title: Impacts of mobility disability and high and increasing body mass index on health-related quality of life and participation in society: a population-based cohort study from Sweden.
abstract: BACKGROUND
  Increasing obesity in adults with mobility disability has become a considerable health problem, similar to the increasing trend of obesity in the general population. The aims of this study were to investigate the association of mobility disability with overweight status and obesity in a large population-based Swedish cohort of adults, and to investigate whether mobility disability, high body mass index (BMI), and increasing BMI over time are predictors of health-related quality of life and participation in society after 8 years of follow-up.
  
  
  METHODS
  The study cohort included 13,549 individuals aged 18-64 years who answered questions about mobility disability, weight, height, health-related quality of life and participation in society in the Stockholm Public Health Survey 2002 and 2010. The cohort was randomly selected from the population of Stockholm County, and divided into six subgroups based on data for mobility disability and overweight status. Multiple binary logistic regression analyses were performed to assess the likelihood for low health-related quality of life and lack of participation.
  
  
  RESULTS
  Respondents with mobility disability had a higher mean BMI than those without mobility disability. Respondents both with and without mobility disability increased in BMI, but with no significant difference in the longitudinal changes (mean difference: 0.078; 95% CI: -0.16 - 0.32). Presence of mobility disability increased the risk of low health-related quality of life and lack of participation in 2010, irrespective of low health-related quality of life and lack of participation in 2002. The risk of pain and low general health (parts of health-related quality of life) increased for every 5 units of higher BMI reported in 2010. In respondents without low general health at baseline, the risk of obtaining low general health increased for every 5 units of higher BMI in 2010 (OR:1.60; CI: 1.47 - 1.74).
  
  
  CONCLUSIONS
  The greatest risk of low general health after 8 years was observed for respondents with both mobility disability and high BMI. These results indicate the importance of working preventively with persons with mobility disability and overweight status or obesity based on the risk of further weight gain.
authors.affiliation: The Swedish Institute for Health Sciences, Department of Health Sciences, Lund University, P,O, Box 187, SE-221 00 Lund, Sweden. Marianne.Holmgren@med.lu.se.
authors.forename: Marianne
authors.initials: M
authors.lastname: Holmgren
authors.forename: Anna
authors.initials: A
authors.lastname: Lindgren
authors.forename: Jeroen
authors.initials: J
authors.lastname: de Munter
authors.forename: Finn
authors.initials: F
authors.lastname: Rasmussen
authors.forename: Gerd
authors.initials: G
authors.lastname: Ahlström
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D006233:Persons with Disabilities; D005260:Female; D006262:Health; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009765:Obesity / Q000150:complications*; D050177:Overweight; D010146:Pain / Q000150:complications; D011788:Quality of Life; D013548:Sweden; D015430:Weight Gain; D055815:Young Adult
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