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Interventions to achieve long-term weight loss in obese older people

in
Publisher: 
Age and Ageing Advance Access
Author: 
Miles D. Witham1 and Alison Avenell2
Date published: 
18 January, 2010
Region: 
United Kingdom

Publication type: 
research
Publication link: 
Interventions to achieve long-term weight loss in obese older people
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Systematic Review

A systematic review and meta-analysis

Miles D. Witham1 and Alison Avenell2

1 Section of Ageing and Health, University of Dundee, Ninewells Hospital, Dundee DD1 9SY, UK
2 Health Services Research Unit, University of Aberdeen, Aberdeen, UK

Address correspondence to: M. Witham. Tel: (+44) 1382 632436; Fax: (+44) 1382 660675. Email: m.witham@dundee.ac.uk

Purpose: the prevalence of obesity is rapidly increasing in older adults. Information is required about what interventions are effective in reducing obesity and influencing health outcomes in this age group.

Design: systematic review and meta-analysis.

Data sources: thirteen databases were searched, earliest date 1966 to December 2008, including Medline, CINAHL, PsycINFO, the Cochrane database and EMBASE.

Study selection: we included studies with participants’ mean age ≥60 years and mean body mass index ≥30 kg/m2, with outcomes at a minimum of 1 year. Data were independently extracted by two reviewers and differences resolved by consensus.

Data extraction: nine eligible trials were included. Study interventions targeted diet, physical activity and mixed approaches. Populations included patients with coronary artery disease, diabetes mellitus and osteoarthritis.

Results: meta-analysis (seven studies) demonstrated a modest but significant weight loss of 3.0 kg [95% confidence interval (CI) 5.1–0.9] at 1 year. Total cholesterol (four studies) did not show a significant change: –0.36 mmol/l (95% CI –0.75 to 0.04). There was no significant change in high-density lipoprotein, low-density lipoprotein or triglycerides. In one study, recurrence of hypertension or cardiovascular events was significantly reduced (hazard ratio 0.65, 95% CI 0.50–0.85). Six-minute walk test did not significantly change in one study. Health-related quality of life significantly improved in one study but did not improve in a second study.

Conclusions: although modest weight reductions were observed, there is a lack of high-quality evidence to support the efficacy of weight loss programmes in older people.

 

Keywords: obesity, older, weight loss, meta-analysis, elderly, systematic review

 

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