Obesity In Older Adults Research Articles

Integrating a Prevention Care Path into the Daily Life of Older Adults with Mobility Disability Risk: Introducing a Predictive Response Model to Exercise.

IntroductionExercise and nutrition are the best targets to tackle mobility issues in community-dwelling older adults. As exercise response relies on multiple factors, improving the understanding of their interactions is a necessity to tailor effective preventive strategies. Based on a prevention care path designed for community-dwelling older adults with mobility disability risk, our main goal was to determine the predictive factors of the response to a multimodal intervention, combining structured exercise training and nutritional counselling. Thus, this study aimed to tailor prevention programs for non-responder participants.MethodsWe analyzed the response of participants to a prevention program and built a multivariate predictive model to highlight the profile of the best responders. The model was based on the likelihood of at least 1 point of short physical performance battery (SPPB) score gain. Inclusion criteria were being aged ≥70 years and having completed a multicomponent group-based supervised training consisting of 20 sessions (10 weeks).ResultsA total of 103 participants were included, their mean ± SD age was 81.9 ± 5.7 years. The model demonstrated interactions between baseline SPPB score (OR=0.42; p < 0.001), body mass index (BMI; OR=0.82; p=0.003), and grip strength value (OR=1.15; p=0.008). The highest probability of response was found for participants with low SPPB, normal BMI (21 kg/m2), and high grip strength (27 kg).ConclusionThis study demonstrated that the response to a multimodal intervention in community-dwelling older adults with mobility disability risk was influenced by the baseline SPPB score, BMI, and grip strength value. To increase the proportion of responders, strategies that could be more effective include constituting more homogenous group, and implementing a specific approach for obese sarcopenic older adults and those with low grip strength by increasing the dose of physical activity and monitoring endurance and mobility activities between sessions. Our results provide important consideration for the development of targeted-interventions.

Risk Factors for Sarcopenia, Sarcopenic Obesity, and Sarcopenia Without Obesity in Older Adults

Background: Muscle undergoes change continuously with aging. Sarcopenia, in which muscle mass decrease with aging, is associated with various diseases, the risk of falling, and the deterioration of quality of life. Obesity and sarcopenia also have a synergy effect on the disease of the older adults. Objects: This study examined the risk factors for sarcopenia, sarcopenic obesity, and sarcopenia without obesity and developed prediction models. Methods: This machine-learning study used the 2008–2011 Korea National Health and Nutrition Examination Surveys in the analysis. After data curation, 5,563 older participants were selected, of whom 1,169 had sarcopenia, 538 had sarcopenic obesity, and 631 had sarcopenia without obesity; the remaining 4,394 were normal. Decision tree and random forest models were used to identify risk factors. Results: The risk factors for sarcopenia chosen by both methods were body mass index (BMI) and duration of moderate physical activity; those for sarcopenic obesity were sex, BMI, and duration of moderate physical activity; and those for sarcopenia without obesity were BMI and sex. The areas under the receiver operating characteristic curves of all prediction models exceeded 0.75. BMI could predict sarcopenia-related disease. Conclusion: Risk factors for sarcopenia-related diseases should be identified and programs for sarcopenia-related disease prevention should be developed. Data-mining research using population data should be conducted to enhance the effectiveness of early treatment for people with sarcopenia-related diseases through predictive models.

Weight Loss and Exercise Differentially Affect Insulin Sensitivity, Body Composition, Cardiorespiratory Fitness, and Muscle Strength in Older Adults With Obesity: A Randomized Controlled Trial.

Aging-related disease risk is exacerbated by obesity and physical inactivity. It is unclear how weight loss and increased activity improve risk in older adults. We aimed to determine the effects of diet-induced weight loss with and without exercise on insulin sensitivity, VO2peak, body composition, and physical function in older obese adults. Physically inactive older (68.6 ± 4.5 years) obese (body mass index 37.4 ± 4.9 kg/m2) adults were randomized to health education control (HEC; n = 25); diet-induced weight loss (WL; n = 31); or weight loss and exercise (WLEX; n = 28) for 6 months. Insulin sensitivity was measured by hyperinsulinemic-euglycemic clamp, body composition by dual-energy X-ray absorptiometry and MRI, strength by isokinetic dynamometry, and VO2peak by graded exercise test. WLEX improved (p < .05) peripheral insulin sensitivity (+75 ± 103%) versus HEC (+12 ± 67%); WL (+36 ± 47%) versus HEC did not reach statistical significance. WLEX increased VO2peak (+7 ± 12%) versus WL (-2 ± 24%) and prevented reductions in strength and lean mass induced by WL (p < .05). WLEX decreased abdominal adipose tissue (-16 ± 9%) versus HEC (-3 ± 8%) and intermuscular adipose tissue (-15 ± 13%) versus both HEC (+9 ± 15%) and WL (+2 ± 11%; p < .01). Exercise with weight loss improved insulin sensitivity and VO2peak, decreased ectopic fat, and preserved lean mass and strength. Weight loss alone decreased lean mass and strength. Older adults intending to lose weight should perform regular exercise to promote cardiometabolic and functional benefits, which may not occur with calorie restriction-induced weight loss alone.

