Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 65, Issue 2, Pages 257-268Publisher
WILEY
DOI: 10.1111/jgs.14514
Keywords
obesity; weight loss; interventions; systematic review
Categories
Funding
- Health Resources Services Administration [U1QHP28718]
- Junior Faculty Career Development Award, Department of Medicine, Dartmouth-Hitchcock Medical Center
- Dartmouth Centers for Health and Aging
- National Institute of Mental Health (NIMH) [K12 HS021695]
- National Institutes of Health, National Center for Advancing Translational Sciences [1KL2TR001088]
- Centers for Disease Control and Prevention [U4DP005018, U48DP005018]
- Health Resources and Services Administration [U1QHP28718]
- NIMH [R01 MH102325, R01 MH104555, T32 MH073553]
- Medical Student Research Fellowship at the Geisel School of Medicine
- Dartmouth Health Promotion and Disease Prevention Research Center
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OBJECTIVES: To identify geriatric obesity interventions that can guide clinical recommendations. DESIGN: Systematic review using Medline (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, EMBASE (Ovid), and PsycINFO (Proquest) from January 1, 2005, to October 12, 2015, to identify English-language randomized controlled trials. PARTICIPANTS: Individuals aged 60 and older (mean age = 65) and classified as having obesity (body mass index = 30 kg/m(2)). INTERVENTIONS: Behavioral weight loss interventions not involving pharmacological or procedural therapies lasting 6 months or longer. MEASUREMENTS: Two investigators performed the systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and achieved a high concordance rate (97.3%) in summarizing the primary outcomes. The three primary outcomes were weight loss, physical performance, and quality of life. RESULTS: Of 5,741 citations, 19 were included. (Six studies were unique, and the remaining 13 were based on the same study population.) Duration ranged from 6 to 18 months (n = 405 participants, age range 66.7-71.1). Weight loss in the intervention groups ranged from 0.5 to 10.7 kg (0.1-9.3%). Five studies had a resistance exercise program accompanying a dietary component. Greater weight loss was observed in groups with a dietary component than those with exercise alone. Exercise alone led to better physical function but no significant weight loss. Combined dietary and exercise components led to the greatest improvement in physical performance measures and quality of life and mitigated reductions in muscle and bone mass observed in diet-only study arms. Heterogeneous outcomes were observed, which limited the ability to synthesize the data quantitatively. CONCLUSIONS: The evidence supporting geriatric obesity interventions to improve physical function and quality of life is of low to moderate quality. Well-designed trials are needed in this population.
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