title: Assessing the association of obesity and asthma morbidity in older adults.
abstract: Obesity is a robust predictor of poor asthma control in younger adults. Given the high prevalence of asthma and obesity in older Americans, weight reduction could benefit asthma management in this population.
  
  
  
  To assess the association between obesity and asthma outcomes among older adults.
  
  
  
  We recruited from urban primary care clinics a prospective cohort of nonsmoking individuals with asthma who were 60 years or older without a history of other respiratory diseases. At baseline, body mass index (BMI) measurements were classified as normal (BMI, 18-25), overweight (BMI, 25-30), or obese (BMI, >30). Measures of asthma morbidity (Asthma Control Questionnaire [ACQ], and Mini Asthma Quality of Life Questionnaire [Mini-AQLQ]) and asthma-related resource utilization (inpatient or outpatient) were taken at baseline and at 3- and 12-month interviews. We used generalized estimating equation models to assess associations between obesity and asthma outcomes after controlling for potential confounders.
  
  
  
  Of the 437 older adults with asthma in the study, 17% had a normal BMI, 32% were overweight, and 51% were obese. Unadjusted analyses revealed that obesity was associated with lower ACQ scores (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.09-1.31) and poorer Mini-AQLQ scores (OR, 1.21; 95% CI, 1.11-1.33). Adjusted analyses revealed no significant association between obesity and ACQ (OR, 1.05; 95% CI, 0.96-1.15) and Mini-AQLQ (OR, 1.08; 95% CI, 0.99-1.19).
  
  
  
  Our study suggests that obesity is not independently associated with worse asthma outcomes in older adults, reflecting potential differences in the mechanisms that link obesity with asthma control in older vs younger populations.
authors.affiliation: Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York; Graduate Program in Public Health, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Kevin Y
authors.initials: KY
authors.lastname: Xu
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Wisnivesky
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Melissa
authors.initials: M
authors.lastname: Martynenko
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Grace
authors.initials: G
authors.lastname: Mhango
authors.affiliation: Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Busse
authors.affiliation: Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Fernando
authors.initials: F
authors.lastname: Holguin
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: alex.federman@mountsinai.org.
authors.forename: Alex D
authors.initials: AD
authors.lastname: Federman
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009765:Obesity / Q000453:epidemiology*; D063868:Patient Outcome Assessment; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires