Severe elder obesity and 1-year diminished lower extremity physical performance in homebound older adults
Severe elder obesity and 1-year diminished lower extremity physical performance in homebound older adults
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DOI：
10.1111/j.1532-5415.2006.00842.x
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发表时间：
2006-09-01
影响因子：
6.3
通讯作者：
Branch, Laurence G.
中科院分区：
文献类型：
--
作者：
Sharkey, Joseph R.;Ory, Marcia G.;Branch, Laurence G.
目的：为了确定老年人的严重肥胖是否与随机抽样的居家老年人的下肢体能（LEP）下降独立相关，这些老年人被认为是可走动的。设计：前瞻性队列，随访1年（2000-02）。设置：对北卡罗来纳州4个县的居家老年人进行家庭评估。参与者：随机抽取282名60岁及以上的家庭送餐者，他们在营养和功能研究的1年随访评估中完成了家庭评估（n=253）或养老院居民（n=29）。选择基线和1年LEP（定时步行、静态和动态平衡和椅子上升）和基线体重指数（BMI，基于测量的体重和膝关节高度）的客观指标。BMI分为体重不足/正常（< 25.0 kg/m2）、超重（25.0-29.9 kg/m2）、中度肥胖（30.0-34.9 kg/m2）和重度肥胖（>= 35.0 kg/m2）。根据总评分，将总体LEP分为差、中等或好。样本特征包括抑郁症，害怕跌倒，医疗条件和药物使用。测量：近23%的参与者中度肥胖和15%严重肥胖。只有重度肥胖独立增加了1年时个体测试和整体LEP表现下降的优势（优势比2.9-7.0）。重度肥胖与LEP差在两个评估或与LEP在1 year.CONCLUSIONS下降独立相关：这些结果强调需要区分中度和重度肥胖的老年人在关键功能结果的关系。研究结果将老年人的严重肥胖确定为未来干预的重要目标。特别是，这需要更好地理解干预目标，无论是主要针对减轻体重还是改善身体表现。
OBJECTIVES: To determine whether severe obesity in older people is independently associated with diminished lower extremity physical performance (LEP) in a random sample of homebound older adults that were considered ambulatory.DESIGN: Prospective cohort with 1 year of follow-up (2000-02).SETTING: In-home assessments of homebound older adults in four North Carolina counties.PARTICIPANTS: Random sample of 282 home-delivered meal recipients aged 60 and older who completed both in-home assessments (n=253) or were nursing home residents (n=29) at the 1-year follow-up assessment of the Nutrition and Function Study.MEASUREMENTS: Objective measures were selected for baseline and 1-year LEP (timed walking, static and dynamic balance, and chair rise) and baseline body mass index (BMI, based on measured weight and knee height). BMI was categorized as underweight/normal (< 25.0 kg/m(2)), overweight (25.0-29.9 kg/m(2)), moderately obese (30.0-34.9 kg/m(2)), and severely obese (>= 35.0 kg/m(2)). Based on summary scores, overall LEP was categorized as poor, intermediate, or good. Sample characteristics included depressive symptomatology, fear of falling, medical conditions, and medication use.MEASUREMENTS: Almost 23% of participants were moderately obese and 15% severely obese. Only severe obesity independently increased the odds (odds ratio 2.9-7.0) for diminished performance at 1 year in individual tests and in overall LEP performance. Severe obesity was independently associated with poor LEP at both assessments or with decline in LEP at 1 year.CONCLUSIONS: These results highlight the need to distinguish between moderate and severe obesity in older people in terms of relationships with key functional outcomes. The findings identify severe obesity in older people as an important target for future interventions. In particular, this calls for greater understanding of intervention goals, whether to primarily target weight reduction or improvement in physical performance.