Prevalence and determinants of overweight and obesity in old age in Germany

BMC Geriatrics

Hans-Helmut König⁶  Steffi G. Riedel-Heller⁷  Martin Scherer⁴  Wolfgang Maier¹  Michael Wagner¹  Kathrin Heser⁹  Edelgard Mösch⁵  Horst Bickel⁵  Tobias Luck⁷  Angela Fuchs²  Michael Pentzek²  Jochen Werle³  Siegfried Weyerer³  Jana Prokein⁸  Birgitt Wiese⁸  Carolin Lange⁴  Annette Ernst⁴  Thomas Lehnert⁶  André Hajek⁶ 

[1] German Center for Neurodegenerative Diseases, Bonn, Germany;Institute of General Practice, Medical Faculty Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany;Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany;Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany;Department of Psychiatry, Technical University of Munich, Munich, Germany;Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany;Institute of General Practice, Hannover Medical School, Hannover, Germany;Department of Psychiatry, University of Bonn, Bonn, Germany

关键词: Longitudinal;    Elderly;    Physical Activity;    Overweight;    Obesity;   

Others  :  1220020
DOI  :  10.1186/s12877-015-0081-5

 received in 2015-02-24, accepted in 2015-06-30,  发布年份 2015

【 摘 要 】

Background

Mean body weight gradually increases with age. Yet, little data exists on the prevalence of excess weight in populations aged 80 years or older. Moreover, little is known about predictors of overweight and obesity in old age. Thus, the purpose of this study was: To present data on the prevalence of excess weight in old age in Germany, to investigate predictors of excess weight in a cross-sectional approach and to examine factors affecting excess weight in a longitudinal approach.

Methods

Subjects consisted of 1,882 individuals aged 79 years or older. The course of excess weight was observed over 3 years. Excess weight was defined as follows: Overweight (25 kg/m ²  ≤ BMI < 30 kg/m ² ) and obesity (BMI ≥ 30 kg/m ² ). We used fixed effects regressions to estimate effects of time dependent variables on BMI, and overweight or obesity, respectively.

Results

The majority was overweight (40.0 %) or obese (13.7 %). Cross-sectional regressions revealed that BMI was positively associated with younger age, severe walking impairments and negatively associated with cognitive impairments. Excess weight was positively associated with younger age, elementary education, walking impairments and physical inactivity, while excess weight was negatively associated with cognitive impairment. Longitudinal regressions showed that age and severely impaired walking disabilities reduced BMI. The probability of transitions to excess weight decreased considerably with older age and occurrence of severe walking impairments (overweight).

Conclusions

Marked differences between predictors in cross- and longitudinal setting exist, underlining the complex nature of excess weight in old age.

