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  • Original Article
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Clinical Studies and Practice

Long-term obesity and physical functioning in older Americans

Subjects

Abstract

Background:

Americans are becoming obese earlier in their lives, increasing the average exposure to obesity. Nonetheless, the impact of long-term obesity on later life functioning is not well known.

Methods:

We analyzed data from 7258 adults aged 60–79 years from the US 1999–2010 National Health and Nutrition Examination Survey. Respondents were defined as limited if they reported ‘some difficulty’ ‘much difficulty’ or ‘unable to do’ any of the eight functional tasks. Respondents were defined as severely limited if they reported ‘much difficulty’ or ‘unable to do’ any task. Generalized regression models (logistic and Poisson) predicted the relative odds of any limitation, severe limitation, the total number of limitations and each individual limitation as a function of body mass index (BMI) at age 25 years and current BMI. Models were adjusted for age, sex, race/ethnicity and level of education.

Results:

Overall, being overweight or obese at age 25 years was associated with higher odds of being functionally limited, but these associations were greatly diminished or eliminated after adjustment for current BMI. For example, those obese at age 25 years had 2.38 times the odds (95% confidence interval (CI): 1.77, 3.20) of reporting any functional limitations compared with those normal weight at 25 years, but only 1.28 times the odds (95% CI: 0.93, 1.76) after adjustment for current BMI. For severe limitations, the corresponding results were 2.72 (95% CI: 2.13–3.46) and 1.32 (95% CI:1.00–1.75) before and after adjustment for current BMI. Some associations between obesity at age 25 years and individual tasks remained significant after adjustment for current BMI.

Conclusions:

We conclude that long-term overweight/obesity are significantly associated with later life functional limitations, though this is largely explained by their strong association with higher levels of later-life BMI. Prevention of additional weight gain for those who are overweight or obese early in life could help mitigate their risk of future loss of functioning.

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References

  1. Reither EN, Hauser RM, Yang Y . Do birth cohorts matter? Age-period-cohort analyses of the obesity epidemic in the United States. Soc Sci Med 2009; 69: 1439–1448.

    Article  Google Scholar 

  2. Flegal KM, Carroll MD, Kit BK, Ogden CL . Prevalence of obesity and trends in the distribution of body mass index among us adults, 1999-2010. JAMA 2012; 307: 491–497.

    Article  Google Scholar 

  3. Beswick AD, Rees K, Dieppe P, Ayis S, Gooberman-Hill R, Horwood J et al. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet 2008; 371: 725–735.

    Article  Google Scholar 

  4. Guralnik JM, Alecxih L, Branch LG, Wiener JM . Medical and long-term care costs when older persons become more dependent. Am J Public Health 2002; 92: 1244–1245.

    Article  Google Scholar 

  5. Alley D, Lloyd J, Shaffer T, Stuart B . Changes in the association between body mass index and medicare costs, 1997-2006. Arch Intern Med 2012; 172: 277–278.

    Article  Google Scholar 

  6. Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M . Health and economic burden of the projected obesity trends in the USA and the UK. Lancet 2009; 378: 815–825.

    Article  Google Scholar 

  7. Alley DE, Chang VW . The changing relationship of obesity and dDisability, 1988-2004. JAMA 2007; 298: 2020–2027.

    Article  CAS  Google Scholar 

  8. Abdullah A, Wolfe R, Mannan H, Stoelwinder JU, Stevenson C, Peeters A . Epidemiologic merit of obese-years, the combination of degree and duration of obesity. Am J Epidemiol 2012; 176: 99–107.

    Article  Google Scholar 

  9. Schaap LA, Koster A, Visser M . Adiposity, muscle mass, and muscle strength in relation to functional decline in older persons. Epidemiol Rev 2013; 35: 51–65.

    Article  Google Scholar 

  10. Drumond Andrade FC, Mohd Nazan AI, Lebrao ML, De Oliveira Duarte YA . The impact of body mass index and weight changes on disability transitions and mortality in brazilian older adults. J Aging Res 2013; 2013: 905094.

    Article  Google Scholar 

  11. Samper-Ternent R, Al Snih S . Obesity in older adults: epidemiology and implications for disability and disease. Rev Clin Gerontol 2012; 22: 10–34.

    Article  Google Scholar 

  12. Ferraro KF, Su YP, Gretebeck RJ, Black DR, Badylak SF . Body mass index and disability in adulthood: a 20-year panel study. Am J Public Health 2002; 92: 834–840.

    Article  Google Scholar 

  13. Backholer K, Wong E, Freak-Poli R, Walls HL, Peeters A . Increasing body weight and risk of limitations in activities of daily living: a systematic review and meta-analysis. Obes Rev 2012; 13: 456–468.

    Article  CAS  Google Scholar 

  14. Centers for Disease Control and Prevention (CDC). NHANES 1999-2000 Public Release File Documentation. National Center for Health Statistics: Hyattsville, MD, USA, 2002.

  15. Sergi G, Perissinotto E, Pisent C, Buja A, Maggi S, Coin A et al. An adequate threshold for body mass index to detect underweight condition in elderly persons: the Italian Longitudinal Study on Aging (ILSA). J Gerontol A Biol Sci Med Sci 2005; 60: 866–871.

    Article  Google Scholar 

  16. Norgan NG, Cameron N . The accuracy of body weight and height recall in middle-aged men. Int J Obes Relat Metab Disord 2000; 24: 1695–1698.

