Advertisement

Current Geriatrics Reports

, Volume 4, Issue 3, pp 211–220 | Cite as

Obesity in Older Adults: Prevalence, Health Risk and Management of Care Among Nursing Home Residents

  • Sue O. MacDonell
  • Jody C. Miller
  • Debra L. Waters
  • Lisa A. Houghton
Nutrition, Obesity, and Diabetes (DT Villareal, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Nutrition, Obesity, and Diabetes

Abstract

The total number of older adults has increased markedly in recent decades with concurrent escalation in the proportion with a body mass index ≥30 kg/m2. Community-based studies indicate that obesity has a significant impact on the physical functioning and independence of older adults and increases the risk for nursing home admission. This review aims to describe the prevalence of obesity in nursing homes and the impact of such on individual health and aged care resources and to explore whether intervention strategies could improve obesity and quality of life in the nursing home population.

Keywords

Obesity BMI Bariatric Sarcopenia Frailty Aging Aged care Nursing home Elderly 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Sue O. MacDonell, Jody C. Miller, Debra L. Waters and Lisa A. Houghton declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of Importance •• Of major importance

  1. 1.
    WHO. Global health and aging. (2011). http://www.who.int/ageing/publications/global_health/en/ Accessed: 01 May 2015
  2. 2.
    United Nations. World population ageing 2013. In: Department of Economic and Social Affairs Population Division, editor.: ST/ESA/SER.A/348; 2013.Google Scholar
  3. 3.
    OECD. Health at a Glance 2013: OECD Indicators. 2013; doi:  10.1787/health_glance-2013-en.
  4. 4.
    Arterburn DE, Crane PK, Sullivan SD. The coming epidemic of obesity in elderly Americans. J Am Geriatr Soc. 2004;52(11):1907–12.PubMedCrossRefGoogle Scholar
  5. 5.
    Ministry of Health. Understanding excess body weight: New Zealand health survey. Wellington: Ministry of Health; 2015.Google Scholar
  6. 6.
    Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311(8):806–14. doi: 10.1001/jama.2014.732.PubMedCrossRefGoogle Scholar
  7. 7.
    Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014;384(9945):766–81.PubMedCrossRefGoogle Scholar
  8. 8.•
    Vlassopoulos A, Combet E, Lean MEJ. Changing distributions of body size and adiposity with age. Int J Obes. 2014;38(6):857–64. This secondary analysis of British data examines changing pattern of BMI and waist circumference in older age.CrossRefGoogle Scholar
  9. 9.
    Elkins JS, Whitmer RA, Sidney S, Sorel M, Yaffe K, Johnston SC. Midlife obesity and long-term risk of nursing home admission. Obesity. 2006;14(8):1472–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Zizza CA, Herring A, Stevens J, Popkin BM. Obesity affects nursing-care facility admission among Whites but not Blacks. Obes Res. 2002;10(8):816–23.PubMedCrossRefGoogle Scholar
  11. 11.•
    Villareal DT, Apovian CM, Kushner RF, Klein S. Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Obes Res. 2005;13(11):1849–63. This joint position statement provides an overview of age-related changes in body composition, clinical implications of obesity in older adults and recommended obesity treatment guidelines.PubMedCrossRefGoogle Scholar
  12. 12.
    Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. JAMDA. 2011;12(4):249–56.PubMedGoogle Scholar
  13. 13.
    Gallagher D, Ruts E, Visser M, Heshka S, Baumgartner RN, Wang J, et al. Weight stability masks sarcopenia in elderly men and women. Am J Physiol Endocrinol Metab. 2000;279(2):E366–75.PubMedGoogle Scholar