【 授权许可】

   
2015 Hajek et al.

【 参考文献 】

• [1]Arterburn DE, Crane PK, Sullivan SD: The coming epidemic of obesity in elderly Americans. J Am Geriatr Soc. 2004, 52:1907-12.
• [2]Benito-León J, Mitchell AJ, Hernández-Gallego J, Bermejo-Pareja F: Obesity and impaired cognitive functioning in the elderly: a population-based cross-sectional study (NEDICES). Eur J Neurol. 2013, 20:899-e77.
• [3]Bouchard DR, Dionne IJ, Brochu M: Sarcopenic/obesity and physical capacity in older men and women: data from the Nutrition as a Determinant of Successful Aging (NuAge)-the Quebec Longitudinal Study. Obesity. 2009, 17:2082-8.
• [4]Brüderl J: Kausalanalyse mit Paneldaten. In Handbuch der sozialwissenschaftlichen Datenanalyse. Edited by Wolf C, Best H. VS-Verlag, Wiesbaden; 2010:963-94.
• [5]Bundesamt S: Bevölkerung Deutschlands bis 2060-Ergebnisse der 12. koordinierten Bevölkerungsvorausberechnung, Wiesbaden; 2009.
• [6]Cameron AC, Trivedi PK: Microeconometrics using Stata. Stata Press, Texas; 2009.
• [7]Cameron AC, Trivedi PK. Microeconometrics: methods and applications. New York: Cambridge University Press; 2005.
• [8]Cetin DC, Nasr G: Obesity in the elderly: More complicated than you think. Clev Clin J Med. 2014, 81:51-61.
• [9]Chapman IM: Obesity in old age. Front Horm Res. 2008, 36:97-106.
• [10]Cohen AK, Rai M, Rehkopf DH, Abrams B: Educational attainment and obesity: a systematic review. Obes Rev. 2013, 14:989-1005.
• [11]Connor Gorber S, Tremblay M, Moher D, Gorber B: A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev 2007, 8:307-26.
• [12]Dahl AK, Fauth EB, Ernsth-Bravell M, Hassing LB, Ram N, Gerstof D: Body mass index, change in body mass index, and survival in old and very old persons. J Am Geriatr Soc. 2013, 61:512-8.
• [13]de Hollander E, van Zutphen M, Bogers RP, Bemelmans WJ, de Groot L: The impact of body mass index in old age on cause-specific mortality. J Nutr Health Aging. 2012, 16:100-6.
• [14]Elias MF, Elias PK, Sullivan LM, Wolf PA, D'agostino RB: Lower cognitive function in the presence of obesity and hypertension: the Framingham heart study. Int J Obes. 2003, 27:260-8.
• [15]Elmadfa I, Meyer AL: Body composition, changing physiological functions and nutrient requirements of the elderly. Ann Nutr Metab. 2008, 52:2-5.
• [16]Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al.: National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9 · 1 million participants. Lancet 2011, 377:557-67.
• [17]Flegal KM, Carroll MD, Kit BK, Ogden CL: Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. J Am Med Assoc. 2012, 307:491-7.
• [18]Genton L, Karsegard VL, Chevalley T, Kossovsky MP, Darmon P, Pichard C: Body composition changes over 9 years in healthy elderly subjects and impact of physical activity. Clin Nutr. 2011, 30:436-42.
• [19]Gunstad J, Lhotsky A, Wendell CR, Ferrucci L, Zonderman AB: Longitudinal examination of obesity and cognitive function: results from the Baltimore Longitudinal Study of Aging. Neuroepidemiology. 2010, 34:222.
• [20]Gutiérrez F, Juan L, López E, Banegas JR, Graciani A, Rodríguez-Artalejo F: Prevalence of overweight and obesity in elderly people in Spain. Obes Res 2004, 12:710-5.
• [21]Han TS, Tajar A, Lean ME: Obesity and weight management in the elderly. Brit Med Bull. 2011, 97:169-96.
• [22]Jeong S, Nam H, Son M, Son E, Cho K: Interactive effect of obesity indexes on cognition. Dement Geriatr Cogn Disord. 2004, 19:91-6.
• [23]Johnson MA, Bales CW: Is There a Best Body Mass Index for Older Adults? Moving Closer to Evidence-Based Recommendations Regarding “Overweight” Health, and Mortality. J Nutr Gerontol Geriatr 2014, 33:1-9.
• [24]Kaplan MS, Huguet N, Newsom JT, McFarland BH, Lindsay J: Prevalence and correlates of overweight and obesity among older adults: findings from the Canadian National Population Health Survey. J Gerontol A Biol Sci Med Sci. 2003, 58:M1018-M1030.
• [25]Kilander L, Nyman H, Boberg M, Lithell H: Cognitive function, vascular risk factors and education. A cross‐sectional study based on a cohort of 70‐year‐old men. J Intern Med 1997, 242:313-21.