Sex Differences in the Association Between Risk of Obstructive Sleep Apnea, Insomnia, and Frailty in Older Adults.

PurposeTo analyze the association between risk of obstructive sleep apnea (OSA), insomnia, sleepiness and self-assessed sleep duration with frailty in older adults.Patients and MethodsCross-sectional study with 1643 older adults (60 to 97 years old) who participated in round 6 (2019) of the Cohort of Obesity Sarcopenia and Obesity in Older Adults of the Mexican Institute of Social Security. The Berlin Questionnaire was used to assess risk of OSA, the Athens Insomnia Scale for insomnia, the Epworth Scale for sleepiness, and sleep duration by self-report. Frailty was assessed with the frailty criteria proposed by Fried. Sociodemographic and health variables were also collected. Statistical analysis was performed with logistic regression and was stratified by sex.ResultsThis study included 1643 participants (823 men and 820 women). Mean age was 67.1 ± 5.9 years. The percentage of frail older adults was 10.5% (n = 172), with risk of OSA 26.1% (n = 429), with insomnia 30.3% (n = 497) and with sleepiness 18.9% (n = 310). In all participants, risk of OSA and insomnia were associated with frailty. In the stratified analysis by sex, the association between risk of OSA and frailty was observed in women (odds ratio (OR) = 1.84, 95% confidence interval (CI) 1.05, 3.22), but not in men (OR = 1.19, 95% CI: 0.65, 2.19). Insomnia was significantly associated with frailty in women (OR = 2.38, 95% CI: 1.35, 4.20) and in men (OR = 1.88, 95% CI: 1.01, 3.52). Neither sleepiness nor sleep duration was associated with frailty.ConclusionIn community-dwelling older adults, both the risk of OSA and insomnia conferred greater odds of presenting frailty in women. It is required to implement strategies aimed at improving sleep hygiene and detecting patients with OSA and insomnia.

The Effect of Laser Therapy Along With Mediterranean Diet Versus Mediterranean Diet Only on Older Adults With Non-alcoholic Fatty Liver Disease: A Randomized Clinical Trial.

Introduction: Obesity is the major pathogenesis of the non-alcoholic fatty liver disease (NAFLD). The combination of low-level laser therapy (LLLT) and Mediterranean diet (MD) is a new approach for improving liver function. Methods: 60 obese older adults (65-75 years old) with NAFLD were randomly assigned equally to two groups: a study group and a control group. The study group received LLLT and MD, while the control group followed MD only. These findings evaluated the changes in the level of liver enzymes, serum lipid profile, and anthropometric measurements (body mass index [BMI] and waist circumference [WC]) after 12 weeks of intervention. Results: Both study and control groups showed a significant reduction in the levels of liver enzymes, serum lipid profile, BMI, and WC (P < 0.001 and P < 0.01 respectively); however, the study group showed more significant results compared to the control group (P < 0.01). Conclusion: LLLT and MD may be considered as a treatment approach for NAFLD in older adults to improve their liver function, control dyslipidemia, and help in losing weight.

Decreasing Older Adult COVID-19 Risk Factors Using Digital Technology to Implement a Plant-Based-Diet: An Opinion Paper.

A disproportionate number of COVID-19 cases affect older, minority populations. Obese older adults are at higher risk of developing severe COVID-19 complications and lower survival rates, and minority older adults often experience higher rates of obesity. A plant-based diet intervention may improve COVID-19-related modifiable risk factors for obesity. Encouraging the consumption of plant-based diets comprising vegetables, fruits, whole grains, legumes, seeds, and nuts by utilizing community outreach strategies and digital technology can contribute to improving COVID-19 risk factors among this population.

