing, walking, bathing, eating, getting in or out of bed, using the toilet). Multivariable logistic regression was conducted to assess associations. RESULTS Data on 4471 individuals aged ≥50 years and free of disability at baseline were analyzed [mean (SD) age 62.3 (8.6) years; 48.3 % males]. In the overall sample, compared to no dynapenia and no abdominal obesity, dynapenic abdominal obesity was associated with 2.15 (95%CI = 1.17-3.93) times higher odds for incident disability at 4-year follow-up. This association was significant among men (OR = 3.78; 95%CI = 1.70-8.38) but not among women (OR = 1.34; 95%CI = 0.60-2.98). CONCLUSIONS Interventions to prevent or address dynapenic abdominal obesity may aid in the prevention of disability, especially among men.
Collapse
Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireleand, UK.
| | - Nicola Veronese
- University of Palermo, Department of Internal Medicine, Geriatrics Section, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra, IdiSNA, Pamplona, Spain; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA; One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Yvonne Barnet
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain.
| |
Collapse
|
11
|
Williamson K, Blane DN, Lean MEJ. Challenges in obtaining accurate anthropometric measures for adults with severe obesity: A community-based study. Scand J Public Health 2023; 51:935-943. [PMID: 35491931 DOI: 10.1177/14034948221089111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
AIMS The number of people with severe obesity (BMI ⩾40 kg/m2) is increasing rapidly, but is poorly documented, partly as a result of inappropriate standard anthropometric measurement methods for community-based people. METHODS As part of a broader study, people receiving care services and with severe obesity were visited at home. The people were assessed for measurements using different weighing scales and a standard portable stadiometer. If the stadiometer could not be used, their half arm span and knee height were measured to estimate their height using standard predictive equations. RESULTS Measurements were taken for 15 women and 10 men (n = 25) aged 40-87 years (mean 62 years). Weights ranged from 98.4 to 211.8 kg (mean 150 kg), with 16 participants requiring bariatric scales. For the six people who were unable to stand, we used wheelchair scales (n = 1), bed weighing scales (n = 2), routine weights from care home records (n = 2) or weight data from hospital records (n = 1). The standard portable stadiometer could only be used for one person; the others required alternative measures from which to estimate height. Large body habitus obscured bony landmarks, meaning alternative measures gave diverse heights. Fourteen participants had a ⩾8 cm difference in height between estimates from half arm span and knee height measurements. CONCLUSIONS
Standard practice commonly does not provide reliable measurements for people with severe obesity, particularly those with mobility difficulties. An inability to measure weight and height accurately can exclude people from appropriate care, obscuring the true numbers affected and the effectiveness of future service planning. Safe community care requires the availability of specialist scales and standardised methods for height estimation appropriate for older and disabled people with severe obesity.
Collapse
Affiliation(s)
- Kath Williamson
- School of Medicine, Dentistry & Nursing, University of Glasgow, UK
| | - David N Blane
- General Practice & Primary Care, Institute of Health and Wellbeing, University of Glasgow, UK
| | - Michael E J Lean
- School of Medicine, Dentistry & Nursing, University of Glasgow, UK
| |
Collapse
|
12
|
Chardon M, Barbieri FA, Penedo T, Santos PCR, Vuillerme N. A Systematic Review of the Influence of Overweight and Obesity across the Lifespan on Obstacle Crossing during Walking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5931. [PMID: 37297535 PMCID: PMC10252433 DOI: 10.3390/ijerph20115931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 06/12/2023]
Abstract
This study aimed to systematically review and summarize the available data regarding the influence of overweight and obesity across the lifespan on obstacle crossing during walking. Four databases were systematically searched with no limitation on publication date following the Cochrane Handbook for Systematic Reviews and PRISMA guidelines. Only full-text English-language articles published in a peer-reviewed journal were eligible. They had to compare obstacle crossing during walking by overweight or obese individuals with individuals of normal body weight. Five studies were considered eligible. All the studies assessed kinematics; only one assessed kinetics, but none investigated muscle activity or obstacle contact. Compared to normal individuals crossing obstacles, overweight or obese individuals exhibited lower velocity, shorter step length, lower cadence, and less time spent in single-limb support. They also exhibited increased step width, more time spent in double support, and greater trailing leg ground force reaction and centre of mass acceleration. Overall, the small number of included studies did not allow us to draw any conclusions. However, being overweight or obese seems to have a potentially negative influence on the kinematics of gait parameters due to a tendency to trip, fall, and suffer severe fall-related injuries when negotiating obstacles on foot in real-life environments.
Collapse
Affiliation(s)
- Matthias Chardon
- Autonomie, Gérontologie, E-santé, Imagerie et Société (AGEIS), Université Grenoble Alpes, 38400 Grenoble, France
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, School of Sciences, São Paulo State University (Unesp), Bauru 15782, Brazil
| | - Fabio A. Barbieri
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, School of Sciences, São Paulo State University (Unesp), Bauru 15782, Brazil
| | - Tiago Penedo
- Autonomie, Gérontologie, E-santé, Imagerie et Société (AGEIS), Université Grenoble Alpes, 38400 Grenoble, France
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, School of Sciences, São Paulo State University (Unesp), Bauru 15782, Brazil
| | - Paulo C. R. Santos
- Autonomie, Gérontologie, E-santé, Imagerie et Société (AGEIS), Université Grenoble Alpes, 38400 Grenoble, France
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot 7632706, Israel
| | - Nicolas Vuillerme
- Autonomie, Gérontologie, E-santé, Imagerie et Société (AGEIS), Université Grenoble Alpes, 38400 Grenoble, France
- Institut Universitaire de France, 75005 Paris, France
| |
Collapse
|
13
|
Williamson K, Blane DN, Grieve E, Lean MEJ. Overlooked and under-evidenced: Community health and long-term care service needs, utilization, and costs incurred by people with severe obesity. Clin Obes 2023; 13:e12570. [PMID: 36447339 DOI: 10.1111/cob.12570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 12/05/2022]
Abstract
Numbers of people with severe obesity (BMI ≥ 40 kg/m2 ), with need for community health and long-term care (LTC) services, are increasing, but documentation is lacking. We identified individuals with severe obesity known to community health and care professionals in a representative United Kingdom region and used an investigator-administered questionnaire to record needs and use of community health and LTC services. Data were verified against health and LTC records. Local and published sources informed detailed micro-costing. Twenty-five individuals (15 women) consented, aged 40-87 (mean = 62) years, BMI 40-77 (mean = 55) kg/m2 : 20 participants (80%) were housebound. Twenty-two different cross-sector community health and LTC services were used, including community equipment service (n = 23), district nursing (n = 20), occupational therapy (n = 14), and LTC (n = 12). Twenty-four (96%) participants used three or more services, with longest care episode lasting over 14 years. Total annual service costs incurred by participants varied from £2053 to £82 792; mean £26 594 (lower estimate £80 064; mean £22 462/upper estimate £88 870; mean £30 726), with greatest costs being for LTC. Individual costs for equipment (currently provided) and home adaptations (ever provided) ranged widely, from zero to £35 946. Total mean annual costs increased by ascending BMI category, up to BMI 70 kg/m2 . This study provides a framework with which to inform service provision and economic analysis of weight management interventions. People with severe obesity may need sustained care from multiple community care services.
Collapse
Affiliation(s)
- Kath Williamson
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
- NRS Clinician, Weight Management Team, NHS Lothian, Edinburgh, UK
| | - David N Blane
- General Practice & Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Eleanor Grieve
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Michael E J Lean
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
| |
Collapse
|
14
|
Jacob L, Gyasi RM, Oh H, Smith L, Kostev K, López Sánchez GF, Rahmati M, Haro JM, Tully MA, Shin JI, Yon DK, Koyanagi A. Leisure-time physical activity and sarcopenia among older adults from low- and middle-income countries. J Cachexia Sarcopenia Muscle 2023; 14:1130-1138. [PMID: 36872652 PMCID: PMC10067478 DOI: 10.1002/jcsm.13215] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/10/2023] [Accepted: 02/06/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND There are no data on the association between leisure-time physical activity (LTPA) and sarcopenia in older adults from low- and middle-income countries (LMICs). This study aimed to investigate the association between LTPA and sarcopenia in individuals aged ≥65 years living in six LMICs. METHODS Cross-sectional data from the Study on Global AGEing and Adult Health (China, Ghana, India, Mexico, Russia and South Africa) were analysed. Sarcopenia referred to the presence of both low skeletal muscle mass and weak handgrip strength. LTPA was assessed using the Global Physical Activity Questionnaire and was analysed as a dichotomized variable [high LTPA (>150 min/week of moderate-to-vigorous LTPA) or low LTPA (≤150 min/week)]. Multivariable logistic regression analysis was conducted to assess associations. RESULTS There were 14 585 individuals included in this study [mean (SD) age 72.6 (11.5) years; 55.0% women]. The prevalence of high LTPA and sarcopenia was 8.9% and 12.0%, respectively. After adjusting for potential confounders, low LTPA was significantly associated with higher odds for sarcopenia [prevalence odds ratio (POR) = 1.85, 95% confidence interval (CI) = 1.29-2.65] compared with high LTPA. Significant associations were found in women (POR = 3.22, 95% CI = 1.82-5.68) but not in men (POR = 1.52, 95% CI = 0.99-2.35). CONCLUSIONS A positive and significant association between low LTPA and sarcopenia was found among older adults from LMICs. The promotion of LTPA among older adults in LMICs may aid in the prevention of sarcopenia, especially among females, pending future longitudinal research.
