Claire K Ankuda1,2, John Harris3, Katherine Ornstein4, Deborah A Levine5,6,7,8, Kenneth M Langa6,7,8,9, Amy S Kelley4. 1. Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, Michigan. 2. Department of Family Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan. 3. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania. 4. Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York. 5. Department of Neurology, School of Medicine, University of Michigan, Ann Arbor, Michigan. 6. Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan. 7. Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan. 8. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan. 9. Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
Abstract
OBJECTIVES: To determine the difference in receipt of activity of daily living (ADL) assistance between obese and normal-weight older adults. DESIGN: Retrospective cohort study. SETTING: National Health and Aging Trends Study, 2011-2015. PARTICIPANTS: U.S. adults aged 65 and older with ADL disability and a body mass index (BMI) of 18.5 kg/m2 or greater (N = 5,612) MEASUREMENTS: BMI was classified as normal weight (18.5-24.9 kg/m2 ), overweight (25.0-29.9 kg/m2 ), or obese (≥30.0 kg/m2 ). Primary outcome was self-reported receipt of help with specific ADLs. Models were adjusted for demographic characteristics (age, sex, race), degree of need (self-reported general health, severity of disability), household resources (income, marriage, people in household, number of children), and cognitive status (dementia, proxy respondent). RESULTS: Obese with disabilities had lower rates of receiving assistance with walking inside (odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.50-0.81), walking outside (OR = 0.76, 95% CI = 0.59-0.97), toileting (OR = 0.68, 95% CI = 0.52-0.89), and getting in and out of bed (OR = 0.67, 95% CI = 0.50-0.87) than normal-weight older adults after adjustment for respondent demographic characteristics. Level of need and cognitive status partially explained the associations. In fully adjusted models, older adults with obesity still had significantly lower odds of receiving assistance in getting in and out of bed than normal weight adults (OR = 0.69, 95% CI = 0.49-0.98). CONCLUSION: Older adults with obesity are less likely to receive assistance for ADL disabilities than their normal-weight counterparts-an important concern because of ongoing demographic changes in the United States.
OBJECTIVES: To determine the difference in receipt of activity of daily living (ADL) assistance between obese and normal-weight older adults. DESIGN: Retrospective cohort study. SETTING: National Health and Aging Trends Study, 2011-2015. PARTICIPANTS: U.S. adults aged 65 and older with ADL disability and a body mass index (BMI) of 18.5 kg/m2 or greater (N = 5,612) MEASUREMENTS: BMI was classified as normal weight (18.5-24.9 kg/m2 ), overweight (25.0-29.9 kg/m2 ), or obese (≥30.0 kg/m2 ). Primary outcome was self-reported receipt of help with specific ADLs. Models were adjusted for demographic characteristics (age, sex, race), degree of need (self-reported general health, severity of disability), household resources (income, marriage, people in household, number of children), and cognitive status (dementia, proxy respondent). RESULTS:Obese with disabilities had lower rates of receiving assistance with walking inside (odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.50-0.81), walking outside (OR = 0.76, 95% CI = 0.59-0.97), toileting (OR = 0.68, 95% CI = 0.52-0.89), and getting in and out of bed (OR = 0.67, 95% CI = 0.50-0.87) than normal-weight older adults after adjustment for respondent demographic characteristics. Level of need and cognitive status partially explained the associations. In fully adjusted models, older adults with obesity still had significantly lower odds of receiving assistance in getting in and out of bed than normal weight adults (OR = 0.69, 95% CI = 0.49-0.98). CONCLUSION: Older adults with obesity are less likely to receive assistance for ADL disabilities than their normal-weight counterparts-an important concern because of ongoing demographic changes in the United States.
Authors: Amy M Ahasic; Peter H Van Ness; Terrence E Murphy; Katy L B Araujo; Margaret A Pisani Journal: Age Ageing Date: 2014-10-16 Impact factor: 10.668
Authors: Katherine A Ornstein; Bruce Leff; Kenneth E Covinsky; Christine S Ritchie; Alex D Federman; Laken Roberts; Amy S Kelley; Albert L Siu; Sarah L Szanton Journal: JAMA Intern Med Date: 2015-07 Impact factor: 21.873