    Article  CAS  Google Scholar 

  17. Perry GS, Byers TE, Mokdad AH, Serdula MK, Williamson DF . The validity of self-reports of past body weights by US adults. Epidemiology 1995; 6: 61–66.

    Article  CAS  Google Scholar 

  18. Peeters A, Backholer K . Is the health burden associated with obesity changing? Am J Epidemiol 2012; 176: 840–845.

    Article  Google Scholar 

  19. Anandacoomarasamy A, Caterson I, Sambrook P, Fransen M, March L . The impact of obesity on the musculoskeletal system. Int J Obes 2007; 32: 211–222.

    Article  Google Scholar 

  20. Dodson JA, Arnold SV, Reid KJ, Gill TM, Rich MW, Masoudi FA et al. Physical function and independence 1 year after myocardial infarction: observations from the Translational Research Investigating Underlying disparities in recovery from acute Myocardial infarction: Patients' Health status registry. Am Heart J 2012; 163: 790–796.

    Article  Google Scholar 

  21. Gregg EW, Mangione CM, Cauley JA, Thompson TJ, Schwartz AV, Ensrud KE et al. Diabetes and incidence of functional disability in older women. Diabetes Care 2002; 25: 61–67.

    Article  Google Scholar 

  22. Abbatecola AM, Paolisso G, Fattoretti P, Evans W, Fiore V, Dicioccio L et al. Discovering pathways of sarcopenia in older adults: a role for insulin resistance on mitochondria dysfunction. J Nutr Health Aging 2011; 15: 890–895.

    Article  CAS  Google Scholar 

  23. Abbatecola AM, Ferrucci L, Ceda G, Russo CR, Lauretani F, Bandinelli S et al. Insulin resistance and muscle strength in older persons. J Gerontol A Biol Sci Med Sci 2005; 60: 1278–1282.

    Article  Google Scholar 

  24. Marinou K, Tousoulis D, Antonopoulos AS, Stefanadi E, Stefanadis C . Obesity and cardiovascular disease: From pathophysiology to risk stratification. Int J Cardiol 2010; 138: 3–8.

    Article  Google Scholar 

  25. Fantuzzi G . Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol 2005; 115: 911–919.

    Article  CAS  Google Scholar 

  26. Ferrucci L, Penninx BWJH, Volpato S, Harris TB, Bandeen-Roche K, Balfour J et al. Change in muscle strength explains accelerated decline of physical function in older women with high interleukin-6 serum levels. J Am Geriatr Soc 2002; 50: 1947–1954.

    Article  Google Scholar 

  27. Ferrucci L, Harris TB, Guralnik JM, Tracy RP, Corti MC, Cohen HJ et al. Serum IL-6 level and the development of disability in older persons. J Am Geriatr Soc 1999; 47: 639–646.

    Article  CAS  Google Scholar 

  28. Schaap LA, Pluijm SMF, Deeg DJH, Harris TB, Kritchevsky SB, Newman AB et al. Higher inflammatory marker levels in older persons: associations with 5-year change in muscle mass and muscle strength. J Gerontol A Biol Sci Med Sci 2009; 64A: 1183–1189.

    Article  CAS  Google Scholar 

  29. Rantanen T, Guralnik JM, Sakari-Rantala R, Leveille S, Simonsick EM, Ling S et al. Disability, physical activity, and muscle strength in older women: the women's health and aging study. Arch Phys Med and Rehabil 1999; 80: 130–135.

    Article  CAS  Google Scholar 

  30. Peeters A, Bonneux L, Nusselder WJ, De Laet C, Barendregt JJ . Adult obesity and the burden of disability throughout life. Obes Res 2004; 12: 1145–1151.

    Article  Google Scholar 

  31. Houston DK, Stevens J, Cai J, Morey MC . Role of weight history on functional limitations and disability in late adulthood: the ARIC study. Obes Res 2005; 13: 1793–1802.

    Article  Google Scholar 

  32. Stenholm S, Sallinen J, Koster A, Rantanen T, Sainio P, Heliovaara M et al. Association between obesity history and hand grip strength in older adults-exploring the roles of inflammation and insulin resistance as mediating factors. J Gerontol A Biol Sci Med Sci 2011; 66A: 341–348.

    Article  Google Scholar 

  33. Stenholm S, Rantanen T, Alanen E, Reunanen A, Sainio Pi, Koskinen S . Obesity history as a predictor of walking limitation at old age. Obesity 2007; 15: 929–938.

    Article  Google Scholar 

  34. Abdullah A, Wolfe R, Stoelwinder JU, de Courten M, Stevenson C, Walls HL et al. The number of years lived with obesity and the risk of all-cause and cause-specific mortality. Int J Epidemiol 2011; 40: 985–996.

    Article  Google Scholar 

  35. Dowd JB, Zajacova A . Long-term obesity and cardiovascular, inflammatory, and metabolic risk in US adults. Am J Prev Med 2014; 46: 578–584.

    Article  Google Scholar 

  36. Stevens J, Keil JE, Waid LR, Gazes PC . Accuracy of current, 4-year, and 28-year self-reported body weight in an elderly population. Am J Epidemiol 1990; 132: 1156–1163.

    Article  CAS  Google Scholar 

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Correspondence to J B Dowd.

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Dowd, J., Zajacova, A. Long-term obesity and physical functioning in older Americans. Int J Obes 39, 502–507 (2015). https://doi.org/10.1038/ijo.2014.150

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