  14. 14.
    Hughes VA, Roubenoff R, Wood M, Frontera WR, Evans WJ, Fiatarone Singh MA. Anthropometric assessment of 10-y changes in body composition in the elderly. AJCN. 2004;80(2):475–82.Google Scholar
  15. 15.
    Madden AM, Tsikoura T, Stott DJ. The estimation of body height from ulna length in healthy adults from different ethnic groups. J Hum Nutr Diet. 2012;25(2):121–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Dixon JB, Egger GJ, Finkelstein EA, Kral JG, Lambert GW. ‘Obesity paradox’ misunderstands the biology of optimal weight throughout the life cycle. Int J Obes. 2015;39(1):82–4.CrossRefGoogle Scholar
  17. 17.
    Donini LM, Savina C, Gennaro E, De Felice MR, Rosano A, Pandolfo MM, et al. A systematic review of the literature concerning the relationship between obesity and mortality in the elderly. J Nutr Health Aging. 2012;16(1):89–98.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Kvamme J-M, Holmen J, Wilsgaard T, Florholmen J, Midthjell K, Jacobsen BK. Body mass index and mortality in elderly men and women: the Tromsø and HUNT studies. J Epidemiol Community Health. 2012;66(7):611–7.PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    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(4):643–59.PubMedCrossRefGoogle Scholar
  20. 20.
    Lapane KL, Resnik L. Obesity in nursing homes: an escalating problem. J Am Geriatr Soc. 2005;53(8):1386–91.PubMedCrossRefGoogle Scholar
  21. 21.
    Zhang N, Li Y, Temkin-Greener H. Prevalence of obesity in New York nursing homes: associations with facility characteristics. Gerontologist. 2013;53(4):567–81.PubMedCrossRefGoogle Scholar
  22. 22.••
    Kiesswetter E, Schrader E, Diekmann R, Sieber CC, Volkert D. Varying associations between body mass index and physical and cognitive function in three samples of older adults living in different settings. J Gerontol A Biol Sci Med Sci. 2015. doi: 10.1093/gerona/glv048. This study compares associations between BMI and function in older adults living in three different care settings.PubMedGoogle Scholar
  23. 23.
    Halil M, Ulger Z, Varli M, Doventas A, Ozturk GB, Kuyumcu ME, et al. Sarcopenia assessment project in the nursing homes in Turkey. Eur J Clin Nutr. 2014;68(6):690–4.PubMedCrossRefGoogle Scholar
  24. 24.
    Landi F, Liperoti R, Fusco D, Mastropaolo S, Quattrociocchi D, Proia A, et al. Prevalence and risk factors of sarcopenia among nursing home older residents. J Gerontol A Biol Sci Med Sci. 2012;67A(1):48–55.CrossRefGoogle Scholar
  25. 25.
    Jesus P, Desport JC, Massoulard A, Villemonteix C, Baptiste A, Gindre-Poulvelarie L, et al. Nutritional assessment and follow-up of residents with and without dementia in nursing homes in the Limousin region of France: a health network initiative. J Nutr Health Aging. 2012;16(5):504–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Bahat G, Tufan F, Saka B, Akin S, Ozkaya H, Yucel N, et al. Which body mass index (BMI) is better in the elderly for functional status? Arch Gerontol Geriatr. 2012;54(1):78–81.PubMedCrossRefGoogle Scholar
  27. 27.
    Kaiser R, Winning K, Uter W, Volkert D, Lesser S, Stehle P, et al. Functionality and mortality in obese nursing home residents: an example of ‘risk factor paradox’? JAMDA. 2010;11(6):428–35.PubMedGoogle Scholar
  28. 28.
    Beck AM, Damkjær K. Optimal body mass index in a nursing home population. J Nutr Health Aging. 2008;12(9):675–7.PubMedGoogle Scholar
  29. 29.
