Obesity in Elderly Subjects
In sheep's clothing perhaps, but still a wolf!
- Etty Osher, MD and
- Naftali Stern, MD
- From the Institute of Endocrinology, Metabolism, and Hypertension, Tel Aviv-Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Corresponding author: Naftali Stern, stern{at}tasmc.health.gov.il.
Although the negative impact of high BMI on the risk of death from all-cause mortality is now well established, there is an apparent decline in the relative added risk of obesity with increasing age (1,2). This has led some experts to conclude that obesity should not necessarily be viewed as a disease in individuals older than 55 years. If such shift in the approach to adiposity during the latter phases of life is prematurely accepted, it may not only discourage attempted weight loss in older subjects, but also promote nutritional and lifestyle indulgence, which is presently difficult enough to overcome. It is the purpose of the present commentary to briefly outline the full spectrum of obesity-related hardships in the elderly. In our opinion, obesity-induced complications amount to real disease, which gravely affects quality of life and limits effective lifespan.
OBESITY, HYPERTENSION, DIABETES, AND THE METABOLIC SYNDROME IN ADVANCED AGE
The incidence of hypertension, diabetes, and the metabolic syndrome intensifies with age, and aging per se is closely linked to increased prevalence of most of the abnormalities contributing to the metabolic syndrome (3). The incidence of the metabolic syndrome rises with increasing BMI, and a broader waist circumference is more common in men older than 65 years than in younger age-groups (3). The occurrence of the metabolic syndrome reaches peak levels in the 6th decade for men and the 7th decade for women, and a decline is noted only in the 8th decade for men and for some women in different ethnic groups (3). As recently outlined by the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research, older age and obesity are two of the most powerful risk factors for uncontrolled hypertension (4), and high blood pressure, in turn, is a major determinant of mortality and stroke incidence, particularly in senior years. BMI …