• [26]Kuo H, Jones RN, Milberg WP, Tennstedt S, Talbot L, Morris JN, et al.: Cognitive Function in Normal‐Weight, Overweight, and Obese Older Adults: An Analysis of the Advanced Cognitive Training for Independent and Vital Elderly Cohort. J Am Geriatr Soc. 2006, 54:97-103.
• [27]Lawrence VJ, Kopelman PG: Medical consequences of obesity. Clin Dermatol. 2004, 22:296-302.
• [28]Luck T, Riedel Heller SG, Luppa M, Wiese B, Wollny A, Wagner M, et al.: Risk factors for incident mild cognitive impairment - results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Acta Psychiat Scand 2010, 121:260-72.
• [29]Marcellini F, Giuli C, Papa R, Gagliardi C, Malavolta M, Mocchegiani E: BMI, life-style and psychological conditions in a sample of elderly Italian men and women. J Nutr Health Aging. 2010, 14:515-22.
• [30]McTigue KM, Hess R, Ziouras J: Obesity in older adults: a systematic review of the evidence for diagnosis and treatment. Obesity. 2006, 14:1485-97.
• [31]Mensink GB, Schienkiewitz A, Haftenberger M, Lampert T, Ziese T, Scheidt-Nave C: [Overweight and obesity in Germany: Results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt, Gesundheitsforschung. Gesundheitsschutz 2013, 56:786-94.
• [32]Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH: The disease burden associated with overweight and obesity. J Am Med Assoc. 1999, 282:1523-9.
• [33]OECD. Overweight and obesity among adults. In: OECD, editor. Overweight and obesity among adults: OECD Publishing; 2013. p. 58–9. doi:10.1787/health_glance-2013-21-en.
• [34]Oreopoulos A, Kalantar-Zadeh K, Sharma AM, Fonarow GC: The obesity paradox in the elderly: potential mechanisms and clinical implications. Clin Geriatr Med. 2009, 25:643-59.
• [35]Østbye T, Malhotra R, Chan A: Variation in and Correlates of Body Mass Status of Older Singaporean Men and Women Results From a National Survey. Asia-Pac J Public Health. 2013, 25:48-62.
• [36]Perissinotto E, Pisent C, Sergi G, Grigoletto F, Enzi G: Anthropometric measurements in the elderly: age and gender differences. Brit J Nutr. 2002, 87:177-86.
• [37]Peter RS, Fromm E, Klenk J, Concin H, Nagel G: Change in Height, Weight, and body mass index: Longitudinal data from Austria. Am J Hum Biol 2014, 26:690-6.
• [38]Price GM, Uauy R, Breeze E, Bulpitt CJ, Fletcher AE: Weight, shape, and mortality risk in older persons: elevated waist-hip ratio, not high body mass index, is associated with a greater risk of death. Am J Clin Nutr. 2006, 84:449-60.
• [39]Raguso CA, Kyle U, Kossovsky MP, Roynette C, Paoloni-Giacobino A, Hans D, et al.: A 3-year longitudinal study on body composition changes in the elderly: role of physical exercise. Clin Nutr. 2006, 25:573-80.
• [40]Robertson DA, Savva GM, Kenny RA: Frailty and cognitive impairment-a review of the evidence and causal mechanisms. Ageing Res Rev. 2013, 12:840-51.
• [41]Rothman MD, Leo-Summers L, Gill TM: Prognostic significance of potential frailty criteria. J Am Geriatr Soc. 2008, 56:2211-116.
• [42]Shatenstein B, Kergoat M, Nadon S: Anthropometric changes over 5 years in elderly Canadians by age, gender, and cognitive status. J Gerontol A Biol Sci Med Sci. 2001, 56:M483-M488.
• [43]Smith E, Hay P, Campbell L, Trollor JN: A review of the association between obesity and cognitive function across the lifespan: implications for novel approaches to prevention and treatment. Obes Rev. 2011, 12:740-55.
• [44]Stock JH, Watson MW: Heteroskedasticity‐robust standard errors for fixed effects panel data regression. Econometrica. 2008, 76:155-74.
• [45]Sutin AR, Stephan Y, Carretta H, Terracciano A: Perceived discrimination and physical, cognitive, and emotional health in older adulthood. Am J Geriat Psychiat. 2015, 23:171-9.
• [46]Verghese J, Lipton RB, Katz MJ, Hall CB, Derby CA, Kuslansky G, et al.: Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003, 348:2508-16.
• [47]Vincent HK, Vincent KR, Lamb KM: Obesity and mobility disability in the older adult. Obes Rev. 2010, 11:568-79.
• [48]Weng HH, Bastian LA, Jr T, Donald H, Moser BK, Ostbye T: Number of children associated with obesity in middle-aged women and men: results from the Health and Retirement Study. J Womens Health 2004, 13:85-91.
• [49]Woo J, Leung J, Kwok T: BMI, body composition, and physical functioning in older adults. Obesity. 2007, 15:1886-94.