Two-year follow-up cohort study focused on gender-specific associations between socioeconomic status and body weight changes in overweight and obese middle-aged and older adults

ObjectiveAs overall spread of obesity in populations is generally acknowledged to result from unhealthy lifestyles rather than individual genetic makeup, this study aimed to gain specific insights into its determinants...

Association between accelerometer-measured physical activity, glucose metabolism, and waist circumference in older adults

AimsTo examine the association of physical activity (PA) and sedentary time (ST) with glucose metabolism according to waist circumference (WC) in older people. MethodsA population-based sample of 702 individuals (aged 67–70 years) wore wrist-worn accelerometers for two weeks and underwent an oral glucose tolerance test. The associations between moderate-to-vigorous (MVPA) and light (LPA) PA, ST, and glucose metabolism across the tertiles of WC were analysed using general linear regression. ResultsAmong highest WC tertile, LPA negatively associated with fasting insulin (β = − 0.047, 95% CI − 0.082 to − 0.012), HOMA-IR (β = − 0.098, 95% CI − 0.184 to − 0.012), and HOMA-β (β = − 3.367, CI − 6.570 to − 0.783). ST associated with 120 min glucose (β = 0.140, CI 0.021 to 0.260). Among lowest WC tertile, MVPA negatively associated with 30 min insulin (β = − 0.086, 95% CI − 0.168 to − 0.004) and 120 min insulin (β = − 0.160, 95% CI − 0.257 to − 0.063) and positively associated with Matsuda index (β = 0.076, 95% CI 0.014 to 0.139). Light PA negatively associated with 120 min insulin (β = − 0.054, 95% CI − 0.104 to − 0.005). ConclusionWith the limitation of the cross-sectional study, reducing ST and increasing LPA may be beneficial for glucose metabolism among abdominally obese older adults. Lean older adults could benefit more from increasing MVPA.

Adherence to a Mediterranean diet and health-related quality of life: a cross-sectional analysis of overweight and obese middle-aged and older adults with and without type 2 diabetes mellitus.

The relationship between adherence to a Mediterranean diet (MedDiet) and health-related quality of life (HRQoL) is unclear, particularly in vulnerable older adults. This cross-sectional analysis explored the association between adherence to a MedDiet and subscales of HRQoL in two independent cohorts of overweight and obese middle-aged to older adults with and without type 2 diabetes mellitus (T2DM). Both cohorts were community-dwelling (T2DM aged ≥ 50 years; non-T2DM aged ≥ 60 years) with a BMI ≥ 25 kg/m2. Adherence to a MedDiet was assessed using the Mediterranean Diet Adherence Screener, and HRQoL was determined using the 36-item short-form health survey. Multiple regression analysis was used to examine the association between adherence to a MedDiet and HRQoL subscales. A total of 152 middle-aged to older adults were included (T2DM: n 87, 71·2 (sd 8·2) years, BMI: 29·5 (sd 5·9) kg/m2; non-T2DM: n 65, 68·7 (sd 5·6) years, BMI: 33·7 (sd 4·9) kg/m2). Mean adherence scores for the entire cohort were 5·3 (sd 2·2) (T2DM cohort: 5·6(sd 2·3); non-T2DM cohort: 4·9 (sd 2·0)). In the adjusted model, using pooled data from both study cohorts, adherence to a MedDiet was significantly associated with the general health subscale of HRQoL (β = 0·223; 95 % CI 0·006, 0·044; P = 0·001). Similar findings were also observed in the T2DM cohort (β = 0·280; 95 % CI 0·007, 0·054; P = 0·001). However, no additional significant associations between adherence to a MedDiet and HRQoL subscales were observed. We showed that adherence to a MedDiet was positively associated with the general health subscale of HRQoL in middle-aged to older adults with T2DM. However, larger longitudinal data in older adults with a wider range of adherence scores, particularly higher adherence, are required to better understand the direction of this relationship.

