Effect of age on quality of life after gastric bypass: data from the Scandinavian Obesity Surgery Registry.

Abstract

Whether patients aged 60 years or older should be recommended bariatric surgery is still controversial. To assess the effect of age on health-related quality of life (QoL) over time after gastric bypass. Data from the Swedish national registry for bariatric surgery. Data of 57,215 patients undergoing gastric bypass were retrieved from the Scandinavian Obesity Surgery Register with a follow-up rate at 1,2, and 5 years at 89%, 69%, and 59%, respectively. Patients were divided into 5-years age intervals. Odds ratios for the relative mean changes in QoL were compared by logistic regression. Preoperatively, patients aged 60 years or older scored better on mental aspects (Mental Component Summary score, MCS) of RAND-36 (Short Form Health Survey (higher values better)) as well as OP (Obesity related Problem scale (lower values better)) better than the entire cohort of patients (MCS: mean [95% CI], 46.2 [45.5-46.9] versus 43.5 [43.4-43.7], respectively; OP: mean [95% CI], 55.3 [54.0-56.6] versus 64.1 [63.9-64.4], respectively), whereas the Physical Component Summary (PCS) scores of patients aged 60 years or older were lower (mean [95% CI], 32.3 [31.7-32.8] for the ≥60-yr cohort versus 36.4 [36.2-36.5] for the entire cohort; P < .001 for all). In all age groups, MCS was improved at 1 and 2 years but decreased to baseline at 5 years. The postoperative improvements in PCS and OP were sustained in all age groups. Although the relative increases for PCS and OP in patients aged ≥60 years were somewhat lower compared with the entire cohort at 5 years, the values were well above baseline levels (mean [95% CI], 41.0 [40.0-42.0] versus 32.3 [31.7-32.8] and 22.2 [20.3-24.0] versus 55.3 [54.0-56.6], respectively; P < .001). Mental QoL is transiently improved after bariatric surgery without marked differences between age groups. However, patients aged ≥60 years report pronounced and sustained improvements in physical and obesity-specific QoL 5 years postoperatively. These observations support previous studies that older patients should not be denied bariatric surgery from a risk-benefit perspective, solely based on age.