Collapse
Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Department of Physical Medicine and Rehabilitation, Lariboisière-Fernand Widal Hospital, AP-HP, University Paris Cité, Paris, France
| | - Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya.,National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | | | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khorramabad, Iran
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
| | - Mark A Tully
- School of Medicine, Ulster University, Coleraine, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| |
Collapse
|
15
|
Corona LP, Andrade FCD, Borim FSA, Aprahamian I, Fattori A, Cesari M, Neri AL, Yassuda MS. Weight loss severity and functional decline among the oldest old in a middle-income country: The FIBRA study longitudinal findings. Clin Nutr ESPEN 2023; 53:170-174. [PMID: 36657910 DOI: 10.1016/j.clnesp.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 11/09/2022] [Accepted: 12/04/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Nutritional status is a key modifiable risk factor associated with disability, and further evidence suggests that weight change is also linked to this adverse outcome. Thus, this study aims to evaluate weight loss severity and functional decline in instrumental activities of daily living (IADL) in a seven-year period among a sample of Brazilian oldest-old adults. METHODS Longitudinal prospective study using data from the FIBRA study (Frailty in Older Brazilians), a population-based investigation carried out in 2008/2009, with follow-up data collected in 2016/2017 from participants who were 80 years and older in the follow-up in Campinas, Brazil. Of the 167 participants with complete data in 2016-2017, 16 had improved their functional status and were excluded, so the final sample was restricted to 151 participants who maintained or declined functional status. We considered functional decline when a subject had greater IADL dependencies at follow-up than baseline. Logistic regression was performed to assess the effect of weight loss, according to severity (moderate weight loss: 5-10% of body weight; severe weight loss >10%) in increasing the number of disabilities than the group with stable weight, controlling for covariates (gender, age, education, and morbidity). An alpha level of <5% was adopted. RESULTS During the follow-up period, 60.3% of the participants kept stable weight, 21.8% had moderate weight loss, and 17.9% had severe weight loss. During the follow-up, only severe weight loss was associated with a higher risk of functional decline (OR = 2.74; p = 0.032). CONCLUSIONS Severe weight loss was associated with functional decline. This finding reinforces the importance of early identification of weight loss among older adults.
Collapse
Affiliation(s)
- Ligiana P Corona
- Faculty of Applied Sciences, State University of Campinas (UNICAMP), R. Pedro Zaccaria, 1300 - 13484-35, Limeira, SP, Brazil.
| | - Flavia C D Andrade
- School of Social Work, University of Illinois at Urbana-Champaign, 1010 W. Nevada St., Office 2107, Urbana, IL, USA
| | - Flavia S A Borim
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Tessália Vieira de Camargo, 126 - 13083-887, Campinas, SP, Brazil
| | - Ivan Aprahamian
- Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Jundiaí Medical School (FMJ), R. Francisco Teles, 250 - 13202-550, Jundiaí, SP, Brazil
| | - André Fattori
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Tessália Vieira de Camargo, 126 - 13083-887, Campinas, SP, Brazil
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università di Milano, Via Festa Del Perdono, 7, 20122, Milano, MI, Italy
| | - Anita L Neri
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Tessália Vieira de Camargo, 126 - 13083-887, Campinas, SP, Brazil
| | - Monica S Yassuda
- School of Arts, Sciences and Humanities (EACH), University of Sao Paulo (USP), Rua Arlindo Béttio, 1000 - 03828-000, São Paulo, SP, Brazil
| |
Collapse
|
16
|
Zadoń H, Michnik R, Nowakowska-Lipiec K. Exploring the impact of body mass change on fatigue and activity of the muscular system during daily routine. Technol Health Care 2023; 31:2487-2498. [PMID: 37955073 DOI: 10.3233/thc-235014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND Correct body weight is one of the factors that allows you to maintain a properly functioning body. Abnormal body weight can cause muscle tissue remodelling, affecting activity and muscle fatigue. Changes in the muscular system can cause occurrence of functional limitations. OBJECTIVE To determine the effect of weight change on fatigue and activity of the muscular system during daily activities. METHODS The evaluation of musculoskeletal functioning was based on the results of computer simulations conducted in the AnyBody Modeling System. The following activities were analysed: standing, sitting down and getting up from a chair, holding and lifting an object, and walking. The simulations of the activities were carried out using averaged kinematic data, and by changing body mass in the range of 50 kg to 100 kg by increments of 2 kg, to map different nutritional status from excessive thinness to extreme obesity. Identification of loads in the musculoskeletal system was based on solving an inverse dynamics problem and then the estimation of muscle force values using static optimization. The simulation results allowed to determine the value of muscle fatigue and the level of muscle activity. RESULTS For activities (i.e., standing, walking, sitting down and getting up from a chair) it was observed that the value of muscle fatigue increases with increasing body mass. However, for activities that cause more load on the musculoskeletal system, i.e. lifting and holding an object, the highest value of muscle fatigue was observed in underweight individuals. CONCLUSION The change in body weight alters the functioning of the muscular system and thus the ability to perform activities. It was shown that in case of underweight, overweight or obese people, abnormal body weight can be the reason for occurrence of difficulties in performing the activities of lifting and holding a 20 kg object, as well as walking.
Collapse
|
17
|
Ahmed S, Faruque M, Moniruzzaman M, Roby NU, Ashraf F, Yano Y, Miura K, Ahmed MSAM. The pattern of physical disability and determinants of activities of daily living among people with diabetes in Bangladesh. Endocrinol Diabetes Metab 2022; 5:e365. [PMID: 36102126 PMCID: PMC9471590 DOI: 10.1002/edm2.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Diabetes mellitus itself is a known predictor of physical disability and impairment in activities of daily living (ADL); however, there are existing controversies about the factors explaining the association between diabetes and disability. Therefore, we assessed the possible determinants associated with ADL impairment among people with diabetes in Dhaka city, Bangladesh. METHODS We conducted a cross-sectional study among 480 people with diabetes aged between 50 and 70 years, and attended a tertiary level hospital in Dhaka city. For determining the ADL impairment, we used the Katz Index Scoring (6 = no impairment; <6 = impairment). Age, sex, educational attainment, household expenditure, body mass index, the status of diabetes (controlled or uncontrolled), hypertension and medication adherence to anti-diabetic drugs were included in the statistical models, and we defined any ADL impairment (Katz score <6) as an event. Multivariable logistic regression was performed to assess the significance of relevant factors. RESULTS The mean age of the participants was 59.0 (standard deviation [SD], 7.0) years. The majority of the participants (76.3%) had at least some sort of physical disability. In multivariable logistic regression analysis after adjusting for all covariates simultaneously, age (odds ratio [95% confidence interval]: 1.35 [1.20 to 1.75] per 1-SD increment), BMI (1.32 [1.08 to 1.21] per 1-SD increment), higher educational attainment (0.34 [0.09-0.90]), multi-morbidity (2.79 [1.48-5.25]) and uncontrolled diabetes (1.35 [1.10-1.45]) were independently associated with ADL impairment. CONCLUSIONS Physical disability was common, and ADL impairment was associated with age, educational attainment, BMI, multi-morbidities and uncontrolled diabetes among the people with diabetes in Bangladesh.
Collapse
Affiliation(s)
- Sabrina Ahmed
- Department of Noncommunicable DiseasesBangladesh University of Health SciencesDhakaBangladesh
- NCD Epidemiology Research CenterShiga University of Medical ScienceOtsuJapan
| | - Mithila Faruque
- Department of Noncommunicable DiseasesBangladesh University of Health SciencesDhakaBangladesh
| | - Mohammad Moniruzzaman
- Department of Noncommunicable DiseasesBangladesh University of Health SciencesDhakaBangladesh
- NCD Epidemiology Research CenterShiga University of Medical ScienceOtsuJapan
| | - Naym Uddin Roby
- School of Rehabilitation ScienceMcMaster UniversityHamiltonOntarioCanada
| | - Fatema Ashraf
- Department of Gynaecology and ObstetricsShaheed Suhrawardy Medical CollegeDhakaBangladesh
| | - Yuichiro Yano
- NCD Epidemiology Research CenterShiga University of Medical ScienceOtsuJapan
| | - Katsuyuki Miura
- NCD Epidemiology Research CenterShiga University of Medical ScienceOtsuJapan
| | - M. S. A. Mansur Ahmed
- Department of Noncommunicable DiseasesBangladesh University of Health SciencesDhakaBangladesh
| |
Collapse
|
18
|
Makarawung DJS, de Vries CEE, List EB, Monpellier VM, Mou D, Klassen AF, Pusic AL, van Veen RN, Mink van der Molen AB. Patient-Level Factors Associated with Health-Related Quality of Life and Satisfaction with Body After Bariatric Surgery: a Multicenter, Cross-Sectional Study. Obes Surg 2022; 32:3079-3087. [PMID: 35859022 DOI: 10.1007/s11695-022-06214-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Health-Related Quality of Life (HRQL) is a key outcome of success after bariatric surgery. Not all patients report improved HRQL scores postoperatively, which may be due to patient-level factors. It is unknown which factors influence HRQL after surgery. Our objective was to assess patient-level factors associated with HRQL after surgery. METHODS This international cross-sectional study included 730 patients who had bariatric surgery. Participants completed BODY-Q scales pertaining to HRQL and satisfaction with body, and demographic characteristics were obtained. The sample was divided into three groups based on time since surgery: 0 - 1 year, 1 - 3 years and more than 3 years. Uni- and multivariable linear regression analyses were conducted to identify variables associated with the BODY-Q scales per group. RESULTS The 0 - 1 year postoperative group included 377 patients (50.9%), the 1 - 3 years postoperative group 218 (29.4%) and the more than 3 years postoperative group 135 patients (18.2%). Lower current body-mass index (BMI), more weight loss (%TWL), being employed, having no comorbidities, higher age and shorter time since surgery were significantly associated with improved HRQL outcomes postoperatively. None of these factors influenced all BODY-Q scales. The effect of current BMI increased with longer time since surgery. CONCLUSION Factors including current BMI, %TWL, employment status, presence of comorbidities, age and time since surgery were associated with HRQL postoperatively. This information may be used to optimize patient-tailored care, improve patient education and underline the importance of long-term follow-up with special attention to weight regain to ensure lasting improvement in HRQL.
Collapse
Affiliation(s)
- Dennis J S Makarawung
- Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands.