Global prevalence of sarcopenic obesity in older adults: A systematic review and meta-analysis

Sarcopenic obesity (SO), which refers to the coexistence of sarcopenia and obesity. It can lead to physical disability, morbidity, and even mortality. This systematic review and meta-analysis aimed to estimate the global prevalence of SO in older adults.We searched PubMed, Embase, and Web of Science for studies reporting the prevalence of SO from inception to December 2020. Two researchers independently screened the literature, evaluated study quality, and extracted data. A random-effects model was used to pool the estimates for the prevalence of SO. Subgroup analysis, sensitivity analysis, and meta-regression analysis were conducted. Publication bias was assessed using a funnel plot and the Egger test. All statistical analyses were performed using Stata 15.0 software.This review included 50 studies, we found that the global prevalence of SO in older adults was 11%. Subgroup analyses showed that the prevalence of SO was higher among studies using diagnostic criteria of muscle mass alone (15%) to diagnose sarcopenia, using dual-energy X-ray absorptiometry (15%) to assess muscle mass, and those focused on age ≥ 75 years old (23%), hospitalized (16%), South Americans (21%) and North Americans (19%). There were no significant differences in the prevalence of SO among studies using body fat percentage (10%), body mass index (13%), waist circumference (16%) to diagnose obesity and in female (14%), male (10%) patients. Sensitivity analysis showed that none of the studies affected the overall pooled results. Meta-regression analysis found that publication year, geographical region, study setting, and the diagnostic criteria of sarcopenia were sources of heterogeneity.This meta-analysis indicated SO affects more than one in ten older adults globally. Therefore, we should attach importance to the screening and early diagnosis of SO in older adults, then selecting appropriate interventions to reduce the occurrence of it and various adverse outcomes in this demographic.

Increased Sodium Consumption Is Associated With Abdominal Obesity in Older Adults

ObjectivesSodium intake has been widely studied for its role in cardiovascular disease (CVD) and blood pressure (BP) changes. Some studies have suggested that sodium intake is associated with an increased risk of obesity. Although BMI is a common measure of obesity, waist circumference (WC) may serve as a better predictor of increased obesity-related CVD risk. The objective of this study was to examine the association of measures of body fat distribution including body mass index (BMI), WC, waist to hip ratio (WHP), and waist to height ratio (WHT) with sodium intake and BP in older adults. MethodsOne hundred twenty-eight adults aged 65–80 were included in this cross-sectional study. Dietary data was collected through a food frequency questionnaire (110 food items). Anthropometric and BP measurements were also collected. Multiple linear regression analyses were conducted to examine the association of obesity measures with sodium intake and BP levels. One-way ANOVA was used to determine differences in sodium and BP readings between BMI categories (Normal: 18.5–24.9; Overweight: 25.0–29.9 and Obese: 30.0 and above). ResultsWC and WHT were both significantly associated with sodium intake after controlling for age, gender, physical activity, and total calorie intake. Obese individuals consumed significantly more sodium than individuals with normal weight (2834 ± 974 mg in obese individuals; 2172 ± 840 mg in normal weight individuals; P = 0.044). BMI, WC, WHP, and WHT were significantly associated with systolic and diastolic BP. Mean systolic BP was significantly different between individuals with normal BMI and obese BMI (126 ± 16.5 mmHg in normal BMI; 139.7 ± 22.9 mmHg in obese BMI; P = 0.047). The mean diastolic BP showed a statistically significant difference between the normal BMI and overweight individuals (70.9 ± 10.4 mmHg in normal BMI; 79.3 ± 15.2 mmHg in overweight; P = 0.036) but not in obese individuals. ConclusionsHigher sodium consumption was significantly related with higher abdominal body fat mass as measured by WC and WHT in older adults. Higher BMI, WC, WHP, and WHT were also associated with systolic and diastolic BP levels. Our findings suggest that excessive sodium intake is an independent risk factor for obesity in older adults. Funding SourcesNone.

The Association of Meal Timing With Body Composition &amp; Cardiometabolic Health in Obese Older Adults

