EASO Task Force Sessions
João Breda, Trudy M. A. Wijnhoven, Joop M.A. van Raaij, Angela Spinelli, Hovengen, M. Wauters, Starc, Yngve, Marie Kunešová, U. O'Dwyer, Iveta Pudule, Aušra Petrauskienė, Victoria Farrugia Sant’Angelo, Ragnhild Hovengen, Jørgen R. Meisfjord, Ana Rito, Gregor Starc, Agneta Sjöberg, Agneta Yngve, Viktoria Anna Kovacs · Obesity Reviews · 2011
Obesity is a common problem in the elderly (aged 60 plus), although its prevalence decreases in extreme old age.It is estimated that about 44% of people lose weight in the later half of the life, while 19% gain weight.Mortality risk associated with an increased BMI is lower in elderly than in young-and middle-aged adults.It was found that weight loss in the magnitude of 10% of total body weight is associated with a modest to strong increase in morbidity and mortality risk in older adults.Sarcopenic obesity, with accumulation of intra-abdominal fat, is a major determinant of health status in the elderly.Inflammatory markers, endocrine changes and adipokines may be useful in identifying high-risk individuals and in monitoring the effect of interventions.Obesity has profound effects on both systolic and dyastolic left ventricular function.Despite these evidence, many studies have suggested that obese patients with heart failure have better prognosis than leaner patients which is termed the ''obesity paradox''.The reason for obesity paradox in cardiovasular diseases, especially heart failure, remain unclear.As one of the possible explanations, the obesity paradox in the elderly may be due to the use of BMI (influenced by muscle mass), rather than better measure of body fat.Weight loss generally brings multiple benefits, but these can not be assumed for elderly population since this process includes, beside reduction of fat mass, and loss of fat-free mass and bone mineral mass with adverse consequences fot the obese, elderly subjects.One of the benefits of being overweight or obese is that individual has a decreased risk of osteoporosis and there is some concern that weight loss could be associated with the promotion of osteoporosis.Excess weight reduces the loss of bone mass by stressing the skeleton, and elderly obese people are less likely to suffer hip fractures.In older people the risk from bariatric surgery outweigh benefits, since in patients with age over 60 years periperative complications, secondary complications and lover success in reducing weight are more often.