- Department of Plastic Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands.
| | - Claire E E de Vries
- Department of Surgery, OLVG West, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
- Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Emile B List
- Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Valerie M Monpellier
- Dutch Obesity Clinic (Nederlandse Obesitas Kliniek), Amersfoortseweg 43, 3712 BA, Huis Ter Heide, the Netherlands
| | - Danny Mou
- Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Anne F Klassen
- Department of Pediatrics, McMaster University, 1200 Main St W, Hamilton, ON, L8N 3Z5, Canada
| | - Andrea L Pusic
- Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Ruben N van Veen
- Department of Surgery, OLVG West, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
| | | |
Collapse
|
19
|
Nielsen SS, Skou ST, Larsen AE, Bricca A, Søndergaard J, Christensen JR. The Effect of Occupational Engagement on Lifestyle in Adults Living with Chronic Pain: A Systematic Review and Meta-analysis. Occup Ther Int 2022; 2022:7082159. [PMID: 35814357 PMCID: PMC9208937 DOI: 10.1155/2022/7082159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/24/2022] [Accepted: 03/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background Healthy lifestyle is important to decrease health risks in individuals living with chronic pain. From an occupational therapy perspective, human health and lifestyle are linked to occupational engagement in meaningful everyday activities. This study is aimed at investigating the effect of including occupational engagement in chronic pain interventions on lifestyle. Methods In this systematic review (PROSPERO reg. CRD42020159279), we included randomized controlled trials (RCTs) on interventions involving occupational engagement (i.e., occupational performance based on involvement, choice, positive meaning, and commitment) and assessing modifiable lifestyle factors: physical activity, body anthropometrics, alcohol consumption, smoking, stress, and sleep. We sought the databases Ovid MEDLINE, Embase, PsycINFO, CINAHL, Cochrane, Scopus, Web of Science, OTseeker, ClinicalTrials.gov, OpenGrey, and the web engine Google Scholar and citations and references of relevant publications. We evaluated methodological quality with the Cochrane risk-of-bias tool 2.0, determined the overall evidence certainty using the GRADE methodology, and performed meta-analysis when two or more trials reported on the outcomes. Results Of the 9526 items identified, 286 were full text screened. We included twelve articles with eleven RCTs comprising 995 adults and assessing physical activity, sleep quality, stress, and Body Mass Index. Sufficient data for meta-analysis was only available for physical activity and sleep quality. The meta-analysis suggested a moderate increase in physical activity after behavioral interventions for fibromyalgia and musculoskeletal pain (SMD = 0.69 (0.29; 1.09)) and a small increase in sleep quality up to 6 months after multidisciplinary self-management of fibromyalgia (SMD = 0.35 (95% CI 0.08; 0.61)). The overall certainty of the evidence was deemed low. Conclusion Including occupational engagement in chronic pain interventions may increase short-term physical activity and long-term sleep quality. Due to the few available RCTs including occupational engagement in chronic pain treatment for adults living with chronic pain, further high-quality RCTs are needed and will likely change the conclusion.
Collapse
Affiliation(s)
- Svetlana Solgaard Nielsen
- Research Unit for User Perspectives, Department of Public Health, University of Southern Denmark, J. B. Winsloews Vej 9B, 5000 Odense C, Denmark
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Faelledvej 2C, 4200 Slagelse, Denmark
| | - Søren T. Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Faelledvej 2C, 4200 Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Anette Enemark Larsen
- Department of Therapy and Midwifery Studies, Faculty of Health Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen N, Denmark
| | - Alessio Bricca
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Faelledvej 2C, 4200 Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Jens Søndergaard
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsloews Vej 9A, 5000 Odense C, Denmark
| | - Jeanette Reffstrup Christensen
- Research Unit for User Perspectives, Department of Public Health, University of Southern Denmark, J. B. Winsloews Vej 9B, 5000 Odense C, Denmark
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsloews Vej 9A, 5000 Odense C, Denmark
- Research Unit for General Practice, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
| |
Collapse
|
20
|
Chardon M, Barbieri FA, Penedo T, Santos PCR, Vuillerme N. The Effects of Overweight and Obesity on Obstacle Crossing During Walking: Protocol for a Systematic Review. JMIR Res Protoc 2022; 11:e36234. [PMID: 35594080 PMCID: PMC9166666 DOI: 10.2196/36234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/01/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Overweight and obesity are significant global health concerns that involve deficits in gait and balance that affect daily activities. Although much is reported about the effect of overweight and obesity on gait during unobstructed walking, not much is known about how overweight and obesity could impact gait under more challenging conditions, such as environments with obstacles. OBJECTIVE The aim of this study is to systematically review and synthesize the available data regarding the effects of overweight and obesity on obstacle crossing during walking. METHODS This review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. PubMed, Web of Science, Scopus, and SPORTDiscus will be systematically searched with no limitations on publication date. Only full-text English-language articles published in a peer-reviewed journal will be included. Included articles must have compared obstacle crossing during walking in individuals with overweight or obesity to individuals of normal body weight. A total of 2 independent reviewers will select the articles and extract the following 4 sets of data: (1) study characteristics, (2) sample description, (3) obstacle crossing task protocol, and (4) main results obtained. If a considerable number of homogeneous papers are included, a meta-analysis will be conducted. A preliminary search was conducted in November 2021. RESULTS The results will include the article selection flowchart as well as tables and figures synthesizing the extracted data on the effects of overweight and obesity on obstacle crossing during walking. The preliminary search identified 73 original records, of which 5 articles met the inclusion criteria. CONCLUSIONS This review will present researchers and clinicians with an overview of published studies that have compared the performance of obstacle crossing for individuals with overweight and obesity to those of normal body weight. Gaining insight into the control strategies adopted by individuals with overweight and obesity is critical for safe and successful obstacle crossing in this population. We therefore believe that our findings could be useful for identifying people at risk of falls and developing and implementing fall prevention programs for individuals with overweight and obesity. TRIAL REGISTRATION PROSPERO CRD42021269949; https://tinyurl.com/3yrwccu4. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/36234.
Collapse
Affiliation(s)
- Matthias Chardon
- AGEIS, Université Grenoble Alpes, La Tronche, France
- Human Movement Research Laboratory, Department of Physical Education. School of Sciences, São Paulo State University, Bauru, Brazil
| | - Fabio Augusto Barbieri
- Human Movement Research Laboratory, Department of Physical Education. School of Sciences, São Paulo State University, Bauru, Brazil
| | - Tiago Penedo
- AGEIS, Université Grenoble Alpes, La Tronche, France
- Human Movement Research Laboratory, Department of Physical Education. School of Sciences, São Paulo State University, Bauru, Brazil
| | - Paulo Cezar Rocha Santos
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
| | - Nicolas Vuillerme
- AGEIS, Université Grenoble Alpes, La Tronche, France
- Institut Universitaire de France, Paris, France
| |
Collapse
|
21
|
Christensen JR, Konge MB, Devantier M, Brandt CJ, Gommesen JB, Kolind MI. Preferred Content in Occupational Therapy-Based Weight Loss Interventions: A Survey. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:199-208. [PMID: 35481436 DOI: 10.1177/15394492221088511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite decades of attempts from doctors and dietitians to break the obesity curve, obesity rates are increasing in Denmark. To counteract this, municipal occupational therapy-based interventions are in development as part of the Danish Obesity Intervention Trial (DO: IT). The objective was to survey Danish adults on preferred content in an occupational therapy municipal weight loss intervention and determine if preferences differed by gender and age. A 21-item questionnaire was developed to explore preferences related to diet, physical activity, occupational balance, habits, and social relations. In all, 429 respondents were included. Chi-square statistics were performed to determine if preferences differed by gender and age. A total of 15 of the 21 items indicated gender-based differences in preferences. Two items indicated age-based differences. Notably, compared to men, women indicated significantly more interest in content relating to habit formation and occupational balance. Gender-based differences should be considered when developing a weight loss intervention.
Collapse
Affiliation(s)
- Jeanette Reffstrup Christensen
- Department of Public Health, University of Southern Denmark, Odense, Denmark.,Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Maria B Konge
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Martin Devantier
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Carl J Brandt
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Joakim B Gommesen
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mikkel I Kolind
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
22
|
Lazzer S, D’Alleva M, Vaccari F, Tringali G, De Micheli R, Sartorio A. Effects of a 3-Week Inpatient Multidisciplinary Body Weight Reduction Program on Body Composition and Physical Capabilities in Adolescents and Adults With Obesity. Front Nutr 2022; 9:840018. [PMID: 35433781 PMCID: PMC9008348 DOI: 10.3389/fnut.2022.840018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/18/2022] [Indexed: 12/04/2022] Open
Abstract
Background The aim of the present study was to examine the short-term changes in body composition and physical capabilities in subjects with obesity during a multidisciplinary inpatient body weight reduction program (BWRP). Methods One hundred thirty-nine adolescents (56 boys and 83 girls; BMI: 37.1 ± 6.5 kg/m2; Fat Mass, FM: 45.3 ± 7.2%) and 71 adults (27 males and 44 females; BMI: 44 ± 4.7 kg/m2; FM: 51.4 ± 4.7%) followed a 3-week inpatient BWRP consisting of regular physical activity, moderate energy restriction, nutritional education and psychological counseling. Before (T0) and after the end of the BWRP (T21), body composition was assessed with an impedancemeter, lower limb muscle power with Margaria Stair Climbing Test (SCT), lower limb functionality with Short Physical Performance Battery (SPPB), and the capacity of performing activity of daily living (ADL) with Physical Performance Test (PPT). Results At T21, obese adolescents showed a 4% reduction in body mass (BM) (p < 0.001), associated with a FM reduction in boys (−10%) and girls (−6%) (p < 0.001) and with a 3% reduction in fat-free mass (FFM) recorded only in boys (p = 0.013). Obese adults showed a 5% BM reduction (p < 0.001), associated with a 2% FFM and 9% FM reduction (p < 0.001) in males, and 7% FM reduction in females (p < 0.001). Regarding physical capabilities, at T21 in obese adolescents, PPT score increased by 4% (p < 0.001), SCT decreased by −5% (boys) and −7% (girls) (p < 0.001), while SPPB score did not change significantly. In obese adults at T21, PPT score increased by 9% (p < 0.001), SCT decreased by −16% (p < 0.001) only in females, and SPPB score increased by 7% (males) and 10% (females) (p < 0.01). Conclusion In conclusion, moderate energy restriction and regular physical activity determine a 4-5% BM reduction during a 3-week inpatient BWRP, improve physical capabilities and induce beneficial changes in body composition in adolescents and adults with obesity. Trial registration This study was approved by the Ethical Committee of the Istituto Auxologico Italiano (Milan, Italy; research code: 01C124; acronym: PRORIPONATFIS). Registered 11 November 2020 - Retrospectively registered.
