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Treatment of obesity in older persons-A systematic review.

Published on Apr 1, 2019in Obesity Reviews8.192
· DOI :10.1111/obr.12815
Cilla Haywood7
Estimated H-index: 7
(University of Melbourne),
Priya Sumithran10
Estimated H-index: 10
(University of Melbourne)
Abstract
The study aims to systematically review the available evidence regarding weight loss interventions (lifestyle, surgical, and pharmacological) for obesity in adults aged over 60 years. A search of prospective, randomized studies took place in January 2018, on Medline (Web of Science) and PubMed databases. Search terms included the following: elderly, obese, hypocaloric, pharmacotherapy, and bariatric surgery. Abstracts were screened for eligibility. A total of 256 publications regarding lifestyle interventions were identified; of these, 69 studies were eligible. As no eligible studies were identified for pharmacotherapy or bariatric surgery, the search was broadened to include non‐ randomized studies. Four pharmacotherapy and 66 surgery studies were included. Lifestyle intervention had similar weight loss efficacy in older compared with younger people, with positive effects on a number of relevant outcomes, including physical function and cardiovascular parameters. There was little data regarding obesity pharmacotherapy in older persons. The available data for bariatric surgery indicate comparable weight loss and resolution of type 2 diabetes, with similar or slightly higher complication rates in older compared with younger people. Older age alone should not be considered a contraindication to intensive lifestyle or surgical intervention for obesity. There are insufficient data to guide clinical decisions regarding obesity pharmacotherapy in older people.
  • References (144)
  • Citations (1)
References144
Newest
#1Vasilios Kotsis (A.U.Th.: Aristotle University of Thessaloniki)H-Index: 20
#2Jens Jordan (MHH: Hannover Medical School)H-Index: 60
Last. Peter NilssonH-Index: 108
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Obesity is a key factor for cardiovascular diseases and complications. Obesity is associated with hypertension, dyslipidemia and type II diabetes, which are the major predictors of cardiovascular disease in the future. It predisposes for atrial fibrillation, heart failure, sudden cardiac death, rena
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#1Miguel Peralta (University of Lisbon)H-Index: 6
#2Madalena RamosH-Index: 4
Last. Adilson Marques (NOVA: Universidade Nova de Lisboa)H-Index: 14
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Aims: Overweight and obesity are clinical public-health concerns worldwide. Amongst older adults, the prevalence of overweight and obesity is considered high. The purpose of this study was to provide current data regarding the prevalence and trends of overweight and obesity of adults from 2005 to 2013 in 10 European countries. Methods: The data used in the present study were derived from the first, second, fourth and fifth waves of the Survey of Health, Ageing and Retirement in Europe. The prese...
14 CitationsSource
#1Katherine D. Gray (NewYork–Presbyterian Hospital)H-Index: 6
#2Maureen D. Moore (NewYork–Presbyterian Hospital)H-Index: 8
Last. Cheguevara Afaneh (NewYork–Presbyterian Hospital)H-Index: 15
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Purpose We sought to assess outcomes of laparoscopic sleeve gastrectomy (LSG) vs laparoscopic Roux-en-Y gastric bypass (LRYGB) in a cohort of morbidly obese, elderly patients.
5 CitationsSource
#1Cilla Haywood (University of Melbourne)H-Index: 7
#2Luke A. Prendergast (La Trobe University)H-Index: 14
Last. Joseph Proietto (University of Melbourne)H-Index: 51
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Background: Obesity contributes to disability in older adults, and this is offset by weight loss and exercise. Very Low Calorie Diets (VLCDs) achieve rapid weight loss; however, these have not been rigorously evaluated in older people. Methods: A randomized trial was conducted from August 2012 through December 2015. The intervention was 12 weeks of thrice weekly exercise combined with either healthy eating advice (Ex/HE), hypocaloric diet (Ex/Diet), or VLCD (Ex/VLCD). Outcomes were physical func...
10 CitationsSource
#1Aiko Hayashi (Chiba University)H-Index: 2
#2Yukari Maeda (Chiba University)H-Index: 1
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Aim Laparoscopic sleeve gastrectomy (LSG) has proven to be the most effective strategy for the treatment of morbid obesity, however its efficacy and safety in an aging population has not yet been confirmed. In this study, we evaluated the effectiveness and safety of LSG in elderly obese Japanese patients. Methods Three obese individuals aged >60 years and 11 obese individuals aged <60 years who underwent LSG were enrolled. Pre- and postoperative changes after at least 12 months were examined, in...
