Increasing body weight and risk of limitations in activities of daily living: a systematic review and meta-analysis.
This study examined the relationship between normal weight, overweight and obesity class I and II+, and the risk of disability, which is defined as impairment in activities of daily living (ADL). Systematic searching of the literature identified eight cross-sectional studies and four longitudinal studies that were comparable for meta-analysis. An additional four cross-sectional studies and one longitudinal study were included for qualitative review. Results from the meta-analysis of cross-sectional studies revealed a graded increase in the risk of ADL limitations from overweight (1.04, 95% confidence interval [CI] 1.00-1.08), class I obesity (1.16, 95% CI 1.11-1.21) and class II+ obesity (1.76, 95% CI 1.28-2.41), relative to normal weight. Meta-analyses of longitudinal studies revealed a similar graded relationship; however, the magnitude of this relationship was slightly greater for all body mass index categories. Qualitative analysis of studies that met the inclusion criteria but were not compatible for meta-analysis supported the pooled results. No studies identified met all of the pre-defined quality criteria, and subgroup analysis was inhibited due to insufficient comparable studies. We conclude that increasing body weight increases the risk of disability in a graded manner, but also emphasize the need for additional studies using contemporary longitudinal cohorts with large numbers of obese class III individuals, a range of ages and with measured height and weight, and incident ADL questions.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. kathryn.backholer@bakeridi.edu.au
K
K
Backholer
E
E
Wong
R
R
Freak-Poli
H L
HL
Walls
A
A
Peeters
D000203:Activities of Daily Living; D015992:Body Mass Index; D017281:Cost of Illness; D006233:Persons with Disabilities; D006801:Humans; D009765:Obesity / Q000145:classification / Q000150:complications* / Q000473:pathology; D012720:Severity of Illness Index; D015430:Weight Gain / Q000502:physiology*