Collapse
Affiliation(s)
- Stefano Lazzer
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Mattia D’Alleva
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
- *Correspondence: Mattia D’Alleva,
| | - Filippo Vaccari
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Gabriella Tringali
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Scientific Institute for Hospitalization and Care (IRCCS), Piancavallo, Italy
| | - Roberta De Micheli
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Scientific Institute for Hospitalization and Care (IRCCS), Piancavallo, Italy
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Scientific Institute for Hospitalization and Care (IRCCS), Piancavallo, Italy
- Division of Auxology, Istituto Auxologico Italiano, Scientific Institute for Hospitalization and Care (IRCCS), Piancavallo, Italy
| |
Collapse
|
23
|
Kokura Y, Nishioka S. Association Between Weight Loss and Activities of Daily Living in Obese and Overweight Patients after Stroke: A Cross-Sectional Study. J Stroke Cerebrovasc Dis 2021; 30:106052. [PMID: 34419833 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/27/2021] [Accepted: 08/08/2021] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Whether weight loss during hospitalization is associated with improvement in activities of daily living (ADL) in overweight and obese stroke patients remains unclear. This study investigated the association between decreases in body mass index (BMI), fat-free mass (FFM), and fat mass (FM) and ADL improvement. MATERIALS AND METHODS In this cross-sectional study, we analyzed data of patients admitted to acute care hospitals with stroke. Patients were classified into two groups based on their change in BMI during their hospital stay (i.e. decreased or nondecreased group). To control and adjust for patient characteristics and confounders, we created an inverse probability-weighted (IPW) model using propensity scoring, which was used to compare the Functional Independence Measure Motor (FIM-M) efficacy between the two groups. We also compared FFM and FM between admission and discharge in each group. RESULTS A total of 556 patients were analyzed, among whom 391 (70.3%) had a decrease in BMI and 165 (29.7%) had a nondecrease. After IPW adjustment, efficiency of FIM-M was significantly higher in the nondecreased group as compared to that in the decreased group (median: 0.44 vs. 0.29, P < 0.001). FFM and FM were significantly decreased from admission to discharge in the decreased group, but there was no significanct difference observed in the nondecreased group. Preserving BMI during hospitalization was associated with a positive improvement in ADL in overweight and obese stroke patients undergoing rehabilitation. CONCLUSIONS Risks and benefits of weight loss should be balanced in nutritional care and rehabilitation for overweight and obese stroke patients.
Collapse
Affiliation(s)
- Yoji Kokura
- Department of Clinical Nutrition, Keiju Medical Center, 94 Tomioka chou, Nanao, Ishikawa 926-8605, Japan; Department of Medical Nutrition, Graduate School of Human Life Science, Osaka City University, Osaka, Japan.
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| |
Collapse
|
24
|
Smith L, Shin JI, López-Sánchez GF, Veronese N, Soysal P, Oh H, Grabovac I, Barnett Y, Jacob L, Koyanagi A. Association between food insecurity and fall-related injury among adults aged ≥65 years in low- and middle-income countries: The role of mental health conditions. Arch Gerontol Geriatr 2021; 96:104438. [PMID: 34062309 DOI: 10.1016/j.archger.2021.104438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/07/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE We investigated the association between food insecurity and fall-related injury among older adults from six low- and middle-income countries (LMICs), and the extent to which this association is mediated by mental health. METHODS Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Fall-related injury referred to those that occurred in the past 12 months. Multivariable logistic regression analysis and mediation analysis were conducted to assess associations. RESULTS Data on 14,585 adults aged ≥65 years [mean (SD) age 72.5 (11.5) years; 54.9% females] were analyzed. After adjustment for potential confounders, severe food insecurity (versus no food insecurity) was associated with 1.95 (95%CI = 1.11-3.41) times higher odds for fall-related injury. Moderate food insecurity was not significantly associated with fall-related injury (OR = 1.34; 95%CI = 0.81-2.25). The mediation analysis showed that 37.3%, 21.8%, 17.7%, and 14.0% of the association between severe food insecurity and fall-related injury was explained by anxiety, sleep problems, depression, and cognition, respectively. CONCLUSION Severe food insecurity was associated with higher odds for injurious falls among older adults in LMICs, and a large proportion of this association may be explained by mental health complications. Interventions to improve mental health among those who are food insecure and a strong focus on societal and government efforts to reduce food insecurity may contribute to a decrease in injurious falls.
Collapse
Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK.
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Hans Oh
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Yvonne Barnett
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France; ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
| |
Collapse
|
25
|
Tavares Milhem Ygnatios N, de Oliveira C, Vaz de Melo Mambrini J, Bof de Andrade F, Lima-Costa MF, Lustosa Torres J. Differences in disability and nutritional status among older Brazilian and English adults: the Brazilian Longitudinal Study of Aging (ELSI-Brazil) and English Longitudinal Study of Aging (ELSA) cohorts. Am J Clin Nutr 2021; 114:422-428. [PMID: 33831943 PMCID: PMC8436132 DOI: 10.1093/ajcn/nqab060] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/16/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Brazil and England are 2 countries at different stages in their demographic, epidemiological, and nutritional transitions and with distinct socioeconomic and politic contexts, but with similar universal health systems. We aimed to examine disability and its association with objective anthropometric indicators of nutritional status, including BMI, waist circumference, and waist-to-height ratio, comparing older Brazilian and English adults. METHODS We used cross-sectional data from 2 nationally representative aging studies. For Brazil, we included 9412 participants who participated in the baseline (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The English data were from 8024 participants of the wave 6 (2012-2013) of the English Longitudinal Study of Aging (ELSA). Disability was defined as difficulty to perform at least 1 activity of daily living. We used logistic regression models to examine the association between anthropometric indicators and disability, adjusted for sociodemographic and health-related characteristics, considering the interaction term between each anthropometric indicator and country. RESULTS All health-related characteristics were worse in Brazil than England, although the prevalence of disability was similar among Brazilian (17.85%) and English (16.27%) older adults. Fully adjusted models showed statistically significant interaction terms between country and anthropometric indicators. The strength of the associations in Brazil was weaker compared with England. All anthropometric indicators were positively associated with disability: elevated BMI, in Brazil (OR: 1.27; 95% CI: 1.06, 1.51) and in England (OR: 1.80; 95% CI: 1.51, 2.14); elevated waist circumference, in Brazil (OR: 1.21; 95% CI: 1.02, 1.44) and in England (OR: 1.90; 95% CI: 1.51, 2.37); and elevated waist-to-height ratio, in Brazil (OR: 1.20; 95% CI: 0.96, 1.52) and in England (OR: 1.83; 95% CI: 1.37, 2.44). CONCLUSIONS Elevated BMI and waist circumference increased the odds of disability in both populations. However, these associations were stronger in England than in Brazil.
Collapse
Affiliation(s)
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | | | | | | | | |
Collapse
|
26
|
Moreno-Cabañas A, Ortega JF, Morales-Palomo F, Ramirez-Jimenez M, Alvarez-Jimenez L, Mora-Rodriguez R. Concurrent endurance and resistance training enhances muscular adaptations in individuals with metabolic syndrome. Scand J Med Sci Sports 2021; 31:1440-1449. [PMID: 33730398 DOI: 10.1111/sms.13950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 01/10/2023]
Abstract
The purpose of the study was to determine if concurrent training (endurance and resistance in a single session) elicits leg muscular adaptations beyond the ones obtained by endurance training alone in sedentary individuals with metabolic syndrome (MetS). Sixty-six MetS individuals (37% women, age 56 ± 7 years, BMI 32 ± 5 kg m-2 and 3.8 ± 0.8 MetS factors) were randomized to undergo one of the following 16-week isocaloric exercise programs: (i) 4 + 1 bouts of 4 min at 90% of HRMAX of intense aerobic cycling (IAC + IAC group; n = 33), (ii) 4 IAC bouts followed by 3 sets of 12 repetitions of 3 lower-limb free-weight exercises (IAC + RT group; n = 33). We measured the effects of training on maximal cycling power, leg press maximum strength (1RM), countermovement jump height (CMJ), and mean propulsive velocity (MPV) at workloads ranging from 10% to 100% of baseline 1RM leg press. After intervention, MetS components (Z-score) improved similarly in both groups (p = 0.002). Likewise, maximal cycling power during a ramp test improved similarly in both groups (time effect p < 0.001). However, leg press 1RM improved more in IAC + RT than in IAC + IAC (47 ± 5 vs 13 ± 5 kg, respectively, interaction p < 0.001). CMJ only improved with IAC + RT (0.8 ± 0.2 cm, p = 0.001). Leg press MPV at heavy loads (ie, 80%-100% 1RM) improved more with concurrent training (0.12 ± 0.01 vs 0.06 ± 0.02 m s-1 , interaction p = 0.013). In conclusion, in unconditioned MetS individuals, intense aerobic cycling alone improves leg muscle performance. However, substituting 20% of intense aerobic cycling by resistance training further improves 1RM leg press, MPV at high loads, and jumping ability while providing similar improvement in MetS components.
Collapse
Affiliation(s)
| | - Juan Fernando Ortega
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
| | - Felix Morales-Palomo
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
| | | | | | | |
Collapse
|
27
|
Gait strategy and body composition in patients with Prader-Willi syndrome. Eat Weight Disord 2021; 26:115-124. [PMID: 31797332 DOI: 10.1007/s40519-019-00825-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Individuals with Prader-Willi syndrome (PWS) exhibit reduced lean body mass and increased fat-lean mass ratio when compared with individuals of normal weight and obese ones. Thus, research on the association of functional limitations during gait and body composition may be of great importance from a rehabilitative viewpoint. In particular, the aim of this study was to compare the gait profile of persons with PWS to that of unaffected individuals and to see if a relationship exists between gait profile and body composition in individuals with PWS. METHODS Eighteen individuals with PWS and 20 unaffected individuals (Healthy Group: HG) were assessed. Their gait pattern was quantified with 3D-Gait Analysis (3D-GA). Overall body weight, lean and fat masses were measured by dual-energy X-ray absorptiometry. RESULTS Individuals with PWS were found to be characterized by a significantly different (p < 0.05) gait pattern with respect to healthy controls in terms of both kinematic and kinetic parameters. No correlations were found between kinematic parameters and overall mass and lean/fat mass, while some parameters associated with ground reaction force were found to be significantly correlated with overall mass, lean mass and fat mass. Significant regression models were obtained, including impact and propulsive force and loading rate. CONCLUSION Our data suggest that in individuals with PWS, gait is influenced by the overall and lean body mass. Thus, therapeutic strategies should target both weight reduction and lean mass increase to optimize gait, minimize articular stress, and reduce the risk of repetitive strain on the lower limbs. LEVEL OF EVIDENCE Level III: Case-control analytic study.
