Obesity in Older Adults: Lifespan and Healthspan

So much attention goes into obesity for children and young persons that one might wonder if it’s much of a concern for older adults. A new study in BMC Geriatrics offers good insight. Mild and moderate obesity might not have much of an effect on a older person’s lifespan, though severe obesity does. But regardless of severity, obesity can have a significant effect on healthspan for older adults – the years that a person lives in good health.

This is no small matter because the prevalence of obesity is growing robustly in older adults. It now stands at 43 percent – roughly the same as it is in the total population.

A Large Cohort of Medicare Beneficiaries

Haomiao Jia and Erica Lubetkin analyzed data from more than 100,000 persons in the Medicare Health Outcomes Survey, Cohort 15. Ages ranged from 65 to more than 95, with 87 percent of the sample falling between 65 and 85 years old. BMI came from self reports, which the authors note as a limitation.

They found that mild and moderate (class 1 and 2) obesity were not associated with increased mortality. But severe (class 3) obesity was. However, for any degree of obesity at age 65, active life expectancy (ALE) was a year less than for a person who is in the range of normal weight or overweight. The authors conclude:

“Although older adults with obesity have a similar life expectancy as normal weight persons, they have a significantly shorter ALE. Given the complex relationship of BMI and ALE, a ‘one size fits all’ approach to weight management is not advisable.”

Smart, Personalized Obesity Care

John Batsis and Alexandra Zagaria explain that some of the same principles of obesity care for younger persons are appropriate for older adults. Lifestyle, pharmacotherapy, and bariatric surgery each can be helpful, according to individual patient needs. They explain the importance:

“The epidemic of geriatric obesity will continue to affect the role of primary care providers with time. The importance of lifespan prevention measures to delay the onset of disability and impairments in health-related quality of life cannot be overstated.”

Chronic pain is a common concern for older adults that can limit a person’s physical functioning. Obesity, too has become common, and it can be an important factor that leads to more chronic pain.

So without a doubt, obesity deserves attention in older adults, not just because severe obesity shortens lifespan, but because even mild obesity can shorten healthspan.

Click here for the study by Jia and Lubetkin. For an excellent review of obesity care for older adults by Batsis and Zagaria, click here.

Portrait of an Old Woman, painting by Pierre-Auguste Renoir / WikiArt

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April 14, 2022