Journal of Community Health

, Volume 35, Issue 6, pp 586–591 | Cite as

Weight Change and Functional Limitations Among Older Adults in North Carolina

  • April P. Carson
  • DaJuanicia N. Holmes
  • Daniel L. Howard
Original Paper


There is emerging evidence that weight change during older adulthood is associated with decreased physical function; however, less is known about the association between weight change during middle to older adulthood and physical function. This study assessed the association of weight change between middle and older adulthood and functional limitations among 2,531 older African-American and white participants, ages 65 and older at baseline (1987), from the Piedmont Health Survey of the Elderly. Weight gainers had ≥8% increase in weight, weight losers had >8% decrease in weight, and weight maintainers had <8% increase or decrease between age 50 and baseline. Functional limitations were categorized as none (0), mild (1–3), or severe (4 or more) using items from the activities of daily living scale by Katz and the extremity function scale by Nagi. Modified Poisson regression was used to assess these associations in crude and adjusted analyses. Weight gain and weight loss between age 50 and baseline were associated with severe functional limitations (prevalence ratio (PR) = 1.19, 95% CI: 1.04, 1.36 and PR = 1.58, 95% CI: 1.41, 1.78, respectively) compared to weight maintainers after adjustment for age, race, and gender. These associations were attenuated after additional adjustment for health characteristics, while weaker associations were noted for mild functional limitations. In summary, weight gain and weight loss between middle and older adulthood were associated with severe functional limitations among older adults in North Carolina. Additional research is needed to explore weight change across the life course and its possible effects on physical function later in life.


Weight change Aged Mobility limitation 


  1. 1.
    Flegal, K. M., Carroll, M. D., Kuczmarski, R. J., & Johnson, C. L. (1998). Overweight and obesity in the United States: Prevalence and trends, 1960–1994. International Journal of Obesity and Related Metabolic Disorders, 22(1), 39–47.CrossRefPubMedGoogle Scholar
  2. 2.
    Flegal, K. M., Carroll, M. D., Ogden, C. L., & Johnson, C. L. (2002). Prevalence and trends in obesity among US adults, 1999–2000. JAMA, 288(14), 1723–1727.CrossRefPubMedGoogle Scholar
  3. 3.
    Ogden, C. L., Carroll, M. D., Curtin, L. R., McDowell, M. A., Tabak, C. J., et al. (2006). Prevalence of overweight and obesity in the United States, 1999–2004. JAMA, 295(13), 1549–1555.CrossRefPubMedGoogle Scholar
  4. 4.
    Burke, G. L., Bertoni, A. G., Shea, S., Tracy, R., Watson, K. E., et al. (2008). The impact of obesity on cardiovascular disease risk factors and subclinical vascular disease: The multi-ethnic study of atherosclerosis. Archives of Internal Medicine, 168(9), 928–935.CrossRefPubMedGoogle Scholar
  5. 5.
    Flegal, K. M., Graubard, B. I., Williamson, D. F., & Gail, M. H. (2007). Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA, 298(17), 2028–2037.CrossRefPubMedGoogle Scholar
  6. 6.
    Jensen, G. L. (2005). Obesity and functional decline: Epidemiology and geriatric consequences. Clinics in Geriatric Medicine, 21(4), 677–687.CrossRefPubMedGoogle Scholar
  7. 7.
    Villareal, D. T., Apovian, C. M., Kushner, R. F., & Klein, S. (2005). Obesity in older adults: Technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. The American Journal of Clinical Nutrition, 82(5), 923–934.PubMedGoogle Scholar
  8. 8.
    Houston, D. K., Stevens, J., Cai, J., & Morey, M. C. (2005). Role of weight history on functional limitations and disability in late adulthood: The ARIC study. Obesity Research, 13(10), 1793–1802.CrossRefPubMedGoogle Scholar
  9. 9.
    Fine, J. T., Colditz, G. A., Coakley, E. H., Moseley, G., Manson, J. E., et al. (1999). A prospective study of weight change and health-related quality of life in women. JAMA, 282(22), 2136–2142.CrossRefPubMedGoogle Scholar
  10. 10.
    Launer, L. J., Harris, T., Rumpel, C., & Madans, J. (1994). Body mass index, weight change, and risk of mobility disability in middle-aged and older women. The epidemiologic follow-up study of NHANES I. JAMA, 271(14), 1093–1098.CrossRefPubMedGoogle Scholar
  11. 11.
    Lee, J. S., Kritchevsky, S. B., Tylavsky, F., Harris, T., Simonsick, E. M., et al. (2005). Weight change, weight change intention, and the incidence of mobility limitation in well-functioning community-dwelling older adults. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 60(8), 1007–1012.PubMedGoogle Scholar
  12. 12.
    Cornoni-Huntley, J., Ostfeld, A. M., Taylor, J. O., Wallace, R. B., Blazer, D., et al. (1993). Established populations for epidemiologic studies of the elderly: Study design and methodology. Aging (Milan, Italy), 5(1), 27–37.Google Scholar
  13. 13.
    Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA, 185, 914–919.PubMedGoogle Scholar
  14. 14.
    Nagi, S. Z. (1976). An epidemiology of disability among adults in the United States. The Milbank Memorial Fund Quarterly. Health and Society, 54(4), 439–467.CrossRefPubMedGoogle Scholar
  15. 15.
    Zou, G. (2004). A modified poisson regression approach to prospective studies with binary data. American Journal of Epidemiology, 159(7), 702–706.CrossRefPubMedGoogle Scholar
  16. 16.
    Al Snih, S., Raji, M. A., Markides, K. S., Ottenbacher, K. J., & Goodwin, J. S. (2005). Weight change and lower body disability in older Mexican Americans. Journal of the American Geriatrics Society, 53(10), 1730–1737.CrossRefPubMedGoogle Scholar
  17. 17.
    Stevens, J., Truesdale, K. P., McClain, J. E., & Cai, J. (2006). The definition of weight maintenance. International Journal of Obesity, 30(3), 391–399.CrossRefPubMedGoogle Scholar
  18. 18.
    Stevens, J., Keil, J. E., Waid, L. R., & Gazes, P. C. (1990). Accuracy of current, 4-year, and 28-year self-reported body weight in an elderly population. American Journal of Epidemiology, 132(6), 1156–1163.PubMedGoogle Scholar
  19. 19.
    Gorber, S. C., Tremblay, M., Moher, D., & Gorber, B. (2007). A comparison of direct vs. self-report measures for assessing height, weight and body mass index: A systematic review. Obesity Reviews, 8(4), 307–326.CrossRefPubMedGoogle Scholar
  20. 20.
    Kuczmarski, M. F., Kuczmarski, R. J., & Najjar, M. (2001). Effects of age on validity of self-reported height, weight, and body mass index: Findings from the Third National Health and Nutrition Examination Survey, 1988–1994. Journal of the American Dietetic Association, 101(1), 28–34. (quiz 35-6).CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • April P. Carson
    • 1
  • DaJuanicia N. Holmes
    • 1
  • Daniel L. Howard
    • 2
  1. 1.The Institute for Health, Social, and Community ResearchShaw UniversityRaleighUSA
  2. 2.The Robert Wood Johnson Foundation Center for Health Policy, Meharry Medical CollegeNashvilleUSA

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