Collapse
|
28
|
Impact of chronic disorders and obesity on quality of life in Northern Jordan. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01103-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
|
29
|
Sarcopenia and fall-related injury among older adults in five low- and middle-income countries. Exp Gerontol 2021; 147:111262. [PMID: 33516908 DOI: 10.1016/j.exger.2021.111262] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 12/11/2022]
Abstract
Sarcopenia is a common condition in older people and increasing evidence suggests that it can be considered as a potential risk factor for falls and fractures. However, no studies on this topic from low- and middle-income countries (LMICs) are available. Thus, we assessed this association among older adults from five LMICs (China, India, Ghana, Mexico, and Russia). Community-based, nationally representative, cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. The presence of fall-related injury was ascertained through self-reported information. Multivariable logistic regression analysis and meta-analysis were conducted. The sample consisted of 13,101 individuals aged ≥65 years (mean (SD) age 72.6 (11.3) years; 45% males). The prevalence of fall-related injury was higher among those with sarcopenia than in those without this condition (e.g., Mexico 9.8% vs. 2.7%). Adjusted analyses showed that sarcopenia was associated with a 1.85 (95%CI = 1.24-2.77) times higher odds for fall-related injury, with a low level of between-country heterogeneity. Future studies of longitudinal design may shed light on whether sarcopenia in LMICs may be considered as a risk factor for falls.
Collapse
|
30
|
Amiri S, Behnezhad S. Sleep Disturbances and Physical Impairment: A Systematic Review and Meta-Analysis. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2021.1871699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Sohrab Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
31
|
Zhang Y, Xiong Y, Yu Q, Shen S, Chen L, Lei X. The activity of daily living (ADL) subgroups and health impairment among Chinese elderly: a latent profile analysis. BMC Geriatr 2021; 21:30. [PMID: 33413125 PMCID: PMC7791986 DOI: 10.1186/s12877-020-01986-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/22/2020] [Indexed: 02/08/2023] Open
Abstract
Background Disability in aged people became one of the major challenges in China due to the acceleration of population aging. Nevertheless, there were limited methods to appropriately discriminate the degree of combined basic activity of daily living (BADL) and instrumental activity of daily living (IADL). The present study explored an empirical typology of the activity of daily living (ADL) and its association with health status among the elderly in China. Methods Data throughout the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was retrieved and Latent profile analysis (LPA) was conducted to identify the subgroups of ADL for included elderly subjects. Multinomial regression was performed to detect the effect of identified characteristics with ADL subgroups, and the restricted cubic spine was drawn to show the changes in the relationship between age-specific ADL disability and BMI. Results The overall participants (n=8108) were divided into three ADL classes by LPA - ‘no BADL limitation-no IADL limitation’ (Class one, n=6062, 75%), ‘no BADL limitation- IADL impairment’ (Class two, n=1526, 19%), and ‘BADL impairment- IADL impairment’ (Class three, n=520, 6%). Compared with the participants in Class one, the oldest-old, living without spouse, lacking of exercise, short in social activities, having experience of falls, having comorbidity of diabetes, heart disease, stroke, decreased cognitive function, depression symptom were highly associated with Class two and Class three. Additionally, malnutrition and asthma were associated with combined BADL/IADL impairment (Class three), while illiteracy was only associated with IADL impairment (Class two). Furthermore, a statistically significant U-shape association was detected between age and BADL/IADL disability (Class three vs. Class two) as well as BMI and BADL/IADL disability (Class three vs. Class one). The elderly aged 80–90 with IADL impairment were less likely to evolve into combined BADL/IADL impairment, and the elderly who were underweight or obese may have higher risk of combined BADL/IADL impairment. Conclusion A novel functional assessment was explored based on LPA, by which elderly people could be classified into three distinct classes of combined BADL/IADL. The predictors identified with particular IADL/BADL classes could draw early attention to the onset of functional disability and enlighten targeted interventions to address consequent problems of aged people.
Collapse
Affiliation(s)
- Yangchang Zhang
- Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yang Xiong
- Andrology lab / Department of urology, the West China Hospital, Sichuan University, Chengdu, China
| | - Qiuhua Yu
- Department of Nursing, Chongqing Medical University, Chongqing, China
| | - Shisi Shen
- Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,The First School of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Li Chen
- The School of Public Health, Peking University, Beijing, China
| | - Xun Lei
- Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health and Management, Chongqing Medical University, Chongqing, China.
| |
Collapse
|
32
|
Ervin CM, Whalley D, von Huth Smith L, Crawford R, Dine J, Fehnel SE. Development of the impact of weight on daily activities questionnaire: A patient-reported outcome measure. Clin Obes 2020; 10:e12387. [PMID: 32935465 PMCID: PMC7685113 DOI: 10.1111/cob.12387] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/03/2020] [Accepted: 06/07/2020] [Indexed: 12/02/2022]
Abstract
While patient-reported outcome measures are available to evaluate health-related quality of life and functioning in obesity, existing measures do not evaluate the impact of excess weight and weight loss on the ability to perform regularly occurring daily activities. Three iterative sets of qualitative interviews were conducted in two countries (United States, n = 23; United Kingdom, n = 23) with individuals with body mass index ≥30 kg/m2 to inform development of the Impact of Weight on Daily Activities Questionnaire (IWDAQ) for use in clinical trials to evaluate daily activity limitations associated with excess weight. Candidate concepts were selected based on the literature, expert opinion, and previously conducted qualitative research, after which the draft IWDAQ was developed and tested. Interviews included a brief concept elicitation phase, followed by cognitive debriefing during which the IWDAQ was refined based upon participants' feedback. The IWDAQ uses a novel, adaptive questionnaire design, such that clinical trial participants choose the three IWDAQ activities they would most like to improve with weight loss and rate the degree of limitation in each of these activities at baseline. By allowing individuals participating in trials to identify and monitor changes in the activities they most want to see improve with weight loss, the 19-item IWDAQ has the potential to detect the benefits of weight-loss treatment that individuals with obesity value most.
Collapse
Affiliation(s)
- Claire M. Ervin
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| | - Diane Whalley
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsManchesterUK
| | | | - Rebecca Crawford
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsManchesterUK
| | - Jennifer Dine
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| | - Sheri E Fehnel
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| |
Collapse
|
33
|
Brunani A, Sirtori A, Capodaglio P, Donini LM, Buscemi S, Carbonelli MG, Giordano F, Mazzali G, Pasqualinotto L, Zenti MG, Barbieri V, Villa V, Leonardi M, Raggi A. Disability assessment in an Italian cohort of patients with obesity using an International Classification of Functioning, Disability and Health (ICF)-derived questionnaire. Eur J Phys Rehabil Med 2020; 57:630-638. [PMID: 33165313 DOI: 10.23736/s1973-9087.20.06512-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Obesity is a clinical condition that contributes to the development of related disability in different areas (physical, psychological and social). Multidisciplinary treatment calls for specific instruments able to evaluate all related functional problems. We have developed a tool (an ICF-based assessment instrument, the ICF-OB schedule) to evaluate obesity-related disability, composed of an inventory of 71-items from the WHO International Classification of Functioning, Disability and Health (ICF). AIM The aim of the present study was to validate this new tool for the definition of obesity-related disability. We also sought to examine the relationship between obesity disability, an index of multimorbidity (Cumulative Illness Rating Scale [CIRS]) and a well-validated score of perceived obesity-related disability (Italian Obesity Society Test for Obesity-Related Disability [TSD-OC]). DESIGN Process validation of the ICF-OB schedule. SETTING Baseline conditions of out- and in-patients. POPULATION A large cohort of obese patients recruited from 9 multidisciplinary centers belonging to the Italian Obesity Society (SIO) network, which provide specialized obesity care. METHODS A total of 353 patients (F: 70%, age: 50.2±12.7yrs, BMI: 41.4±8.3kg/m2) were enrolled between January 2017 and June 2018. The ICF-OB was used to define patients' functioning and disability profiles in order to set and appraise rehabilitation goals. RESULTS We described the distribution of body functions (BF), body structures (BS) and activities and participations (A&P) categories and the agreement rates were significant for the majority of these. The ICF-OB was more often significantly associated, and with stronger coefficients, with patients' comorbidities as described by the CIRS rather than with Body Mass Index (BMI). The TSD-OC also presented a strong association with A&P indexes. CONCLUSIONS The complexity of clinical condition, that generates disability in obesity might be well identified with the use of this new instrument that appear significant related to the perceived disability for each patients and also with their multimorbidity. CLINICAL REHABILITATION IMPACT The ICF-OB shows great promise as a tool for goal setting in the rehabilitation of obese patients.