Abstract Objectives To determine the association between eating window and time of last calorie intake with body composition and cardiometabolic health in obese older adults. Methods We performed a cross-sectional analysis on 36 community-dwelling, overweight-to-obese (BMI 28.0–39.9 kg/m2) older adults (aged 70.6 ± 6.1 years, 83% women, 86% white), recruited to participate in a weight loss and exercise trial. Time of food and nutrient intake were extracted from three 24-hour food recalls. Eating window was calculated as the time elapsed between the first and last food intake. We recorded the time of last calorie intake either from food or drink. Blood glucose, triglycerides, high-density (HDL) &amp; low-density (LDL) lipoprotein cholesterols were measured as markers of cardiometabolic health. Body composition metrics, including total fat and lean mass, were assessed by dual-energy X-ray absorptiometry. Body weight and height were measured to calculate BMI. Partial correlation was used to determine the relationships between eating window and last calorie intake with body composition and cardiometabolic markers, while controlling for sex, age, and total calorie intake. Results On average, participants’ eating window was 12.0 ± 1.1 hours. Eating window in 43% of participants was &amp;lt;12 hours, while it was ≥13 hours in 29% of the participants. Time of last calorie intake in the majority of participants (86%) was between 6:00–8:00 PM. After controlling for potential confounders, longer eating windows were associated with higher triglyceride levels (P = 0.032) and lower HDL (P = 0.035), while no association was observed with the other cardiometabolic markers. We also observed negative trends, though not statistically significant, between longer eating windows and greater weight, BMI, and fat mass. No association was observed between time of last calorie intake, body composition and cardiometabolicy markers. Conclusions Our results suggest that timing of food intake may influence cardiometabolic risk and obesity in older adults. However, further research is required to determine the importance of meal timing on obesity in older adults. Funding Sources Center for Disease Control (U48 DP000025) and NIA T32-AG0001810.

Changes in the Visceral Adiposity Index (VAI) Among Obese Older Adults After a 12-Month Exercise and Diet Intervention

ObjectivesThe Visceral Adiposity Index (VAI) was developed to estimate adipose tissue dysfunction as well as visceral fat distribution. In an ancillary analysis of the CROSSROADS Study (clinicaltrials.gov #NCT00955903), this study investigated the effects of exercise with and without intentional energy restriction on VAI changes among older adults with obesity. MethodsParticipants (n = 163, 37.4% male, 70.3 ± 4.7 years) were randomized to the following groups: exercise only, exercise + nutrient-dense weight maintenance diet, and exercise + nutrient-dense energy restriction of 500 kcal/d. Visceral adiposity determined by magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA), anthropometrics, and cardiometabolic biomarkers were assessed at baseline and 12 months. Waist circumference, body mass index, triglycerides, and high-density lipoprotein (HDL) cholesterol were used to compute VAI at both time points. Data were analyzed utilizing Spearman’s correlations and general linear models to determine differences among groups following adjustment for covariates. ResultsAmong all participants, significant correlations were observed between VAI and glucose, insulin, tumor necrosis factor-alpha (TNF-α), and the adiponectin: leptin ratio at baseline (r = 0.343, P < 0.001; r = 0.363, P < 0.001; r = 0.200, P = 0.011; r = –0.246, P = 0.002, respectively). DXA and MRI measures of visceral adiposity were not significantly correlated with VAI. Upon completion of the 12-month study period, there were significant differences in VAI among groups [F (2,137) = 5.957, P = 0.003)]. Post hoc analysis revealed that VAI was significantly lower in the exercise + nutrient-dense energy restriction group compared to the exercise only group (P = 0.002). ConclusionsResults suggest that VAI may be an adequate measure of adipose tissue dysfunction, yet its ability to estimate levels of visceral adiposity warrants further investigation to determine clinical utility. Nonetheless, results suggest that an exercise + nutrient-dense energy restriction intervention may reduce VAI among older adults with obesity. Funding SourcesNIH.

Modifying pathways by age and sex for the association between combined sleep disordered breathing and long sleep duration with neurocognitive decline in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

We aimed to determine whether obesity or metabolic syndrome (MetS) modify associations between sleep-disordered breathing (SDB), self-reported sleep duration (SD), and phenotypes of combined SDB/SD with 7-year neurocognitive decline (ND) in a community based-cohort of U.S. Hispanic/Latinos (N=5500) in different age and sex groups. The exposures were baseline SDB (respiratory event index ≥ 15), sleepiness (Epworth Sleepiness Scale ≥ 10), SD (<6hours, 6-9hours, ≥ 9hours). The outcome was 7-year ND. Mean age was 56.0years, 54.8% were females. Obesity modified the association between SDB/SD and ND in memory (F=21.49, P<0.001) and global cognition (F=9.14, P<0.001) in the oldest age group. Women without MetS with combined long sleep/SDB exhibited most pronounced decline in global cognition (F=3.07, P=0.010). The association between combined SDB/long sleep and declines in memory and global cognition was most pronounced in obese older adults. Among women, MetS status modified the association between long sleep/SDB and decline in global cognition.

