Journal Article

Health consequences of obesity in the elderly: a review of four unresolved questions

Zamboni, M, Zoico, E, Harris, T B, Bissoli, L, Bosello, O, Meigs, J B, Mazzali, G, Di Francesco, V, Fantin, F

2005

Overview

Obesity prevalence is growing progressively even among older age groups. Controversy exists about the potential harms of obesity in the elderly. Debate persists about the relation between obesity in old age and total or disease-specific mortality, the definition of obesity in the elderly, its clinical relevance, and about the need for its treatment. Knowledge of age-related body composition and fat distribution changes will help us to better understand the relationships between obesity, morbidity and mortality in the elderly. Review of the literature supports that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages. Weight gain or fat redistribution in older age may still confer adverse health risks (for earlier mortality, comorbidities conferring independent adverse health risks, or for functional decline). Evaluation of comorbidity and weight history should be performed in the elderly in order to generate a comprehensive assessment of the potential adverse health effects of overweight or obesity. The risks of obesity in the elderly have been underestimated by a number of confounders such as survival effect, competing mortalities, relatively shortened life expectancy in older persons, smoking, weight change and unintentional weight loss. Identification of elderly subjects with sarcopenic obesity is probably clinically relevant, but the definition of sarcopenic obesity, the benefits of its clinical identification, as well as its relation to clinical consequences require further study. Studies on the effect of voluntary weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5–10% of initial body weight) may be beneficial. In older as well as in younger adults, voluntary weight loss may help to prevent the adverse health consequences of obesity.

• Publisher: Nature Publishing Group UK,Nature Publishing,Nature Publishing Group
• Subject: Adipose Tissue / Adipose Tissue - anatomy & histology / Adipose Tissue - physiology / Age groups / Aged / Aging / Aging - physiology / anatomy & histology / Biological and medical sciences / Body Composition / Body Composition - physiology / Body fat / body fat distribution / Body Mass Index / Body weight / complications / Disability Evaluation / Disease / elderly / Epidemiology / Geriatrics / Health Promotion and Disease Prevention / Health risk assessment / Health risks / Humans / Industrialized nations / Internal Medicine / Life Expectancy / Longitudinal studies / Lung Diseases / Lung Diseases - complications / Medical sciences / Medicine / Medicine & Public Health / Metabolic Diseases / Metabolic Syndrome / Metabolic Syndrome - complications / Middle age / Morbidity / Mortality / Obesity / Obesity - complications / Obesity - epidemiology / Obesity - mortality / Obesity - physiopathology / obesity-related diseases / Older people / Osteoarthritis / Osteoarthritis - complications / Overweight / physiology / physiopathology / Prevalence / Public Health / review / waist circumference / Weight control / weight loss / Weight Loss - physiology / Womens health