Collapse
Affiliation(s)
- Amelia Brunani
- IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Verbania, Verbania-Cusio-Ossola, Italy -
| | - Anna Sirtori
- IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Verbania, Verbania-Cusio-Ossola, Italy
| | - Paolo Capodaglio
- IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Verbania, Verbania-Cusio-Ossola, Italy
| | - Lorenzo M Donini
- Food Science and Human Nutrition Research Unit, Sapienza University, Rome, Italy
| | - Silvio Buscemi
- Unit of Endocrinology, Metabolic and Nutrition Diseases, University Hospital Policlinico "P. Giaccone", University of Palermo, Palermo, Italy
| | | | - Francesca Giordano
- Centro per la Cura dell'Obesità Casa di Cura Solatrix, Rovereto, Trento, Italy
| | - Gloria Mazzali
- Department of Medicine, Geriatrics Division, University of Verona, Verona, Italy
| | | | - Maria G Zenti
- Departement of Medicine, Endocrinology Division, University of Verona, Verona, Italy
| | - Valerio Barbieri
- Centro per i Disturbi Alimentari, Policlinico S. Pietro, Bergamo, Italy
| | - Valentina Villa
- IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Verbania, Verbania-Cusio-Ossola, Italy
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | |
Collapse
|
34
|
Evangelou C, Kartakoullis N, Hadjicharalambous M, Aphamis G, Hadjimarkou M, Sakkas GK, Giannaki CD. Depressive symptoms, sleep quality, physical fitness, and fatigue among adult women with different obesity status. SPORT SCIENCES FOR HEALTH 2019. [DOI: 10.1007/s11332-019-00559-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
35
|
Prediction of adult class II/III obesity from childhood BMI: the i3C consortium. Int J Obes (Lond) 2019; 44:1164-1172. [PMID: 31597933 PMCID: PMC7141944 DOI: 10.1038/s41366-019-0461-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 09/03/2019] [Accepted: 09/12/2019] [Indexed: 12/25/2022]
Abstract
Background and Objectives: Adult class II/III obesity (BMI ≥ 35 kg/m2) has significant adverse health outcomes. Early prevention and treatment are critical, but prospective childhood risk estimates are lacking. This study aimed to define the prospective risk of adult class II/III obesity, using childhood BMI. Methods: Children ages 3–19 years enrolled in cohorts of The International Childhood Cardiovascular Cohort (i3C) Consortium with measured BMI assessments in childhood and adulthood were included. Prospective risk of adult class II/III obesity was modeled based on childhood age, sex, race and BMI. Results: 12 142 individuals (44% male, 85% white) were assessed at median age 14 [Interquartile range, IQR: 11, 16] and 33 [28, 39] years. Class II/III adult obesity developed in 6% of children with normal weight; 29% of children with overweight; 56% of children with obesity; and 80% of children with severe obesity. However, 38% of the 1 440 adults with class II/III obesity (553/1440) were normal weight as children. Prospective risk of adult class II/III obesity varied by age, sex and race within childhood weight status classifications, and is notably higher for girls, black participants, and those in the United States. The risk of class II/III obesity increased with older adult age. Conclusions: Children with obesity or severe obesity have a substantial risk of adult class II/III obesity, and observed prospective risk estimates are now presented by age, sex, race and childhood BMI. Clinical monitoring of children’s BMI for adult class II/III obesity risk may be especially important for females and black Americans. This study developed prospective risk estimates of adult class II/III obesity using childhood BMI, childhood age, sex and race, using longitudinal international data.
Collapse
|
36
|
Jacob L, Smith L, Thoumie P, Haro JM, Stickley A, Koyanagi A. Association between intelligence quotient and disability: The role of socioeconomic status. Ann Phys Rehabil Med 2019; 63:296-301. [PMID: 31550549 DOI: 10.1016/j.rehab.2019.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/18/2019] [Accepted: 07/29/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND No study has investigated the association between intelligence quotient (IQ) and disability (i.e., difficulties in activities of daily living [ADL] or instrumental activities of daily living [IADL]) in the general population. OBJECTIVE The goal of this nationally representative study was to analyse the potential IQ-disability association in England and identify influential factors in this association. METHODS Cross-sectional data were analyzed from the 2007 Adult Psychiatric Morbidity Survey (n=6872). IQ was assessed by using the National Adult Reading Test, which consists of a list of 50 words and is scored by counting the number of errors in reading the words aloud. Disability was defined as difficulties in at least 1 of the 7 domains of ADL and IADL. Regression and mediation analyses were conducted to analyze the association between IQ and disability and identify potential factors involved in this relationship, estimating odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Among the 6872 participants, the mean (SD) age was 46.9 (18.9) years; 51.8% were women. The prevalence of disability increased from 27.7% with IQ 120-129 to 51.0% with IQ 70-79. After adjusting for sex, age and ethnicity, as compared with IQ 120-129, with IQ 110-119, 100-109, 90-99, 80-89, and 70-79, the probability of disability was increased (OR 1.22 [95% CI 1.01-1.48], 1.42 [1.16-1.72], 1.86 [1.54-2.25], 2.41 [1.92-3.03], and 4.71 [3.56-6.17], respectively). In addition, we found a positive association between a 1-SD decrease in IQ and disability (OR 1.53, 95% CI 1.43-1.63). Finally, income (mediated percentage 26.9%), social class (18.0%) and education (11.6%) strongly affected the IQ-disability association, and these socioeconomic factors collectively explained 37.1% of the association. CONCLUSIONS Low IQ was positively associated with disability in England, and socioeconomic status explained more than one-third of this relationship.
Collapse
Affiliation(s)
- Louis Jacob
- Faculty of medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180 Montigny-le-Bretonneux, France; Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain.
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Philippe Thoumie
- Inserm U-1150, Service de médecine physique et réadaptation, Hôpital Rothschild and Sorbonne University Agathe, AP-HP, 75012 Paris, France
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
| |
Collapse
|
37
|
The relationship of childhood sexual and physical abuse with adulthood disability. Ann Phys Rehabil Med 2019; 63:332-339. [PMID: 31276839 DOI: 10.1016/j.rehab.2019.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/26/2019] [Accepted: 06/01/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to examine the association of childhood sexual and physical abuse with disability in adulthood, and to assess how several demographic, physical, behavioral, psychosocial, and psychiatric factors may influence this association. METHODS This study used nationally representative cross-sectional data from 7403 people aged≥16 years who participated in the 2007 Adult Psychiatric Morbidity Survey. Information on childhood sexual talk, sexual touching, sexual intercourse, and physical abuse occurring before the age of 16, and disability in activities of daily living and instrumental activities of daily living in adulthood were collected. Multivariable logistic regression analyses were conducted. RESULTS After adjusting for age, sex, and ethnicity, we found a positive association between different types of childhood abuse and adulthood disability: sexual talk (OR 1.54; 95% CI 1.27-1.85); sexual touching (OR 1.82; 95% CI 1.49-2.22); sexual intercourse (OR 2.58; 95% CI 1.75-3.81); physical abuse (OR 2.84; 95% CI 2.20-3.68). Increasing number of types of childhood abuse was associated with increased odds of adulthood disability. The odds of adulthood disability was increased for individuals who experienced all types of childhood abuse versus no childhood abuse (OR 3.59; 95% CI 1.64-7.84). Finally, the association between any childhood abuse and adulthood disability was largely explained by anxiety disorder, number of chronic physical conditions, and loneliness. CONCLUSIONS Childhood abuse is positively associated with adulthood disability in England. Future longitudinal studies are warranted to understand the potentially complex interplay of factors that may increase risk for disability in individuals who experienced childhood abuse.
Collapse
|
38
|
Jackson SE, Williams K, Beeken RJ, Steptoe A. Changes in Health and Wellbeing in the Years Leading up to a Cancer Diagnosis: A Prospective Cohort Study. Cancer Prev Res (Phila) 2019; 12:79-88. [PMID: 30606717 PMCID: PMC6365212 DOI: 10.1158/1940-6207.capr-18-0277] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/10/2018] [Accepted: 12/10/2018] [Indexed: 12/30/2022]
Abstract
Emerging evidence suggests cancer survivors suffer impairments in health and wellbeing that predate their diagnosis. This study prospectively examined changes from 4 to 6 years prediagnosis to 0 to 2 years postdiagnosis. Data were from 477 cancer survivors and 5,451 cancer-free comparisons participating in the English Longitudinal Study of Ageing. We examined group-by-time interactions for self-rated health, quality of life (QoL), depression, life satisfaction and impairments in mobility, activities of daily living (ADL), and instrumental ADLs (IADL). All health and wellbeing markers worsened over time in both groups. A greater decline in cancer survivors' self-rated health was evident as early as 2 to 4 years prediagnosis (P < 0.001). Around diagnosis, there were greater declines in IADL impairment (P < 0.001), QoL (P < 0.001), and depression (P < 0.001) in cancer survivors than in controls. Mobility and ADL impairments were consistently more prevalent among cancer survivors (P < 0.001), and life satisfaction was consistently lower (P = 0.004), but the rate of change over time did not differ significantly between groups. These results suggest there may be early signs of deterioration in perceived health that precede development of symptoms leading to cancer diagnosis by many years. Some of the impaired wellbeing in cancer patients may be long-standing, while other changes are more acute and may require targeted support following diagnosis.
Collapse
Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Kate Williams
- Department of Behavioural Science and Health, University College London, London, UK
- Acaster Lloyd Consulting Ltd, London, UK
| | - Rebecca J Beeken
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| |
Collapse
|
39
|
Chen N, Li X, Wang J, Zhou C, Wang C. Rural-urban differences in the association between disability and body mass index among the oldest-old in China. Arch Gerontol Geriatr 2018; 81:98-104. [PMID: 30529805 DOI: 10.1016/j.archger.2018.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 11/21/2018] [Accepted: 12/03/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The issue of disability prevention is considered as a priority for research in geriatrics in modern society, especially for the oldest-old. There are many evidences certificated that obesity is associated with disability in developed countries. However, few studies pay attention to relationship between them in developing countries. Furthermore, it is also unknown whether the association is similar among the oldest-old in rural and urban areas. The purpose of this study is to explore rural-urban differences in the association between disability and BMI among the oldest-old in China. METHODS 4076 seniors (80+) were included from the 2014 wave of Chinese Longitudinal Healthy Study. Disability, body mass index and other information including socio-demographic variables, health behavior conditions and health status were collected. Logistic regression analysis was employed to examine the association. RESULTS Of 4076 respondents, 1817 (44.6%) were urban elderly. Overall, 26.6% of the participants had disability, and 31.8% for urban, 22.4% for rural. After controlling for other variables, the significant association between BMI and disability was found for urban oldest seniors, but not for rural ones. Age, living arrangement, Non-communicable disease and annual physical examination were important determinants related to disability. CONCLUSIONS The association between BMI and disability differed according to residence. Both overweight and underweight were red flags of disability among Chines seniors (80+) in urban areas. Therefore, proper weight management is important for preventing disability among urban oldest-old. Additionally, annual physical examination, prevention and control of chronic diseases should be recommended to all of the oldest-old.
Collapse
Affiliation(s)
- Na Chen
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, PR China
| | - Xin Li
- School of Pharmacy, Nanjing Medical University, Nanjing, PR China
| | - Jin Wang
- Institute of Literature in Chinese Medicine, Nanjing Medical University, Nanjing, PR China.
| | - Chengchao Zhou
- School of Public Health, Shandong University, Jinan, PR China.
| | | |
Collapse
|
40
|
Tsuji T, Rantakokko M, Portegijs E, Viljanen A, Rantanen T. The effect of body mass index, lower extremity performance, and use of a private car on incident life-space restriction: a two-year follow-up study. BMC Geriatr 2018; 18:271. [PMID: 30409120 PMCID: PMC6225643 DOI: 10.1186/s12877-018-0956-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 10/18/2018] [Indexed: 12/05/2022] Open
Abstract
Background The purpose of the study was to explore the single and combined contributions of body mass index (BMI) and lower extremity performance as modifiable physical factors, and the influence of use of a private car as an environmental factor on prevalent and incident life-space restriction in community-dwelling older people. Methods Community-dwelling people aged 75–90 years (n = 823) participated in the Life-Space Mobility in Old Age (LISPE) two-year follow-up study. Participants who reported that the largest life-space area they had attained, without aid from any device or another person, was the neighborhood or less were considered to have life-space restriction. Incident life-space restriction was the endpoint of Cox’s proportional hazard model. BMI, lower extremity performance (Short Physical Performance Battery, SPPB), and use of a private car were predictors. Results At baseline, people who had both obesity (BMI ≥30.0) and impaired lower extremity performance (SPPB 0–9) had a higher prevalence of life-space restriction (prevalence ratio 3.6, 95% confidence interval, CI, 2.0–6.3) compared to those with normal weight (BMI 23.0–24.9) and intact physical performance (SPPB 10–12). The 581 people without life-space restriction at the baseline contributed 1033 person-years during the two-year follow-up. Incident life-space restrictions were reported by 28.3% participants. A higher hazard ratio (HR) for incident life-space restriction was observed in subjects having both obesity and impaired lower extremity performance (HR 3.6, 95% CI, 1.7–7.4), impaired lower extremity performance only (HR 1.9, 95% CI 0.9–4.1), and obesity only (HR 1.8, 95% CI, 0.9–3.5) compared to those with normal weight and intact performance. Private car passengers (HR 2.0, 95% CI, 1.3–3.0) compared to car drivers had a higher risk of life-space restriction. All models were adjusted for age, sex, chronic diseases, and education. Conclusions Older people with impaired lower extremity performance have an increased risk of incident life-space restriction especially if combined with obesity. Also, not driving a car renders older people vulnerable to life-space restriction.
Collapse
Affiliation(s)
- Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo Ward, Chiba City, Chiba, 260-8670, Japan.
| | - Merja Rantakokko
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, FI-40014, Jyväskylä, Finland
| | - Erja Portegijs
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, FI-40014, Jyväskylä, Finland
| | - Anne Viljanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, FI-40014, Jyväskylä, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, FI-40014, Jyväskylä, Finland
| |
Collapse
|
41
|
Lv YB, Yuan JQ, Mao C, Gao X, Yin ZX, Kraus VB, Luo JS, Chen HS, Zeng Y, Wang WT, Wang JN, Shi XM. Association of Body Mass Index With Disability in Activities of Daily Living Among Chinese Adults 80 Years of Age or Older. JAMA Netw Open 2018; 1:e181915. [PMID: 30646143 PMCID: PMC6324469 DOI: 10.1001/jamanetworkopen.2018.1915] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Body mass index (BMI) shows a U-shaped association with impaired physical functioning among adults; the association is reduced or eliminated with aging. OBJECTIVE To examine whether BMI is associated with subsequent disability in activities of daily living (ADL) in Chinese adults age 80 years or older. DESIGN, SETTING, AND PARTICIPANTS Data were obtained on 16 022 adults age 80 years or older who were able to perform ADL independently at baseline from the Chinese Longitudinal Healthy Longevity Study, a community-based prospective cohort study conducted in 23 provinces of China. The study was initiated in 1998, with follow-up and recruitment of new participants in 2000, 2002, 2005, 2008, 2011, and 2014. MAIN OUTCOMES AND MEASURES Disability in ADL was defined as dependence in eating, toileting, bathing, dressing, indoor activities, and/or continence. RESULTS Among the 16 022 participants, 45.2% were men and 54.8% were women, with a mean (SD) age of 92.2 (7.2) years and a mean (SD) BMI (calculated as weight in kilograms divided by height in meters squared) of 19.3 (3.8). During 70 606 person-years of follow-up, 8113 participants with disability in ADL were identified. Cox proportional hazards regression models with penalized splines showed that BMI was linearly associated with disability in ADL: each 1-kg/m2 increase in BMI corresponded to a 4.5% decrease in the risk of disability in ADL. In comparison with individuals in the fourth quintile for BMI, the adjusted hazard ratio for disability in ADL was 1.38 (95% CI, 1.29-1.48) in the first quintile, 1.37 (95% CI, 1.28-1.47) in the second quintile, 1.11 (95% CI, 1.04-1.19) in the third quintile, and 0.85 (95% CI, 0.79-0.91) in the fifth quintile (P < .001 for trend). When BMI was categorized by Chinese guidelines, the underweight group (BMI <18.5) showed significantly increased risk of disability in ADL (hazard ratio, 1.34; 95% CI, 1.28-1.41) and the overweight or obese group (BMI ≥24.0) showed significantly decreased risk of disability in ADL (hazard ratio, 0.84; 95% CI, 0.78-0.91) compared with the normal weight group (BMI 18.5 to <24.0) (P < .001 for trend). CONCLUSIONS AND RELEVANCE Higher BMI was associated with a lower risk of disability in ADL among Chinese adults age 80 years or older, which suggests that current recommendations for BMI may need to be revisited. More attention should be paid on underweight, rather than overweight or obesity, for the prevention of disability in ADL after age 80 years.
Collapse
Affiliation(s)
- Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jin-Qiu Yuan
- Division of Epidemiology, Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, Philadelphia
| | - Zhao-Xue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Jie-Si Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hua-Shuai Chen
- Center for the Study of Aging and Human Development, Geriatric Division of School of Medicine, Duke University, Durham, North Carolina
| | - Yi Zeng
- Center for the Study of Aging and Human Development, Geriatric Division of School of Medicine, Duke University, Durham, North Carolina
- Center for Study of Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, Peking University, Beijing, China
| | - Wen-Tao Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiao-Nan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
42
|
Ashdown-Franks G, Koyanagi A, Vancampfort D, Smith L, Firth J, Schuch F, Veronese N, Stubbs B. Sedentary behavior and perceived stress among adults aged ≥50 years in six low- and middle-income countries. Maturitas 2018; 116:100-107. [PMID: 30244769 DOI: 10.1016/j.maturitas.2018.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/09/2018] [Accepted: 08/04/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sedentary behavior and perceived stress are both negatively associated with physical and mental health. Little is known about the association between sedentary behavior and perceived stress, and there is a particular paucity of data on people aged ≥50 years from low- and middle-income countries (LMICs). METHODS We analyzed cross-sectional, community-based data from 34,129 individuals aged ≥50 years [mean age 62.4 (SD = 16.0) years, 52% females] from six LMICs. Perceived stress was assessed using the Perceived Stress Scale and time spent sedentary per day was self-reported. Multivariable linear regression analyses were conducted, adjusting for important socio-economic and physical and mental health-related confounders. RESULTS The mean perceived stress score increased with greater sedentary time (38.4 for 0-<4 h/day to 54.2 for ≥11 h/day). In the fully adjusted model, 4-8, 8-11, and ≥11 h/day of sedentary behavior (SB) were associated with 1.97 (95%CI = 0.57-3.36), 7.11 (95%CI = 4.96-9.27), and 9.02 (95%CI = 5.45-12.59) times higher mean perceived stress scores, compared with 0-<4 h/day. Greater time spent sedentary was associated with higher perceived stress scores in all six countries, although the association in Mexico fell short of statistical significance. CONCLUSION This is the first multinational analysis to show that a greater amount of sedentary behavior is associated with higher levels of perceived stress among older adults in LMICs. Future research may examine the types and contexts of sedentary behavior, and explore the underlying mechanisms of the relationship.
Collapse
Affiliation(s)
- Garcia Ashdown-Franks
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Exercise Sciences, University of Toronto, 55 Harbord Street, Toronto, Ontario M5S 2W6, Canada.
| | - Ai Koyanagi
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, Barcelona, Spain
| | - Davy Vancampfort
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Sydney, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
| | - Felipe Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Post Graduate Program in Health and Human Development, Universidade La Salle, Canoas, Brazil
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Physiotherapy Department, South London and Maudsley National Health Services Foundation Trust, United Kingdom
| |
Collapse
|
43
|
Abstract
OBJECTIVE Sedentary behaviour (SB) is harmful for health and well-being and may be associated with depression. However, little is known about the correlates of SB in people with depression. Thus, we investigated SB correlates among community-dwelling adults with depression in six low- and middle-income countries. METHODS Cross-sectional data from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. The analysis was restricted to those with DSM-IV Depression or receiving depression treatment in the last 12 months. Self-reported time spent sedentary per day was the outcome. High SB was defined as ≥8 hours of SB per day. The correlates (sociodemographic and health-related) of SB were estimated by multivariable linear and logistic regression analyses. RESULTS In 2375 individuals with depression (mean age=48.0 years; 60.7% female), the prevalence of high SB was 11.1% (95%CI=8.2%-14.9%), while the mean (±SD) time spent sedentary was 215 (±192) minutes per day. Socio-demographic factors significantly associated with high SB were older age and being unmarried, being male and being unemployed. In other domains, no alcohol consumption, current smoking, mild cognitive impairment, bodily pain, arthritis, stroke, disability, and lower levels of social cohesion, COPD, visual impairment, and poor self-rated health was associated with greater time spent sedentary. CONCLUSION Our data suggest that future interventions seeking to reduce SB among individuals with depression may target at risk groups based on identified sociodemographic correlates while the promotion of social cohesion may have the potential to increase the efficacy of future public health initiatives. From a clinical perspective, bodily pain and somatic co-morbidities need to be taken into account.
