Obesity in Caucasian Seniors on the Rise: Is It Truly Harmful? Results of the PolSenior2 Study

Abstract

Obesity is associated with an increased risk of morbidity and mortality; however, data suggest that in old age, obesity is not detrimental. The study’s objective was to verify whether obesity frequency still increases in Polish Caucasian seniors and to verify the “obesity paradox”. Five thousand and fifty-seven community-dwelling individuals aged ≥ 65 years completed a detailed medical questionnaire, underwent measurements of the body mass index (BMI) and the waist circumference (WC), and an evaluation of physical and cognitive performances. Over a decade, general obesity increased by 2.1%, mostly due to a 3.9% increase in men. Abdominal obesity increased by 1.0%, mainly due to males, in whom it increased by 3.9%. Obesity increased the risk of several aging-related diseases, but this effect was less pronounced in the oldest-old. Obesity did not adversely affect the physical and cognitive functioning or mortality. Through a multivariable analysis, the BMI and WC remained the independent predictors of the Katz Activities of Daily Living score (p < 0.001 and p < 0.05, respectively) and Mini-Mental State Examination score (both p < 0.001). The Kaplan–Meier survival curves revealed that overweight and obesity classes 1 and 2 were associated with the lowest mortality. Through a multivariable analysis, overweight, class 1 obesity, and abdominal obesity remained the independent predictors of a decreased mortality (all p < 0.001). In conclusion, we found that overweight and obesity are not detrimental in seniors, including the oldest-old. We suggest that the anthropometric values defining obesity should be modified for age-advanced people.

Associations of body mass index, waist circumference and the weight‐adjusted waist index with daily living ability impairment in older Chinese people: A cross‐sectional study of the Chinese Longitudinal Healthy Longevity Survey

“…Several previous studies have suggested that BMI may be a protective factor against ADL impairment, 34–36 leading to the ‘obesity paradox’. However, using BMI as an indicator standard for obesity makes it difficult to reflect the effects of fat and muscle content, 37 leading to the biased conclusion that obesity facilitates the maintenance of better functional capacity (BADL/IADL).…”

Cardiovascular effects of weight loss in old adults with overweight/obesity according to change in skeletal muscle mass

“…6 Obesity paradox has been termed although people who are overweight or obese are likely to develop heart diseases, once a person has established heart condition, those with higher BMI appeared to have better prognosis, which is eminent in old adults and patients with heart failure. 7 Skeletal muscle mass (SMM) has been indicated to be the key that explains the heterogenous cardiovascular effects of weight loss, especially the dynamic change in muscle mass along with weight change (WC). [8][9][10] Several studies have suggested that sarcopenia and obesity sarcopenia are detrimental to cardiovascular health.…”

“…Weight management in overweight/obesity old adults has been discussed for decades due to the pandemic of obesity and aging 6 . Obesity paradox has been termed although people who are overweight or obese are likely to develop heart diseases, once a person has established heart condition, those with higher BMI appeared to have better prognosis, which is eminent in old adults and patients with heart failure 7 . Skeletal muscle mass (SMM) has been indicated to be the key that explains the heterogenous cardiovascular effects of weight loss, especially the dynamic change in muscle mass along with weight change (WC) 8–10 .…”