The Relevance of Diet, Physical Activity, Exercise, and Persuasive Technology in the Prevention and Treatment of Sarcopenic Obesity in Older Adults

The aging population faces two conditions that threaten healthy aging: high fat mass (obesity) and low muscle mass and function (sarcopenia). The combination of both—referred to as sarcopenic obesity—synergistically increases the risk of adverse health outcomes. The two conditions often co-occur because they reinforce each other and share common etiologies, including poor nutrition and inactivity. All aging people are at risk of gaining weight and losing muscle mass and could benefit from improvements in physical activity, exercise and dietary intake. one specific window of opportunity is during the transient time of retirement, as older adults already need to restructure their daily activities. It is key to change lifestyle behavior in a sustainable manner, providing scientifically proven, personalized, and acceptable principles that can be integrated in daily life. Health technologies (e.g., applications) can provide promising tools to deliver personalized and appealing lifestyle interventions to a large group of people while keeping health care costs low. Several studies show that health technologies have a strong positive effect on physical activity, exercise and dietary intake. Specifically, health technology is increasingly applied to older people, although strong evidence for long term effects in changing lifestyle behavior is generally lacking. Concluding, technology could play an important role in the highly warranted prevention of sarcopenic obesity in older adults. Although health technology seems to be a promising tool to stimulate changes in physical activity, exercise and dietary intake, studies on long lasting effects and specifically targeted on older people around the time of retirement are warranted.

Intranasal Oxytocin Improves Lean Muscle Mass and Lowers LDL Cholesterol in Older Adults with Sarcopenic Obesity: A Pilot Randomized Controlled Trial

ObjectivesObesity is associated with sarcopenia in older adults, and weight loss can lead to further muscle mass loss. Oxytocin decreases with age, and animal studies suggest that oxytocin administration has trophic effects on skeletal muscle cells and reduces adiposity. We conducted a clinical trial to examine the safety and preliminary efficacy of intranasal oxytocin for older adults with sarcopenic obesity. DesignA double-blind, placebo-controlled randomized controlled trial of intranasal oxytocin (24 IU 4 times per day) for 8 weeks. Setting and ParticipantsTwenty-one older (67.5 ± 5.4 years), obese (30–43 kg/m2), sedentary (<2 strenuous exercise per week) adults with slow gait speed (<1 m/s, proxy measure of sarcopenia) were recruited. MeasuresGeneralized estimating equations were used to evaluate the effect of oxytocin on safety/tolerability of oxytocin administration and whole body muscle and fat mass. ResultsAt baseline, body mass index (BMI) was 36.8 ± 3.6 kg/m2, fat mass 46.09 ± 6.99 kg, lean mass 50.98 ± 11.77 kg, fasting plasma glucose (FPG) 92.0 ± 8.9 mg/dL, hemoglobin A1c (HbA1c) 5.7% ± 0.4%, low density lipoprotein (LDL) 111.3 ± 41.5 mg/dL, high-density lipoprotein (HDL) 47.85 ± 10.96 mg/dL, and triglycerides 140.55 ± 83.50 mg/dL. Oxytocin administration was well tolerated without any significant adverse events. Oxytocin led to a significant increase of 2.25 kg in whole body lean mass compared with placebo (P < .01) with a trend toward decreasing fat mass, and a significantly reduced plasma LDL cholesterol by −19.3 mg/dL (P = .023) compared against placebo. There were no significant changes in BMI, appetite scores, glycemia, plasma HDL, triglycerides, or depressive symptoms. Conclusions and ImplicationsThis proof-of-concept study indicates that oxytocin may be useful for the treatment of sarcopenic obesity in older adults. Oxytocin administration may also provide additional cardiovascular benefits.

The Effects of a Pain Management-Focused Mobile Health Behavior Intervention on Older Adults' Self-efficacy, Satisfaction with Functioning, and Quality of Life: a Randomized Pilot Trial.

