title: Obesity and the risk of disability in a 12-year cohort study: the role of psychological distress.
abstract: OBJECTIVE
  Recent cross-sectional findings suggest that co-occurring obesity and psychological problems amplify the risk of disability, but longitudinal evidence is lacking. We assessed this effect in a longitudinal cohort of adults.
  
  
  METHODS
  Twelve years of data (1994/1995-2006/2007) were obtained from the Canadian National Population Health Survey. This study followed 8,062 adults that were interviewed every 2 years. Disability status was derived from the Health Utility Index Mark 3. Covariates of interest were repeated psychological distress (Kessler K6 scale) and obesity (body mass index ≥30). Incidence of disability was estimated from Cox proportional hazards models, adjusting for sociodemographic and health variables. Hazard rate of disability in those with either obesity (n = 955) or distress (n = 1,044), or both (n = 138) were compared to those without (n = 5,925).
  
  
  RESULTS
  Participants with both obesity and repeated distress had double the risk of disability compared to those with obesity or distress alone {adjusted hazard ratio of 2.8 [95% confidence interval (CI) 1.8, 4.5] compared to 1.4 (CI 1.1, 1.8) and 1.8 (CI 1.4, 2.3), respectively}.
  
  
  CONCLUSIONS
  Recurrent psychological distress combined with obesity amplified the risk for disability normally associated with these conditions.
authors.affiliation: Douglas Mental Health University Institute, McGill University, 6875, LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Gariepy
authors.forename: Jianli
authors.initials: J
authors.lastname: Wang
authors.forename: Alain
authors.initials: A
authors.lastname: Lesage
authors.forename: Norbert
authors.initials: N
authors.lastname: Schmitz
mesh_terms: D000328:Adult; D002170:Canada; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D016016:Proportional Hazards Models; D018570:Risk Assessment; D013315:Stress, Psychological / Q000453:epidemiology*