Author(s): Dr. Gita Rathod and Busa Bansi Vasantbhai

Abstract:
The number of obese older persons in the United States has markedly increased in the last 25 years because of an increase both in the total number of older persons and in the percentage of the older population who are obese. All subjects had evidence of mild to moderate frailty, as defined by meeting at least 2 of 3 criteria: modified Physical Performance Test (PPT) score of 18 to 32, peak oxygen consumption of 11 to 18 mL/min per kilogram of body weight, and self-reported difficulty or need for assistance in 2 instrumental ADLs or 1 basic ADL. These criteria are based on measures that have established predictive validity for disability and mortality in older populations. 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. Moderate weight loss and exercise training improves both objective and subjective measures of physical function and ameliorates frailty in obese older adults. Therefore, diet and exercise should be considered as primary therapy in frail obese older adults. Additional studies are needed to determine the independent and additive effects of weight loss and regular exercise on physical function and whether lifestyle intervention can prevent institutionalization of the growing number of obese older adults in our population.