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Penn researchers find increase in disability among older, obese adults

November 07, 2007

First-ever study links obesity to changing disability rates among older Americans

PHILADELPHIA - Researchers at the University of Pennsylvania School of Medicine report that older adults today are much more likely to suffer from disability than those 10 years ago. This research - the first to track effects of obesity on disability over time - appears in the November 7th issue of the Journal of the American Medical Association.

"Obesity is more hazardous to the health of the elderly than we previously suspected," says Dawn Alley, PhD, lead author, and Robert Wood Johnson Health and Society Scholar at the University of Pennsylvania School of Medicine. "For an older person, suffering from obesity means they are much less likely to be able to walk to the front door or pick up a bag of groceries."

The study reveals that obesity, which has become more common among older Americans, is having an increasingly profound impact on their day-to-day activities and overall health. By comparing health data from 1988-1994 to data from 1999-2004, the researchers found that the odds of suffering from functional impairment have increased 43 percent among obese adults age 60 years and older. This means they are less able to do things like walk a quarter of a mile, climb 10 steps, pick up a 10-pound weight, and bend over.

"We believe that two factors are likely contributing to the rise in disability among older, obese people," says Virginia Chang, MD, PhD, Assistant Professor of Medicine at Penn; Attending Physician, Philadelphia Veterans Affairs Medical Center; and senior study author. "First, people are potentially living longer with their obesity due to improved medical care, and second, people are becoming obese at younger ages than in the past. In both instances, people are living with obesity for longer periods of time, which increases the potential for disability."

The study evaluated health survey data from 9,928 Americans age 60 years and over from the National Heath and Nutrition Examination Surveys (NHANES) conducted from 1988 to 1994 and from 1999 to 2004. Researchers estimated the risk of functional and activities of daily living (ADL) impairment - the inability to move from a bed, dress, or eat - for normal weight, overweight, and obese populations for both time periods, and evaluated trends in the relationship between obesity and disability over time. Results revealed that obesity increased by 8.2% among the population over 60 during this time period, and that the disability gap between obese and non-obese groups widened.

Researchers also found that obese people are not benefiting from some of the health improvements that the rest of the population is experiencing. For example, although the odds of ADL impairment decreased by 34 percent among the general population, no such improvements were seen in the obese population.

Other recent studies have suggested that obese populations have actually become healthier since the 1960s. While other obesity-related risk factors - such as high blood pressure and elevated cholesterol - have declined, this new research suggests that quality of life for obese older people may be deteriorating.

"Preventing disability should be another motivation for health care providers, policymakers and the public to take obesity seriously in the elderly population. Spending time and resources to prevent obesity now may reduce the need to treat disabilities later," says Dr. Alley.

University of Pennsylvania School of Medicine