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For Older Adults, "Overweight" May Be Healthy

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Middle-aged adults who are overweight or obese are more likely to develop health problems like diabetes, and disabilities, and to die earlier than middle-aged adults with lower, "normal" weights. But this may not be true of older adults.

Some studies, in fact, suggest that older people who are overweight may be just as healthy, or even healthier, and live just as long, or longer, than those who are normal weight. In addition, some research suggests that older people who are underweight are the most likely to develop health problems and disabilities and to die younger.

Building on the ACE approach, researchers at the Indiana University School of Medicine, the Indiana University Center for Aging Research, and the Regenstrief Institute Inc., designed a home-based, coordinated team approach to caring for poor older adults. The approach is known as the Geriatric Resources for Assessment and Care of Elders (GRACE) model of care.

Healthcare providers usually urge overweight patients to try to slim down. But this research suggests that that may not be the healthiest thing for older people to do. It might, in fact, make more sense for providers to focus their attention, instead, on underweight older people, who may benefit from gaining weight.

New Research in the Journal of the American Geriatrics Society
To get a better sense of how weight affects lifespan and health in late life, researchers recently studied the health records of nearly 5,900 older Americans, enrolled in the Cardiovascular Health Study. All of the older adults were in a roughly 10-year-long study.

Among other things, these older adults had their weight and height measured each year of the study. They were also asked, each year, whether they would rate their health as "excellent," "very good," "good," "fair," or "poor." And they were asked if they had any problems with daily activities – such as walking, getting out of bed, or bathing.

Using this information and methods for estimating future weight and health, and lifespan, the researchers found that even adults who were normal weight at age 65 were likely to become overweight or obese as they get older.

But being overweight in late life wasn’t necessarily a bad thing, they discovered. In fact, older adults who were overweight -- and even some who were obese -- were no less healthy or more likely to die earlier or have disabilities than those who were normal weight. In some ways, they were actually healthier than normal-weight older adults, the researchers found.

Like other scientists, these researchers also found that underweight older adults were more likely to have poor health, disabilities, and die earlier than others.

"This paper supports the idea that guidelines for weight should be age-appropriate, not "one size fits all,"" they write. "Older adults who are overweight…may be at a healthy weight for their age," the researchers conclude, suggesting that healthcare providers focus more on the dangers of underweight among older people.

The summary above is from the full report titled, "Weight, Mortality, Years of Healthy Life and Active Life Expectancy in Older Adults." It is in the January 2008 issue of the Journal of the American Geriatrics Society (Volume 56, Issue 1). The report is authored by Paula Diehr, PhD, Ellen S. O’Meara, PhD, Annette Fitzpatrick, PhD, Anne B. Newman, MD, MPH, Lewis Kuller, MD, and Gregory Burke, MD, MS.