Collapse
|
44
|
Body mass index and mobility limitations: An analysis of middle-aged and older Black, Hispanic, and White women in the U.S. Obes Res Clin Pract 2018; 12:547-554. [PMID: 29921542 DOI: 10.1016/j.orcp.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION While the Body Mass Index (BMI) did not change significantly for men from 2005 to 2014 in the United States, women exhibited an upward linear trend. Hispanic and Black women, in particular, showed a dramatic increase. Therefore, the objective of this study was to examine the association between BMI and mobility limitations for non-institutionalised middle-aged and older Black, Hispanic, and White women. METHODS The International Classification of Functioning, Disability, and Health model was applied to a sample of 2865 Black, 1846 Hispanic, and 9721 White women categorised as middle-aged and older (i.e., at least 50 years of age) from the 2010 and 2014 Rand Health and Retirement Study. A random effects ordered logit was employed. RESULTS After accounting for personal/activity characteristics, the analyses revealed Black women with greater BMI were associated with a higher likelihood for mobility limitations with an odds ratio of 1.11 [1.06-1.16, 95% CI]. A significant association was also found for Hispanic women with an odds ratio of 1.16 [1.11-1.23, 95% CI] and White women with an odds ratio of 1.16 [1.13-1.19, 95% CI]. Even after accounting for the possibility of endogeneity, BMI remained robust. CONCLUSION Higher-levels of BMI were associated with an increased probability for mobility limitations for Black, Hispanic, and White middle-aged and older women. Those with a vigorous exercise regimen were less likely to be in this category across all ranges of BMI. These results are useful for prioritising minority health policy, particularly given the limited amount of existing research in this specific area.
Collapse
|
45
|
The Independent Associations between Walk Score ® and Neighborhood Socioeconomic Status, Waist Circumference, Waist-To-Hip Ratio and Body Mass Index Among Urban Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061226. [PMID: 29891778 PMCID: PMC6025475 DOI: 10.3390/ijerph15061226] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/03/2018] [Accepted: 06/08/2018] [Indexed: 01/13/2023]
Abstract
Background: Environmental and policy factors can influence weight status via facilitating or discouraging physical activity and healthy diet. Despite mixed evidence, some findings suggest that the neighborhood built environment, including “walkability”, is associated with overweight and obesity. Most of these findings have measured body mass index (BMI), yet other weight status measures including waist circumference (WC) and waist-to-hip (W-H) ratio are also predictive of health outcomes, independent of BMI. Our study aim was to estimate the associations between walkability, measured using Walk Score®, and each of WC, W-H ratio, and BMI among urban Canadian adults. Methods: In 2014, n = 851 adults recruited from 12 structurally and socioeconomic diverse neighborhoods (Calgary, Alberta, Canada) provided complete data on a physical activity, health and demographic questionnaire and self-reported anthropometric measures (i.e., height and weight, WC and hip circumference). Anthropometric data were used to estimate WC, W-H ratio, and BMI which were categorized into low and high risk in relation to their potential adverse effect on health. WC and BMI were also combined to provide a proxy measure of both overall and abdominal adiposity. Multivariable logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between each weight status outcome and Walk Score®. Results: A one-unit increase in Walk Score® was associated with lower odds of being high-risk based on WC (OR = 0.99; 95%CI 0.97⁻0.99). Notably, those residing in socioeconomically disadvantage neighborhoods had significantly higher odds of being high risk based on WC, BMI, and WC-BMI combined compared with advantaged neighborhoods. Conclusions: Interventions that promote healthy weight through the design of neighborhoods that support and enhance the effect of physical activity and diet-related interventions could have a significant population health impact.
Collapse
|
46
|
BMI, Psychosocial Correlates, Pain and Activities of Daily Living in Sickle Cell Disease Patients. PROGRESS IN PREVENTIVE MEDICINE 2018. [DOI: 10.1097/pp9.0000000000000019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
47
|
Wide step width reduces knee abduction moment of obese adults during stair negotiation. J Biomech 2018; 75:138-146. [DOI: 10.1016/j.jbiomech.2018.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 05/03/2018] [Accepted: 05/03/2018] [Indexed: 11/21/2022]
|
48
|
Vancampfort D, Stubbs B, Hallgren M, Lundin A, Firth J, Koyanagi A. Correlates of sedentary behaviour among adults with hazardous drinking habits in six low- and middle-income countries. Psychiatry Res 2018; 261:406-413. [PMID: 29353765 DOI: 10.1016/j.psychres.2018.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 12/27/2017] [Accepted: 01/12/2018] [Indexed: 12/12/2022]
Abstract
Sedentary behaviour is associated with poor mental health, diabetes and cardiovascular disease, all of which are a concern among hazardous drinkers. Little is known about sedentary behaviour and it's correlates in hazardous drinkers, particularly in low- and middle-income countries. We investigated correlates of sedentary behaviour among community-dwelling adults aged ≥18 years with hazardous drinking patterns in six low- and middle-income countries. Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. Hazardous drinking was defined as consuming >7 (females) or >14 (males) standard drinks per week. Associations between time spent sedentary and a range of correlates were examined using multivariable linear and logistic regression. The mean time spent sedentary in 2142 individuals with hazardous drinking patterns (mean age = 45.7 years; 13% female) was 216±135min/day. Nine percent (95%CI=6.1-13.2%) were sedentary for ≥8h per day. Living in an urban setting and unemployment were strong sociodemographic correlates of being sedentary for ≥8h per day. From a health-related perspective, weak grip strength, stroke and disability were associated with increasing time spent sedentary. The current data provides important guidance for future interventions across low- and middle-income countries to assist hazardous drinkers to reduce sedentary behaviour.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Lundin
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Joseph Firth
- NICM, School of Health and Science, University of Western Sydney, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, United States
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| |
Collapse
|
49
|
Goins RT, Schure M, Jensen PN, Suchy-Dicey A, Nelson L, Verney SP, Howard BV, Buchwald D. Lower body functioning and correlates among older American Indians: The Cerebrovascular Disease and Its Consequences in American Indians Study. BMC Geriatr 2018; 18:6. [PMID: 29304750 PMCID: PMC5756432 DOI: 10.1186/s12877-017-0697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 12/19/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND More than six million American Indians live in the United States, and an estimated 1.6 million will be aged ≥65 years old by 2050 tripling in numbers since 2012. Physical functioning and related factors in this population are poorly understood. Our study aimed to assess lower body functioning and identify the prevalence and correlates of "good" functioning in a multi-tribe, community-based sample of older American Indians. METHODS Assessments used the Short Physical Performance Battery (SPPB). "Good" lower body functioning was defined as a total SPPB score of ≥10. Potential correlates included demographic characteristics, study site, anthropometrics, cognitive functioning, depressive symptomatology, grip strength, hypertension, diabetes mellitus, heart disease, prior stroke, smoking, alcohol use, and over-the-counter medication use for arthritis or pain. Data were collected between 2010 and 2013 by the Cerebrovascular Disease and Its Consequences in American Indians Study from community-dwelling adults aged ≥60 years (n = 818). RESULTS The sample's mean age was 73 ± 5.9 years. After adjustment for age and study site, average SPPB scores were 7.0 (95% CI, 6.8, 7.3) in women and 7.8 (95% CI, 7.5, 8.2) in men. Only 25% of the sample were classified with "good" lower body functioning. When treating lower body functioning as a continuous measure and adjusting for age, gender, and study site, the correlates of better functioning that we identified were younger age, male gender, married status, higher levels of education, higher annual household income, Southern Plains study site, lower waist-hip ratio, better cognitive functioning, stronger grip strength, lower levels of depressive symptomatology, alcohol consumption, and the absence of hypertension, diabetes mellitus, and heart disease. In our fully adjusted models, correlates of "good" lower body functioning were younger age, higher annual household income, better cognitive functioning, stronger grip, and the absence of diabetes mellitus and heart disease. CONCLUSIONS These results suggest that "good" lower body functioning is uncommon in this population, whereas its correlates are similar to those found in studies of other older adult populations. Future efforts should include the development or cultural tailoring of interventions to improve lower body functioning in older American Indians.
Collapse
Affiliation(s)
- R. Turner Goins
- College of Health and Human Sciences, Western Carolina University, 3971 Little Savannah Road, Cullowhee, NC 28723 USA
| | - Mark Schure
- Community Health, Montana State University, 305 Herrick Hall, Bozeman, MT 59717 USA
| | - Paul N. Jensen
- Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195 USA
| | - Astrid Suchy-Dicey
- College of Medicine, Initiative for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA 98101 USA
| | - Lonnie Nelson
- College of Nursing, Institute for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA 98101 USA
| | - Steven P. Verney
- Department of Psychology, University of New Mexico, Logan Hall, MSC03-2220, 1 University of New Mexico, Albuquerque, NM 87131-0001 USA
| | - Barbara V. Howard
- MedStar Health Research Institute and Georgetown/Howard Universities Center for Clinical and Translational Sciences, 6525 Belcrest Road, Suite 700, Hyattsville, MD 20782 USA
| | - Dedra Buchwald
- College of Medicine, Institute for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA 98101 USA
| |
Collapse
|
50
|
Gastric Bypass in Older Patients: Complications, Weight Loss, and Resolution of Comorbidities at 2 Years in a Matched Controlled Study. Obes Surg 2018; 26:1806-13. [PMID: 26738894 DOI: 10.1007/s11695-015-2024-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Roux-en-Y gastric bypass (RYGB) has recently been authorized for use in older patients. The objective of this single-center study was to evaluate 2-year weight loss in patients ≥60 years compared with younger matched patients undergoing RYGB. Secondary aims were to record complications and the resolution of comorbidities in a 2-year follow-up. METHODS Of 722 patients with at least 2 years follow-up data, 48 elderly patients were matched with 92 young (<40 years) and 96 middle-aged (40-59 year) patients, according to sex, baseline body mass index, and date of surgery. Weight loss, remission of comorbidities, death, and early (30-day) and 2-year complication rates were compared. RESULTS There were three deaths in the elderly group and none in the other groups. The early complication rate was not significantly different in the elderly group (17.8 %) compared with the young (11.5 %, p = 0.637) and middle-aged (13.7 %, p = 1.000) groups. The 2-year complication rates were not significantly different in the elderly group (9.3 %) compared with the young (23.5 %, p = 0.107) and middle-aged (13.2 %, p = 1.000) groups. The 2-year weight loss was lower in the elderly group (31.8 ± 7.2 %; p < 0.001) than in the young group (38.3 ± 6.9 %) but was not significantly different from that in the middle-aged group (34.4 ± 8.0 %; p = 0.145). Remission rates for diabetes and obstructive sleep apnea were lower in the elderly than in the two younger groups. CONCLUSION After bariatric surgery, major weight loss was observed in patients older than 60, but remission of metabolic comorbidities was less marked than in younger subjects.
Collapse
|