 |
|
Effect of Weight Loss and Exercise on Frailty in Obese Older Adults
Dennis T. Villareal, MD;
Marian Banks, DNS, RN;
David R. Sinacore, PhD, PT;
Catherine Siener, PT;
Samuel Klein, MD
Arch Intern Med. 2006;166:860-866.
Background Obesity exacerbates the age-related decline in physical function and causes frailty in older persons. However, appropriate treatment for obese older persons is unknown. We evaluated the effects of weight loss and exercise therapy on physical function and body composition in obese older persons.
Methods We screened 40 obese older volunteers and eventually randomized 27 frail obese older volunteers to treatment or control groups. Treatment consisted of 6 months of weekly behavioral therapy for weight loss in conjunction with exercise training 3 times per week. Physical function was evaluated with measurements of frailty (Physical Performance Test, peak oxygen consumption, and Functional Status Questionnaire); strength, gait, and balance tests; body composition with dual-energy x-ray absorptiometry; and quality of life using the Medical Outcomes Survey 36-Item Short-Form Health Survey. Results are reported as mean ± SD.
Results Two subjects in the treatment group did not comply with the intervention, and 1 subject in the control group withdrew. Analyses included all 27 subjects originally randomized to the treatment and control groups. The treatment group lost 8.4% ± 5.6% of body weight, whereas weight did not change in the control group (+0.5% ± 2.8%; P<.001). Compared with the control group, fat mass decreased (–6.6 ± 3.4 vs +1.7 ± 4.1 kg; P<.001), without a change in fat-free mass (–1.2 ± 2.1 vs –1.0 ± 3.5 kg; P = .75) in the treatment group. The Physical Performance Test score (2.6 ± 2.5 vs 0.1 ± 1.0; P = .001), peak oxygen consumption (1.7 ± 1.6 vs 0.3 ± 1.1 mL/min per kilogram; P = .02), and Functional Status Questionnaire score (2.9 ± 3.7 vs –0.2 ± 3.9; P = .02) improved in treated subjects compared with control subjects. Treatment also improved strength, walking speed, obstacle course, 1-leg limb stance time, and health survey physical subscale scores (all P<.05).
Conclusion These findings suggest that weight loss and exercise can ameliorate frailty in obese older adults.
Trial Registration clinicaltrials.gov Identifier: NCT00146133
Author Affiliations: Center for Human Nutrition, Division of Geriatrics and Nutritional Science (Drs Villareal, Banks, Sinacore, and Klein and Ms Siener), and Program in Physical Therapy (Dr Sinacore and Ms Siener), Washington University School of Medicine, St Louis, Mo.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Exercise but not diet-induced weight loss decreases skeletal muscle inflammatory gene expression in frail obese elderly persons
Lambert et al.
J. Appl. Physiol. 2008;105:473-478.
ABSTRACT
| FULL TEXT
Effect of Weight Loss and Exercise Therapy on Bone Metabolism and Mass in Obese Older Adults: A One-Year Randomized Controlled Trial
Villareal et al.
J. Clin. Endocrinol. Metab. 2008;93:2181-2187.
ABSTRACT
| FULL TEXT
Obesity, Disability, and Mortality: A Puzzling Link
Ferrucci and Alley
Arch Intern Med 2007;167:750-751.
FULL TEXT
Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis
Christensen et al.
Ann Rheum Dis 2007;66:433-439.
ABSTRACT
| FULL TEXT
Public health success in recent decades may be in danger if lifestyles of the elderly are neglected
van Baak and Visscher
Am. J. Clin. Nutr. 2006;84:1257-1258.
FULL TEXT
Effect of lifestyle intervention on metabolic coronary heart disease risk factors in obese older adults
Villareal et al.
Am. J. Clin. Nutr. 2006;84:1317-1323.
ABSTRACT
| FULL TEXT
|
