Overweight and obesity and the burden of disease and disability in elderly men

OBJECTIVE: To examine the prevalence of disease burden and disability associated with overweight and obesity in men aged 60 - 79 y and to assess whether the current WHO weight guidelines are appropriate in the elderly. DESIGN: Cross-sectional survey 20 y after enrolment. SETTING: General practices in 24 British towns. PARTICIPANTS: In total, 4232 men aged 60 - 79 y (77% of survivors) with measured weight and height. MAIN OUTCOME MEASURES: Cardiovascular ( CV) risk factors, prevalence of diabetes, cardiovascular disease, cancer, disability and regular medication. RESULTS: In total, 17% of the men were obese (body mass index (BMI) greater than or equal to30 kg/m(2)) and a further 52% were overweight (BMI 25 - 29.9 kg/m(2)). Prevalence of hypertension, low HDL-cholesterol, high triglycerides and insulin resistance and the prevalence of most disease outcomes increased with increasing degrees of overweight/ obesity. Men in the normal weight range (18.5-24.9 kg/m(2)) had the lowest prevalence of ill health. Compared with normal weight men, obese men showed a two-fold risk of major CVD (odds ratio (OR) = 1.96, 95% CI 1.44 - 2.67) and locomotor disability (OR = 2.26, 95% CI 1.66, 3.09) and were nearly three times as likely to have diabetes, CV interventions or to be on CV medication. Over 60% of the prevalence of high insulin resistance was attributable to overweight and obesity as was over a third of diabetes and hypertension, a quarter of locomotor disability and a fifth of major CVD. CONCLUSION: In elderly men, overweight and obesity are associated with a significantly increased burden of disease, in particular CV-related disorders and disability. The current guidelines for overweight and obesity appear to be appropriate in elderly men.