Older Obese Have Better Heart Health, Worse Function

­­Cardiovascular health has improved in older obese people in the United States, according to a study in the November 7, 2007, issue of The Journal of the American Medical Association (2007; 298 [17], 2020–27). Recent research has suggested that this population may have grown healthier since the 1960s, with the prevalence of high cholesterol and high blood pressure declining. However, the older obese still have more impaired functional abilities than their nonobese counterparts.

Researchers analyzed data from two National Health and Nutrition Exam­ination Surveys (NHANES III [1988–1994] and NHANES 1999–2004). The surveys included almost 10,000 adults aged 60 years or older. Participants were asked whether it was difficult or impossible for them to perform certain functional tasks (walking a quarter of a mile, walking up 10 steps, stooping, lifting 10 pounds, walking between rooms and standing from an armless chair) and various activities of daily living, or ADL (getting in and out of bed, eating and dressing).

The results showed that the prevalence of obesity (indicated by a BMI ≥ 30) increased by 8.2 percentage points over time, from 23.5% of those 60 or older in 1988–1994 (time 1) to 31.7% in 1999–2004 (time 2). During both time ranges, obese subjects were more likely than normal-weight individuals to be functionally impaired. During time 2, obese individuals were also more likely to have ADL challenges. A broader look at trends over time showed that the prevalence of functional impairment did not change significantly among normal-weight individuals, but it increased among obese individuals by 5.4%, from 36.8% to 42.2%.

“Obese participants in NHANES 1999–2004 were more likely to report functional impairments than obese participants in NHANES III (1988–1994), which suggests an increasing risk of disability in the obese population,” the authors stated in a press release. “Further­more, reductions in ADL disability observed among nonobese older individuals did not occur among obese individuals. Taken together, these findings suggest that recent improvements in cardio­vascular health have not been accompanied by a reduction in disability burden among obese individuals; instead, the risk of some types of disability is actually increasing.”