In a cohort of generally healthy community-dwelling older adults, AC-drug exposure was associated with a statistically significant decrease in the PCS and increase in the MCS throughout the entire follow-up period. However, the effects on the PCS and MCS were small and likely not clinically relevant.

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Obesity in older adults results from several interacting factors. Consequently, interventions have shown mitigated effects. We determined (a) the different subgroups of older adults with obesity based on clusters of associated comorbidities and (b) the trajectory of these clusters to assess their stability over 3 years and factors contributing to transitions. Obese men (n = 193; body mass index [BMI] = 33.15 ± 2.69 kg/m 2 ) and women (n = 220; BMI = 33.71 ± 3.71 kg/m 2 ) aged between 68 and 82 years were studied. Outcome variables were body composition, strength, physical capacity (PC), nutrition, psychological and physical health and social participation. Cluster analyses, stratified by sex, were used to identify obesity profiles at baseline and follow-up. Three profiles were identified, based on general health (GH), psychological health (PH) and PC: Cluster 1: healthy obese (GH+, PH+, PC+); Cluster 2: obese with low PC (GH+/−, PH+/−, PC−); Cluster 3: unhealthy obese (GH−, PH−, PC−). After 3 years, 61.2% and 70.2% of men and women remained in their initial cluster, compared to 20.4% and 13.7% who transitioned towards a worse health cluster and 18.3% and 16.0% who transitioned towards a more favourable cluster, partly explained by changes in physical health for men and physical health and PH for women. The results of this study show that targeting physical function in men and physical health and PH functions in women could prevent further health decline in older adults with obesity. Further studies are needed to investigate the role of these clusters in the prediction of cardiometabolic complications and mortality. K E Y W O R D S aging, functional capacity, obesity management, physical capacities, psychosocial factors | INTRODUCTIONAging is a natural and inevitable process, which is often accompanied by an increase in the number of chronic diseases such as hypertension, dyslipidaemia, metabolic syndrome, coronary heart disease, type 2 diabetes and some types of cancers. 1 However, some researchers suggested that chronic diseases are not intrinsic to the aging process, but rather to the biological changes accompanying aging. 2 For example, gains in fat mass (FM) leading to obesity is one of the most prevalent physical changes related to aging and it is considered as one of the major causes of chronic diseases and physical disabilities in older adults. 3 Obesity in older adults is a multi-factorial condition, which mainly develops from complex interactions between genetic and environmental obesogenic factors. 4 It is recognized that socioeconomic, 5 sociocultural, 6 lifestyle (nutritional 7 and exercise 8 ), behavioral 9 and psychological 10 factors are contributing to the energy homeostasis and its dysregulation may lead to obesity. 11 Therefore, it has been suggested that an effective management of obesity requires a more personalized approach combining multi-area interventions rather than focusing on only one or two aspects. 12 This implies to use multi-and interdisciplinary approaches to characterize older adu...

We read Costa and colleagues' report in 2016 in the Journal of Nutrition in Gerontology and Geriatrics with great interest. In this article, the authors reported a statistically significant association between chronic musculoskeletal pain and nutritional risk after controlling for age, gender, body mass index (BMI), depression (GDS, geriatric depression scale), and diabetes in a Brazilian community-dwelling older adult's population (the PAINEL study, see Table 2 in Costa et al. . However, in their study, Costa and colleagues used the DETERMINE Questionnaire, a questionnaire in which 3 out of the 10 questions are directly or indirectly related to pain (i.e., presence of an illness, tooth or mouth problems, and physical disability). The purpose of this letter is to discuss the potential drawbacks of including pain-related questions in nutrition risk screening tool when these tools are used to investigate the relationship between pain and nutritional risk.