    Roberts HC, Syddall HE, Sparkes J, Ritchie J, Butchart J, Kerr A, et al. Grip strength and its determinants among older people in different healthcare settings. Age Ageing. 2014;43(2):241–6.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Lisko I, Stenholm S, Raitanen J, Hurme M, Hervonen A, Jylhä M et al. Association of body mass index and waist circumference with physical functioning: the vitality 90+ study. J Gerontol A Biol Sci Med Sci. 2014.Google Scholar
  31. 31.
    Mathus-Vliegen EMH, Basdevant A, Finer N, Hainer V, Hauner H, Micic D, et al. Prevalence, pathophysiology, health consequences and treatment options of obesity in the elderly: a guideline. Obes Facts. 2012;5(3):460–83.PubMedCrossRefGoogle Scholar
  32. 32.•
    Felix HC. Personal care assistance needs of obese elders entering nursing homes. JAMDA. 2008;9(5):319–26. One of the first studies examining the impact of obesity on nursing home resourcing; this paper highlights the increased care assistance needed by residents with a BMI ≥30 kg/m 2.PubMedGoogle Scholar
  33. 33.
    Bradway C, Miller E, Heivly A, Fleshner I. Continence care for obese nursing home residents. Urol Nurs. 2010;30(2):121–9.PubMedGoogle Scholar
  34. 34.
    Cai S, Rahman M, Intrator O. Obesity and pressure ulcers among nursing home residents. Med Care. 2013;51(6):478–86.PubMedCentralPubMedGoogle Scholar
  35. 35.
    Dorner TE, Luger E, Tschinderle J, Stein KV, Haider S, Kapan A, et al. Association between nutritional status (MNA-SF) and frailty (SHARE-FI) in acute hospitalised elderly patients. J Nutr Health Aging. 2014;18(3):264–9.PubMedCrossRefGoogle Scholar
  36. 36.
    Lapane KL, Resnik L. Weighing the relevant issues. J Aging Soc Policy. 2006;18(2):1–9.PubMedCrossRefGoogle Scholar
  37. 37.
    Dorner TE, Schwarz F, Kranz A, Freidl W, Rieder A, Gisinger C. Body mass index and the risk of infections in institutionalised geriatric patients. Br J Nutr. 2010;103(12):1830–5.PubMedCrossRefGoogle Scholar
  38. 38.
    Rogers MAM, Mody L, Kaufman SR, Fries BE, McMahon LF, Saint S. Use of urinary collection devices in skilled nursing facilities in five states. J Am Geriatr Soc. 2008;56(5):854–61.PubMedCrossRefGoogle Scholar
  39. 39.
    Batsis JA, Mackenzie TA, Barre LK, Lopez-Jimenez F, Bartels SJ. Sarcopenia, sarcopenic obesity and mortality in older adults: results from the National Health and Nutrition Examination Survey III. Eur J Clin Nutr. 2014;68(9):1001–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing. 2010;39(4):412–23.PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Waters DL, Baumgartner RN. Sarcopenia and obesity. Clin Geriatr Med. 2011;27(3):401–21.PubMedCrossRefGoogle Scholar
  42. 42.
    Volpato S, Bianchi L, Cherubini A, Landi F, Maggio M, Savino E, et al. Prevalence and clinical correlates of sarcopenia in community-dwelling older people: application of the EWGSOP definition and diagnostic algorithm. J Gerontol A Biol Sci Med Sci. 2014;69(4):438–46.PubMedCentralPubMedCrossRefGoogle Scholar
  43. 43.
    Bauer J, Kaiser MJ, Sieber CC. Sarcopenia in nursing home residents. JAMDA. 2008;9(8):545–51.PubMedGoogle Scholar
  44. 44.
    Rizzoli R, Reginster J-y, Arnal J-f, Bautmans I, Beaudart C, Bischoff-ferrari H, et al. Quality of life in sarcopenia and frailty. Calcif Tissue Int. 2013;93(2):101–20.PubMedCentralPubMedCrossRefGoogle Scholar
  45. 45.
    Baumgartner RN, Wayne SJ, Waters DL, Janssen I, Gallagher D, Morley JE. Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res. 2004;12(12):1995–2004.PubMedCrossRefGoogle Scholar
  46. 46.
