Weight Loss Interventions in Older Adults with Obesity: A Systematic Review of Randomized Controlled Trials Since 2005.
Weight Loss Interventions in Older Adults with Obesity: A Systematic Review of Randomized Controlled Trials Since 2005.
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DOI：
10.1111/jgs.14514
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发表时间：
2017-02
影响因子：
6.3
通讯作者：
Bartels SJ
中科院分区：
文献类型：
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作者：
Batsis JA;Gill LE;Masutani RK;Adachi-Mejia AM;Blunt HB;Bagley PJ;Lopez-Jimenez F;Bartels SJ
确定可以指导临床建议的老年肥胖干预措施。从2005年1月1日至2015年10月12日，使用Medline （PubMed）、Cochrane Central Register of Controlled Trials、Web of Science、CINAHL、EMBASE （Ovid）和PsycINFO （Proquest）进行系统评价，以确定英语随机对照试验。年龄在60岁及以上（平均年龄≥65岁）并被归类为肥胖（体重指数≥30 kg/m2）的个体。不涉及持续6个月或更长时间的药理学或程序性治疗的行为减肥干预。两名研究者使用系统评价和荟萃分析标准的首选报告项目进行了系统评价，在总结主要结果方面达到了很高的一致性（97.3%）。三个主要结果是体重减轻、身体表现和生活质量。在5741次引用中，有19次被收录。（6项研究是独一无二的，其余13项研究基于相同的研究人群。）持续时间为6至18个月（n=405名参与者，年龄66.7-71.1岁）。干预组的体重减轻幅度为0.5 - 10.7 kg（0.1-9.3%）。五项研究将抗阻运动计划与饮食成分结合起来。节食组比单纯运动组的减肥效果更好。运动本身可以改善身体机能，但不会显著减轻体重。饮食和运动相结合的成分在体能测量和生活质量方面带来了最大的改善，并减轻了在饮食研究中观察到的肌肉和骨量的减少。观察到异质性结果，这限制了定量综合数据的能力。支持老年肥胖干预改善身体功能和生活质量的证据是低到中等质量的。在这一人群中需要精心设计的试验。
To identify geriatric obesity interventions that can guide clinical recommendations. Systematic review using Medline (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, EMBASE (Ovid), and PsycINFO (Proquest) from January 1, 2005, to October 12, 2015, to identify English-language randomized controlled trials. Individuals aged 60 and older (mean age ≥65) and classified as having obesity (body mass index ≥30 kg/m2). Behavioral weight loss interventions not involving pharmacological or procedural therapies lasting 6 months or longer. Two investigators performed the systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and achieved a high concordance rate (97.3%) in summarizing the primary outcomes. The three primary outcomes were weight loss, physical performance, and quality of life. Of 5,741 citations, 19 were included. (Six studies were unique, and the remaining 13 were based on the same study population.) Duration ranged from 6 to 18 months (n=405 participants, age range 66.7–71.1). Weight loss in the intervention groups ranged from 0.5 to 10.7 kg (0.1–9.3%). Five studies had a resistance exercise program accompanying a dietary component. Greater weight loss was observed in groups with a dietary component than those with exercise alone. Exercise alone led to better physical function but no significant weight loss. Combined dietary and exercise components led to the greatest improvement in physical performance measures and quality of life and mitigated reductions in muscle and bone mass observed in diet-only study arms. Heterogeneous outcomes were observed, which limited the ability to synthesize the data quantitatively. The evidence supporting geriatric obesity interventions to improve physical function and quality of life is of low to moderate quality. Well-designed trials are needed in this population.