More Evidence Ties Obesity to Disability in Older Women

Studies found higher risks for heart disease, mobility problems and early death

Monday, November 11, 2013

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MONDAY, Nov. 11 (HealthDay News) -- Women who are obese as they near retirement age have a higher risk of early death and may find their remaining years blighted by disability, researchers say.
Obese women are three to six times more likely to suffer a disability late in life that will make it difficult for them to get around, with the risk rising with their level of obesity, according to a new study published online Nov. 11 in JAMA Internal Medicine.
A second study in the same journal issue found that being overweight or obese raises your risk of heart attack and heart disease even if you are otherwise healthy.
The number of women aged 85 years and older in the United States is increasing, according to study background information, with 11.6 million women expected to reach 85 by 2050.
Obesity rates also continue to increase, and nearly one-third of U.S. women 75 years and older are obese. This extra weight not only reduces life span, but also can severely harm an older woman's quality of life.
"For dying and losing the ability to walk, the risks were alarmingly high -- over threefold to upwards of over sixfold," said study co-author Eileen Rillamas-Sun, a staff scientist at the Fred Hutchinson Cancer Research Center, in Seattle. "I believe that remaining mobile is very important to most older people, especially since it is useful for retaining one's independence."
The new findings aren't that surprising, but they're important, one expert noted.
Together, the two studies "verify something that we knew, but give us some more ammunition to craft more programs and pay more attention to women's body weight and obesity overall," said Dr. Georges Benjamin, executive director of the American Public Health Association (APHA).
"The obesity epidemic isn't just our kids, and if you are thinking forward we are having this enormous growth as the baby boomers age through society," he said. "We're going to have to spend a lot of time encouraging women to achieve a sensible body weight."
Rillamas-Sun's study examined the health records of nearly 37,000 older women participating in the Women's Health Initiative, a long-term study sponsored by the U.S. National Institutes of Health.
The researchers found that about 12 percent of healthy-weight women had become disabled by age 85, requiring a walker or some other assistance for getting around.
By comparison, between 25 percent and 34 percent of obese women were disabled, with incidence rising with the patient's body mass index (BMI), a measurement of body fat that takes height and weight into account.
Overall, a waist circumference greater than 35 inches was associated with a higher risk of early death, along with new diseases developing during the study period and mobility disability, the researchers said.
These findings, while focused on women, should also give men pause, Rillamas-Sun said.
"I do expect that these findings would be similar in men," she said, noting that her study was modeled on a Honolulu-based heart and aging study, which looked at Japanese-American men. "In that study, they showed that men who were leaner in midlife were more likely to survive to late-age and be healthy."
In the second new study, Danish researchers reviewed the health data of nearly 72,000 people to determine the effects of overweight and obesity on heart health.
The investigators found that people who are overweight or obese have a higher risk of heart attack or heart disease even if they do not have other metabolic syndrome risk factors such as high blood pressure, high cholesterol or type 2 diabetes.
In people without metabolic syndrome, heart attack risk increased 26 percent if they were overweight and 88 percent if they were obese, the researchers said. Obese people without metabolic syndrome also had a 45 percent increased risk of heart disease.
These findings show it is never too late to lose weight, Rillamas-Sun said.
"Obesity, even in older ages as this study shows, is a risk factor for numerous negative health outcomes," she said. "There are weight-loss interventions that have been shown to be effective for older populations, and older adults who have lost weight have been shown to have improvements in their health."
APHA's Benjamin agreed, noting that losing weight can help control diabetes, improve arthritis pain, boost heart health and make a person better able to recuperate from knee or hip replacement surgery.
"This study emphasizes the importance of maintaining a healthy weight and avoiding excessive weight gain after menopause or in your late mid-life. By doing this, you will improve your chances, not only of living longer, but of being healthy and ambulatory in late-age," Rillamas-Sun concluded.

SOURCES: Eileen Rillamas-Sun, Ph.D., staff scientist, Fred Hutchinson Cancer Research Center, Seattle; Georges Benjamin, M.D., executive director, American Public Health Association; Nov. 11, 2013, JAMA Internal Medicine, online

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