Overweight and obesity and the burden of disease and disability in elderly men.
OBJECTIVE
To examine the prevalence of disease burden and disability associated with overweight and obesity in men aged 60-79 y and to assess whether the current WHO weight guidelines are appropriate in the elderly.


METHODS
Cross-sectional survey 20 y after enrollment.


METHODS
General practices in 24 British towns.


METHODS
In total, 4232 men aged 60-79 y (77% of survivors) with measured weight and height.


METHODS
Cardiovascular (CV) risk factors, prevalence of diabetes, cardiovascular disease, cancer, disability and regular medication.


RESULTS
In total, 17% of the men were obese (body mass index (BMI) >/=30 kg/m(2)) and a further 52% were overweight (BMI 25-29.9 kg/m(2)). Prevalence of hypertension, low HDL-cholesterol, high triglycerides and insulin resistance and the prevalence of most disease outcomes increased with increasing degrees of overweight/obesity. Men in the normal weight range (18.5-24.9 kg/m(2)) had the lowest prevalence of ill health. Compared with normal weight men, obese men showed a two-fold risk of major CVD (odds ratio (OR)=1.96, 95% CI 1.44-2.67) and locomotor disability (OR=2.26, 95% CI 1.66, 3.09) and were nearly three times as likely to have diabetes, CV interventions or to be on CV medication. Over 60% of the prevalence of high insulin resistance was attributable to overweight and obesity as was over a third of diabetes and hypertension, a quarter of locomotor disability and a fifth of major CVD.


CONCLUSIONS
In elderly men, overweight and obesity are associated with a significantly increased burden of disease, in particular CV-related disorders and disability. The current guidelines for overweight and obesity appear to be appropriate in elderly men.
Goya Wannamethee
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Department of Primary Care and Population Science, Royal Free and University College Medical School, London, UK. goya@pcps.ucl.ac.uk
Gerald Shaper
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Whincup
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Walker
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D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000209:etiology; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012307:Risk Factors