    Zanandrea V, Barreto de Souto P, Cesari M, Vellas B, Rolland Y. Obesity and nursing home: a review and an update. Clinical Nutrition. 2013;32(5):679–85.PubMedCrossRefGoogle Scholar
  47. 47.
    Woods JL, Walker KZ, Iuliano-Burns S, Strauss BJ. Malnutrition on the menu: nutritional status of institutionalised elderly Australians in low-level care. J Nutr Health Aging. 2009;13(8):693–8.PubMedCrossRefGoogle Scholar
  48. 48.
    Bahat G, Saka B, Tufan F, Akin S, Sivrikaya S, Yucel N, et al. Prevalence of sarcopenia and its association with functional and nutritional status among male residents in a nursing home in Turkey. Aging Male. 2010;13(3):211–4.PubMedCrossRefGoogle Scholar
  49. 49.
    Landi F, Liperoti R, Fusco D, Mastropaolo S, Quattrociocchi D, Proia A, et al. Sarcopenia and mortality among older nursing home residents. JAMDA. 2012;13(2):121–6.PubMedGoogle Scholar
  50. 50.
    Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.PubMedCrossRefGoogle Scholar
  51. 51.
    Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59(3):M255–63.CrossRefGoogle Scholar
  52. 52.
    Blaum CS, Xue QL, Michelon E, Semba RD, Fried LP. The association between obesity and the frailty syndrome in older women: the Women’s Health and Aging Studies. J Am Geriatr Soc. 2005;53(6):927–34.PubMedCrossRefGoogle Scholar
  53. 53.
    Hubbard RE, Lang IA, Llewellyn DJ, Rockwood K. Frailty, body mass index, and abdominal obesity in older people. J Gerontol A Biol Sci Med Sci. 2010;65A(4):377–81.CrossRefGoogle Scholar
  54. 54.
    Wang S-Y, Shamliyan TA, Talley KMC, Ramakrishnan R, Kane RL. Not just specific diseases: systematic review of the association of geriatric syndromes with hospitalization or nursing home admission. Arch Gerontol Geriatr. 2013;57(1):16–26.PubMedCrossRefGoogle Scholar
  55. 55.
    de la Rica-Escuín M, González-Vaca J, Varela-Pérez R, Arjonilla-García MD, Silva-Iglesias M, Oliver-Carbonell JL, et al. Frailty and mortality or incident disability in institutionalized older adults: the FINAL study. Maturitas. 2014;78(4):329–34.PubMedCrossRefGoogle Scholar
  56. 56.
    Freiheit E, Hogan D, Strain L, Schmaltz H, Patten S, Eliasziw M, et al. Operationalizing frailty among older residents of assisted living facilities. BMC Geriatr. 2011;11(1):23.PubMedCentralPubMedCrossRefGoogle Scholar
  57. 57.
    González-Vaca J, de la Rica-Escuín M, Silva-Iglesias M, Arjonilla-García MD, Varela-Pérez R, Oliver-Carbonell JL, et al. Frailty in institutionalized older adults from Albacete. The FINAL study: rationale, design, methodology, prevalence and attributes. Maturitas. 2014;77(1):78–84.PubMedCrossRefGoogle Scholar
  58. 58.
    Matusik P, Tomaszewski K, Chmielowska K, Nowak J, Nowak W, Parnicka A, et al. Severe frailty and cognitive impairment are related to higher mortality in 12-month follow-up of nursing home residents. Arch Gerontol Geriatr. 2012;55(1):22–4.PubMedCrossRefGoogle Scholar
  59. 59.
    Strandberg TE, Sirola J, Pitkala KH, Tilvis RS, Strandberg AY, Stenholm S. Association of midlife obesity and cardiovascular risk with old age frailty: a 26-year follow-up of initially healthy men. Int J Obes. 2012;36(9):1153–7.CrossRefGoogle Scholar
  60. 60.
    Bales CW, Buhr G. Is obesity bad for older persons? A systematic review of the pros and cons of weight reduction in later life. JAMDA. 2008;9(5):302–12.PubMedGoogle Scholar
  61. 61.
    Waters DL, Ward AL, Villareal DT. Weight loss in obese adults 65 years and older: a review of the controversy. Exp Gerontol. 2013;48(10):1054–61.PubMedCentralPubMedCrossRefGoogle Scholar
  62. 62.
    Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011;364(13):1218–29.PubMedCentralPubMedCrossRefGoogle Scholar
  63. 63.
    Verreijen AM, Verlaan S, Engberink MF, Swinkels S, de Vogel-van den Bosch J, Weijs PJ. A high whey protein-, leucine-, and vitamin D-enriched supplement preserves muscle mass during intentional weight loss in obese older adults: a double-blind randomized controlled trial. AJCN. 2015;101(2):279–86.CrossRefGoogle Scholar
  64. 64.••
    Bauer J, Biolo G, Cederholm T, Cesari M, Cruz Jentoft AJ, Morley JE, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE study group. JAMDA. 2013;14(8):542–59. Protein requirements for older adults have been debated for some time. This paper provides an overview of requirements for different clinical conditions in the older age group.PubMedGoogle Scholar
  65. 65.
    Pizzato S, Sergi G, Bolzetta F, De Rui M, De Ronch I, Carraro S et al. Effect of weight loss on mortality in overweight and obese nursing home residents during a 5-year follow-up. Eur J Clin Nutr. 2015.Google Scholar
  66. 66.
    Woods JL, Iuliano-Burns S, Walker KZ. Weight loss in elderly women in low-level care and its association with transfer to high-level care and mortality. Clin Interv Aging. 2011;6:311–7.PubMedCentralPubMedGoogle Scholar
  67. 67.
    Gebhart A, Young MT, Nguyen NT. Bariatric surgery in the elderly: 2009–2013. Surg Obes Relat Dis. 2015;11(2):393–8.PubMedCrossRefGoogle Scholar
  68. 68.
    Luppi CR-O, Balagué C, Targarona EM, Mocanu S, Bollo J, Martínez C, et al. Laparoscopic sleeve gastrectomy in patients over 60 years: impact of age on weight loss and co-morbidity improvement. Surg Obes Relat Dis. 2015;11:296–302.PubMedCrossRefGoogle Scholar
  69. 69.••
    Batsis JA, Dolkart KM. Evaluation of older adults with obesity for bariatric surgery: Geriatricians’ perspective. J Clin Gerontol Geriatr. 2015;6(2):45–53. This provides a comprehensive overview of the role of bariatric surgery in older age groups with clear criteria to assist decision-making.CrossRefGoogle Scholar
  70. 70.
    Grant Thornton Ltd. Aged residential care service review. September 2010. http://nzaca.org.nz/publication/documents/ARSCR.pdf. Accessed 06 May 2014
  71. 71.
    Powell LS, Felix HC, Bradway C, Miller E, Heivly A, Fleshner I. Additional research on the cost of caring for obese nursing home residents is critical to maintaining adequate resources in the long-term care industry. JAMDA. 2010;11(3):222.PubMedGoogle Scholar
  72. 72.
    Yang Z, Zhang N. The burden of overweight and obesity on long-term care and Medicaid financing. Med Care. 2014;52(7):658–63.PubMedCrossRefGoogle Scholar
  73. 73.
    Felix HC, Bradway C, Miller E, Heivly A, Fleshner I, Powell LS. Obese nursing home residents: a call to research action. J Am Geriatr Soc. 2010;58(6):1196–7.PubMedCrossRefGoogle Scholar
  74. 74.
    Onwudiwe NC, Stuart B, Zuckerman IH, Sorkin JD. Obesity and medicare expenditure: accounting for age-related height loss. Obesity. 2011;19(1):204–11.PubMedCentralPubMedCrossRefGoogle Scholar
  75. 75.
    Tolson D, Rolland Y, Katz PR, Woo J, Morley JE, Vellas B. An international survey of nursing homes. JAMDA. 2013;14(7):459–62.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Sue O. MacDonell
    • 1
  • Jody C. Miller
    • 1
  • Debra L. Waters
    • 2
  • Lisa A. Houghton
    • 1
  1. 1.Department of Human NutritionUniversity of OtagoDunedinNew Zealand
  2. 2.Department of Medicine/School of Physiotherapy, Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand

Personalised recommendations