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Obésité de la personne âgée: définition, phénotypes, épidémiologie et conséquences pour la santé

Obesity in the elderly: definition, phenotypes, epidemiology and effects on health

  • Revue Générale/General Review
  • Published:
Obésité

Résumé

L’obésité est difficile à définir chez la personne âgée (PA), car le vieillissement s’accompagne d’une augmentation de la masse grasse et d’une diminution de la masse maigre. L’indice de masse corporelle (IMC) est donc d’interprétation délicate et ce d’autant plus que la taille diminue avec L’âge. Ainsi, le pourcentage de masse grasse de la PA en bonne santé est-il, en moyenne, voisin du seuil qui est habituellement choisi pour définir L’obésité chez L’adulte jeune (25 % pour les hommes et 35 % pour les femmes, dans la tranche d’âge de plus de 60 ans). De plus, il paraît pertinent de considérer la répartition du tissu adipeux (TA) et la masse maigre plutôt que le seul IMC; on décrit ainsi trois formes cliniques, L’obésité abdominale (ou viscérale), L’adiposité lipodystrophique liée à L’âge et L’obésité sarcopénique qui méritent une attention particulière quant à leur pronostic. Les différentes complications de L’obésité sont présentées, L’obésité étant la cause de multiples déficits fonctionnels et un facteur de risque pour les maladies métaboliques et cardiovasculaires mais aussi pour le cancer et le déclin cognitif. Néanmoins, L’excès de TA peut avoir un effet protecteur vis-à-vis de L’ostéoporose et dans les situations d’agression.

Abstract

It is difficult to define what is meant by the term obesity in elderly persons (EPs), as aging is associated with increased body fat and reduced lean body mass. The body mass index (BMI) is thus difficult to interpret, particularly as height also decreases with age. Thus, the percentage of body fat in an EP is around the same level as the threshold at which a young adult would be considered obese (25% for men and 35% for women in the over 60s). Moreover, it would seem important to consider body fat distribution and fat-free mass are situated, rather than just the BMI; in this way, three clinical forms of obesity can be described: abdominal obesity (or central obesity), age-related lipodystrophy and sarcopenia, which all need careful assessment in terms of prognosis. The various complications of obesity are presented, as obesity can cause numerous functional disorders and is a risk factor for metabolic and cardiovascular disease as well as for cancer and cognitive decline. Nevertheless, excess adipose tissue can protect against osteoporosis and wasting disease.

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Authors and Affiliations

  1. Service de diabétologie, maladies métaboliques, maladies de la nutrition, CHU de Nancy, F-54000, Nancy, France

    O. Ziegler

  2. Hôpital Jeanne-d’Arc, BP 303, F-54201, Toul cedex, France

    D. Quilliot

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  1. O. Ziegler
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Correspondence to O. Ziegler.

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Cet article a déjà fait l’objet d’une première publication: Obésité de la personne âgée. Épidémiologie et conséquences d’O. Ziegler et D. Quillot. In: Hébuterne X, Alix E, Raynaud-Simon A, Vellas B (2008) Traité de nutrition de la personne âgée. Springer, Paris

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Ziegler, O., Quilliot, D. Obésité de la personne âgée: définition, phénotypes, épidémiologie et conséquences pour la santé. Obes 4, 166–175 (2009). https://doi.org/10.1007/s11690-009-0184-2

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