TY - JOUR
T1 - Weight Loss Interventions in Older Adults with Obesity
T2 - A Systematic Review of Randomized Controlled Trials Since 2005
AU - Batsis, John A.
AU - Gill, Lydia E.
AU - Masutani, Rebecca K.
AU - Adachi-Mejia, Anna M.
AU - Blunt, Heather B.
AU - Bagley, Pamela J.
AU - Lopez-Jimenez, Francisco
AU - Bartels, Stephen J.
N1 - Funding Information:
Presented at the American Geriatrics Society Annual Meeting, Long Beach, California, May 19 to 21, 2016. We would like to thank Patricia Erwin at Mayo Clinic Rochester for her assistance in the literature review. Conflict of Interest: None. Dr. Batsis receives funding from the Health Resources Services Administration (U1QHP28718) for medical geriatric teaching; the Junior Faculty Career Development Award, Department of Medicine, Dartmouth-Hitchcock Medical Center; and the Dartmouth Centers for Health and Aging. Dr. Bartels receives the following funding: 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; Health Resources and Services Administration U1QHP28718; NIMH: R01 MH102325, R01 MH104555, T32 MH073553. Lydia Gill is a premedical student funded by The Dartmouth Centers for Health and Aging. Rebecca Masutani is a third-year medical student funded the Medical Student Research Fellowship at the Geisel School of Medicine. Support was provided by the Dartmouth Health Promotion and Disease Prevention Research Center, supported by Cooperative Agreement U48DP005018 from the Centers for Disease Control and Prevention. The findings and conclusions in this journal article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Author Contributions: Batsis: conception and design, acquisition of data, analysis, interpretation of data; drafting the article, critical revision for important intellectual content; final approval of the version to be published. Gill: conception and design, acquisition of data, analysis, interpretation of data; critical revision for important intellectual content; final approval of the version to be published. Masutani: acquisition of data, analysis, interpretation of data; critical revision for important intellectual content; final approval of the version to be published. Adachi-Mejia: conception and design, acquisition of data, interpretation of data; critical revision for important intellectual content; final approval of the version to be published. Blunt, Bagley: conception and design, acquisition of data, critical revision for important intellectual content; final approval of the published version. Lopez-Jimenez, Bartels: conception and design, interpretation of data; critical revision for important intellectual content; final approval of the version to be published. Sponsor's Role: The funders played no role in the study design, collection, analysis, interpretation of data, writing of the report, or in the decision to submit the paper for publication. They accept no responsibility for the contents.
Publisher Copyright:
© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society
PY - 2017/2/1
Y1 - 2017/2/1
N2 - 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/m2). 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.
AB - 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/m2). 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.
KW - interventions
KW - obesity
KW - systematic review
KW - weight loss
UR - http://www.scopus.com/inward/record.url?scp=84992496501&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992496501&partnerID=8YFLogxK
U2 - 10.1111/jgs.14514
DO - 10.1111/jgs.14514
M3 - Article
C2 - 27641543
AN - SCOPUS:84992496501
SN - 0002-8614
VL - 65
SP - 257
EP - 268
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 2
ER -