The Impacts of Weight Change and Weight Change Intention on Health-Related Quality of Life in the Korean Elderly

Health conditions and weight change among the older adults over ten years of the SABE Survey

OBJECTIVE

To analyze the relationship between health conditions and weight changes among elderly people monitored by the SABE Survey over a ten-year period in São Paulo/SP.

METHODS

This was a longitudinal study that followed (2000-baseline, 2006 and 2010) change in body weight (outcome variable) and associated health conditions (exposure variables) in the elderly (n=571); multinomial logistic regression analyses were employed.

RESULTS

Average weight increase in the evaluated period was 29.0%. 34.0% (2006) and 12.5% (2010) lost weight and 18.2% (2006) and 39.9% (2010) gained weight. Prevalence of chronic diseases increased from 34.1% (2000) to 51.9% (2006) and 60.1% (2010). Older people with weight gain also rated their overall health as poorer in 2006 (RR:3.15; 95%CI 1.21;8.17) and 2010 (RR:2.46; 95%CI 1.02;5.94). The higher numbers of diseases (RR:2.12; 95%CI 1.00;4.46) and hospitalizations (RR:3.50; 95%CI 1.40;8.72) were associated with a decrease in weight in 2010.

CONCLUSION

Weight changes are related to poorer health status among the elderly.

Benefit-to-Risk Balance of Weight Loss Interventions in Older Adults with Obesity

PURPOSE OF REVIEW

Obesity in the older adult is a burgeoning health epidemic that leads to increased morbidity, disability, and institutionalization. This review presents a brief overview of geriatric-specific consequences of obesity by highlighting the risks and benefits of intentional weight loss.

RECENT FINDINGS

Intentional weight loss reduces the extent of adiposity-related illnesses, yet the approach in older adults is fraught with challenges. Interventions combining caloric restriction and physical exercise (aerobic and resistance) maximize fat loss and minimize loss of muscle and bone. Interventions are also effective at improving physical function, reducing medication burden, and improving symptomatic osteoarthritis in this population. Approaches can mitigate the risks of isolated caloric restriction on muscle and bone in a safe and effective manner. Effective weight loss strategies should be considered in older adults. While there are potential risks, practical clinical approaches can minimize the potential harms while maximizing their benefits.

Towards appropriate nutritional prescribing: challenges and solutions

The appropriate prescribing of nutritional supplements is coming under increasing scrutiny due to rising costs, workforce challenges, and a product pricing model that does not meet the needs of the healthcare economy. Data show that, whilst the number of items being prescribed is marginally decreasing, the cost of these items is increasing, and the assumption that all patients discharged on nutritional borderline substances from hospital have been assessed by a dietitian cannot be made. Standards of communication are highly variable but, with increasing knowledge about best practice and digitalisation, improvements are being made. There is a disparity between adequate knowledge of nutrition, prescribing, and best use of resources to effectively manage patient-centred care and costs. A number of strategies are being trialled to improve education and the utilisation of the right workforce. The need for a clear public health message on the importance of maintaining weight in older age is essential to ensure nutritional borderline substances are appropriately used.