BackgroundThis report investigates the impact of a remote physical activity intervention on self-efficacy, satisfaction with functioning, and health-related quality of life (HRQOL) as assessed by the SF-36 in obese older adults with chronic pain. The intervention was group-mediated in nature and based in social cognitive theory and mindfulness-based relapse prevention.MethodsParticipants (N = 28; 70.21 ± 5.22 years) were randomly assigned to receive either the active intervention, which focused on reducing caloric intake and increasing steps across the day or to a waitlist control condition.ResultsOver 12 weeks, intervention participants reported a moderate, positive improvement in self-efficacy for walking relative to control. They also reported large magnitude improvements in satisfaction for physical functioning as well as improvements on pain and the physical functioning subscales of the SF-36.ConclusionsThese findings expand on previous research showing similar effects in response to structured exercise, this time via a protocol that is likely to be scalable and sustainable for many older adults. Additional work on larger and more diverse samples is warranted.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12529-021-10003-3.

Obesity in Older Adults Indonesia: The Role of Healthy Behaviour Factors and Metabolic Syndrome

Obesity in older adults has been a health problem in both developed and developing countries. This study aimed to determine the problem of obesity in the older adults group according to behavioral factors and metabolic syndrome. This study used a cross-sectional design. The number of samples analyzed was 5120 people, all of which were older adults aged 60 years and over. The prevalence of obesity in older adults was 17.6 percent. The results of the advanced analysis also showed a correlation between the variables gender, age, region, education, smoking behavior, and levels of LDL cholesterol, triglycerides, HDL cholesterol, hypertension, and diabetes mellitus with the incidence of obesity in the older adults.

Effect of Aerobic or Resistance Exercise, or Both, on Intermuscular and Visceral Fat and Physical and Metabolic Function in Older Adults With Obesity While Dieting.

Obesity exacerbates age-related effects on body composition and physical and metabolic function. Which exercise mode is most effective in mitigating these deleterious changes in dieting older adults with obesity is unknown. In a randomized controlled trial, we performed a head-to-head comparison of aerobic (AEX), resistance (REX), or combination (COMB) exercise during matched ~10% weight loss in 160 obese older adults. Prespecified analyses compared 6-month changes in intermuscular adipose tissue (IMAT) and visceral adipose tissue (VAT) assessed using MRI, insulin sensitivity index (ISI) by oral glucose tolerance test, physical function using Modified Physical Performance Test (PPT), VO2peak, gait speed, and knee strength by dynamometry. IMAT and VAT decreased more in COMB than AEX and REX groups (IMAT; -41% vs -28% and -23% and VAT: -36% vs -19% and -21%; p = .003 to .01); IMAT and VAT decreased in all groups more than control (between-group p < .001). ISI increased more in COMB than AEX and REX groups (86% vs 50% and 39%; p = .005 to .03). PPT improved more in COMB than AEX and REX groups, while VO2peak improved more in COMB and AEX than REX group (all p < .05). Knee strength improved more in COMB and REX than AEX group (all p < .05). Changes in IMAT and VAT correlated with PPT (r = -0.28 and -0.39), VO2peak (r = -0.49 and -0.52), gait speed (r = -0.25 and -0.36), and ISI (r = -0.49 and -0.52; all p < .05). Weight loss plus combination aerobic and resistance exercise was most effective in improving ectopic fat deposition and physical and metabolic function in older adults with obesity.

Weight Loss through Lifestyle Intervention Improves Mobility in Older Adults.

The high prevalence of overweight or obesity in older adults is a public health concern because obesity affects health, including the risk of mobility disability. The Mobility and Vitality Lifestyle Program, delivered by community health workers (CHWs), enrolled 303 community-dwelling adults to assess the impact of a 32-session behavioral weight management intervention. Participants completed the program at 26 sites led by 22 CHWs. Participation was limited to people aged 60-75 who had a body mass index (BMI) of 27-45 kg/m2. The primary outcome was the performance on the Short Physical Performance Battery (SPPB) over 12 months. Participants were aged 67.7 (SD 4.1) and mostly female (87%); 22.7% were racial minorities. The mean (SD) BMI at baseline was 34.7 (4.7). Participants attended a median of 24 of 32 sessions; 240 (80.3%) completed the 9- or 13-month outcome assessment. Median weight loss in the sample was 5% of baseline body weight. SPPB total scores improved by +0.31 units (p < .006), gait speed by +0.04 m/s (p < .0001), and time to complete chair stands by -0.95 s (p < .0001). Weight loss of at least 5% was associated with a gain of +0.73 in SPPB scores. Increases in activity (by self-report or device) were not independently associated with SPPB outcomes but did reduce the effect of weight loss. Promoting weight management in a community group setting may be an effective strategy for reducing the risk of disability in older adults.