1 CitationsSource
#1Robert A. Casillas (WLAC: West Los Angeles College)H-Index: 3
#2Benjamin Kim (WLAC: West Los Angeles College)H-Index: 1
Last. Karen J. Coleman (KP: Kaiser Permanente)H-Index: 26
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Abstract Background Most bariatric studies in older adult patients have focused on older operations with limited follow-up and equivocal results. Objectives To compare weight loss and safety in patients ages≥65 years undergoing laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Setting Nine different bariatric surgery centers with 23 surgeons serving over 30,000 bariatric patients. Methods Participants were≥65 years who had a SG or LRYGB between January 1, 20...
10 CitationsSource
#1Damien Bergeat (University of Rennes)H-Index: 8
#2David LechauxH-Index: 1
Last. Vianney BouyguesH-Index: 1
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Background Laparoscopic bariatric surgery (LBS) in older obese patients remains debated regarding postoperative outcomes.
7 CitationsSource
#1Chetan ParmarH-Index: 14
#2Kamal K. MahawarH-Index: 21
Last. Peter K. SmallH-Index: 20
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Introduction There is reluctance amongst many healthcare professionals to offer bariatric surgery to septuagenarians. There is only one study in the scientific literature specifically describing any experience with this group of patients and none that compares the outcomes in this group with younger patients.
4 CitationsSource
#1Ronald Christopher (Arena Pharmaceuticals, Inc.)H-Index: 5
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Abstract Purpose To determine whether dosage adjustment is likely to be necessary for effective and well-tolerated use of a pharmaceutical agent, guidance documents from the US Food and Drug Administration recommend pharmacokinetics studies in patients with impaired renal or impaired hepatic function and in the elderly population. Three studies were conducted to evaluate the pharmacokinetic properties and tolerability of lorcaserin in these populations. Methods Lorcaserin was evaluated in single...
4 CitationsSource
#1Andrés Navarrete (Universidad del Desarrollo)H-Index: 2
#2Ricard CorcellesH-Index: 17
Last. Antonio M. LacyH-Index: 60
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Abstract Background Advanced age is considered to be a relative contraindication to bariatric surgery because of increased perioperative risk and suboptimal excess weight loss. Objectives The aim of this study was to analyze the safety and effectiveness of the sleeve gastrectomy (SG) procedure in a cohort of elderly patients (aged≥60 yr) compared with younger patients (aged Setting Hospital clinic, Barcelona, Spain. Methods A retrospective analysis of all cases of SG in patients≥60 years old bet...
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BACKGROUND: Sarcopenia pre-dating bariatric surgery (BS) has been suggested as concern for the use of BS in older-adults with morbid obesity. OBJECTIVE: To evaluate the impact of age on the prevalence of sarcopenic obesity (SO) in BS-candidates. METHODS: Cross-sectional study including 1370 consecutive BS-candidates aged >/=18, and grouped according to age: 18-39 (reference group), 40-49, 50-59 and >/= 60 years. From body composition analysis data obtained using bioelectrical impedance, skeletal...
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#1Michelle Barrett (University of the Sunshine Coast)H-Index: 1
#2Rebecca McClure (University of the Sunshine Coast)H-Index: 2
Last. Anthony Villani (University of the Sunshine Coast)H-Index: 6
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BACKGROUND AND PURPOSE: Several biological mechanisms describing the pathway to mobility disability and functional decline in older adults with type 2 diabetes mellitus (T2DM) have been postulated, including skeletal muscle atrophy and the concurrent accumulation of fat mass. Therefore, we explored the association between adiposity, muscle strength and physical performance in community-dwelling older adults with T2DM. METHODS: Adiposity was measured by waist circumference (WC) or body fat percen...
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#1Peter R. DiMilia (Dartmouth College)H-Index: 4
#2Alexander C. Mittman (The Dartmouth Institute for Health Policy and Clinical Practice)H-Index: 1
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Purpose of Review Obesity in the older adult is a burgeoning health epidemic that leads to increased morbidity, disability, and institutionalization. This review presents a brief overview of geriatric-specific consequences of obesity by highlighting the risks and benefits of intentional weight loss.
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