Functionality and mortality in obese nursing home residents: an example of 'risk factor paradox'?
BACKGROUND
Although the percentage of obese nursing home residents is increasing, few longitudinal studies have reported on functionality and mortality in this subpopulation. The aim of the present study was to explore functionality and mortality in obese nursing home residents during a 1-year follow-up and to compare these results with those of residents within the normal and low BMI range.


METHODS
Two hundred residents (147 female, 53 male, mean age 85.6 +/- 7.8 years) from 2 Nuremberg nursing homes were included. Body weight and height were measured in all participants. BMI was calculated and categorized as low (<20 kg/m(2)), normal (20-30 kg/m(2)), and high (>30 kg/m(2)). Handgrip strength, timed "up and go" test, and Barthel's Activities of Daily Living were applied as functional parameters. All measurements were done at baseline and after a 1-year follow-up.


RESULTS
At baseline, the prevalence of obesity was 23.5%, whereas low BMI values were present in 8.5% of the residents. After 1 year, there was no significant decline of functionality in the obese group, whereas functional parameters deteriorated significantly in study participants with normal BMI. One-year mortality was lowest in the obese (12.8%), with no deaths in residents with BMI of 35 kg/m(2) or higher. Mortality was highest in residents with low BMI (58.8%).


CONCLUSIONS
In nursing home residents, obesity is associated with increased survival and stable functionality. These observations may therefore be regarded as an expression of "risk factor paradox" in this specific population of older individuals.
Kaiser
Rebecca
R
Department of Geriatric Medicine, University of Erlangen-Nuremberg, Germany. Rebecca.Kaiser@aging.med.uni-erlangen.de
Winning
Katrin
K
Uter
Wolfgang
W
Volkert
Dorothee
D
Lesser
Stephanie
S
Stehle
Peter
P
Kaiser
Matthias J
MJ
Sieber
Cornel C
CC
Bauer
Juergen M
JM
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009043:Motor Activity; D009735:Nursing Homes; D015596:Nutrition Assessment; D009765:Obesity / Q000401:mortality*; D012307:Risk Factors; D011795:Surveys and Questionnaires