title: Generalised and abdominal adiposity are important risk factors for chronic disease in older people: results from a nationally representative survey.
abstract: OBJECTIVE
  To look at the trends in prevalence of generalised (body mass index (BMI) ≥ 25 kg/m2) and abdominal obesity (waist circumference (WC) >102 cm, men; > 88 cm, women) among older people from 1993 to 2008, prevalence of chronic disease by overweight/obesity and WC categories in England 2005 and evaluate the association of these measures with chronic diseases.
  
  
  METHODS
  Analyses of nationally representative cross-sectional population surveys, the Health Survey for England (HSE).
  
  
  METHODS
  Non-institutionalised men and women aged ≥ 65 years (in HSE 2005, 1512 men and 1747 women).
  
  
  METHODS
  Height, weight, waist circumference, blood pressure measurements were taken according to standardised HSE protocols. Information collected on socio-demographic, health behaviour and doctor diagnosed health conditions.
  
  
  RESULTS
  Generalised obesity and abdominal obesity increased among men and women from 1993 to 2008. In 2005, the HSE 2005 focussed on older people. 72% of men and 68% of women aged over 65 were either overweight or obese. Prevalence of raised WC was higher in women (58%) than in men (46%). The prevalence of diabetes and arthritis was higher in people with generalised obesity in both sexes. Men were more likely to have had a joint replacement and had a higher prevalence of stroke if they were overweight only but women were more likely to have had a joint replacement only if they were obese (13%) and had a higher risk of falls with generalised obesity. The pattern was similar for the prevalence of chronic diseases by raised WC. Multivariate analysis showed that generalised and abdominal obesity was independently associated with risk of hypertension, diabetes and arthritis in both men and women. In women only, there was an association between generalised obesity and having a fall in the last year (OR: 1.5), and between abdominal obesity and having a joint replacement (OR: 1.9, p=0.01).
  
  
  CONCLUSIONS
  Complications of obesity such as diabetes, hypertension and arthritis, are more common in men and women aged over 65 who are overweight or obese, as well as in those with a raised WC. These conditions impact on morbidity, mortality and have cost implications for the health service and are known to improve with weight loss even in old age. Treatment strategies to address these conditions such as weight management and prevention of overweight and obesity are important even in older people. There is a need to ensure that older people are given appropriate advice about keeping physically active and eating sensibly.
authors.affiliation: Department of Epidemiology and Public Health, University College London Medical School, University College London, 1-19 Torrington Place, London WC1E 6BT. v.hirani@ucl.ac.uk
authors.forename: V
authors.initials: V
authors.lastname: Hirani
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D001168:Arthritis / Q000453:epidemiology / Q000209:etiology*; D015992:Body Mass Index; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D004739:England / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D007596:Joints / Q000601:surgery; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D056128:Obesity, Abdominal / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D055105:Waist Circumference