jueves, 9 de enero de 2014

Obesidad en el anciano/Obesity in the elderly

Malnutrición en el anciano. Parte II: obesidad, la nueva pandemia


Tania García Zenón, José Antonio Villalobos Silva
Med Int Mex 2012;28(2):154-161
En las últimas décadas se ha incrementado el número de casos de obesidad en todas las edades, incluidos los ancianos. Además de su conocida asociación con: enfermedad cardiovascular, diabetes, hipertensión, dislipidemia, y diversos cánceres, la obesidad también se relaciona con incremento del riesgo de discapacidad física y cognitiva. La edad, por sí misma, no debe contraindicar el tratamiento de la obesidad, siempre y cuando se asegure que cualquier programa de reducción de peso debe minimizar la posibilidad de efectos adversos en la masa muscular, densidad ósea y otros aspecto
http://www.revistasmedicasmexicanas.com.mx/download/med%20interna/2012/Marzo-Abril/Medicina%20Interna%202.9%20Malnutricion.pdf



Obesidad en el anciano: Más complicado de lo que Usted cree

Obesity in the elderly:More complicated than you think
DERRICK C. CETIN, GAELLE NASR
CLEVELAND CLINIC JOURNAL OF MEDICINE VOLUME 81 * NUMBER 1 JANUARY 2014
Abstract
The number of obese older adults is on the rise, although we lack a proper definition of obesity in this age group. The ambiguity is primarily related to sarcopenia, the progressive loss of muscle and gain in fat that come with aging. Whether to treat and how to treat obesity in the elderly is controversial because of a paucity of established guidelines, but also because of the obesity paradox-ie, the apparently protective effect of obesity in this age group.

http://www.ccjm.org/content/81/1/51.full.pdf

http://www.ccjm.org/content/81/1/51.full.pdf


La obesidad visceral no es un factor de riesgo independiente de mortalidad en sujetos mayores de 65 años
Visceral obesity is not an independent risk factor of mortality in subjects over 65 years.
Thomas F, Pannier B, Benetos A, Vischer UM.
Author information
Vasc Health Risk Manag. 2013;9:739-45. doi: 10.2147/VHRM.S49922. Epub 2013 Nov 22.
Abstract
The aim of the study was to determine the role of obesity evaluated by body mass index (BMI), waist circumference (WC), and their combined effect on all-cause mortality according to age and related risk factors. This study included 119,090 subjects (79,325 men and 39,765 women), aged from 17 years to 85 years, who had a general health checkup at the Centre d'Investigations Préventives et Cliniques, Paris, France. The mean follow-up was 5.6±2.4 years. The prevalence of obesity, defined by WC and BMI categories, was determined according to age groups (<55, 55-65, >65 years). All-cause mortality according to obesity and age was determined using Cox regression analysis, adjusted for related risk factors and previous cardiovascular events. For the entire population, WC adjusted for BMI, an index of central obesity, was strongly associated with mortality, even after adjustment for hypertension, dyslipidemia, and diabetes. The prevalence of obesity increased with age, notably when defined by WC. Nonetheless, the association between WC adjusted for BMI and mortality was not observed in subjects>65 years old (hazard ratio [HR]=1.010, P=NS) but was found in subjects<55 (HR=1.030, P<0.0001) and 55-65 years old (HR=1.023, P<0.05). By contrast, hypertension (HR=1.31, P<0.05), previous cardiovascular events (HR=1.98, P<0.05), and smoking (HR=1.33, P<0.05) remained associated with mortality even after age 65. In conclusion, WC adjusted for BMI is strongly and independently associated with all-cause mortality before 65 years of age, after taking into account the associated risk factors. This relationship disappears in subjects>65 years of age, suggesting a differential impact of visceral fat deposition according to age.
KEYWORDS: abdominal, aging, body mass index, hypertension, smoking

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3839799/pdf/vhrm-9-739.pdf


Asociación de IMC con la causa específica de muerte en ancianos chinos hipertensos

Association of body mass index with cause specific deaths in Chinese elderly hypertensive patients: Minhang community study.
Wang Y, Wang Y, Qain Y, Zhang J, Tang X, Sun J, Zhu D.
PLoS One. 2013 Aug 13;8(8):e71223. doi: 10.1371/journal.pone.0071223. eCollection 2013.
Abstract
BACKGROUND: Most studies have suggested that elevated body mass index (BMI) was associated with the risk of death from all cause and from specific causes. However, there was little evidence illustrating the effect of BMI on the mortality in elderly hypertensive patients in Chinese population. METHODS: The information of 10,957 hypertensive patients at baseline not less than 60 years were from Xinzhuang, a town in Minhang district of Shanghai, was extracted from the Electronic Health Record (EHR) system. All study participants were divided into eight categories of baseline BMI (with cut-points at 18, 20, 22, 24, 26, 28 and 30 kg/m(2)). Relative hazard ratio of death from all cause, cardiovascular and non-cardiovascular cause by baseline BMI groups were calculated, standardized for sex, age, smoking, drinking, physical activity, systolic blood pressure, history of cardiovascular disorders, serum lipid disturbance, diabetes mellitus and antihypertensive drug treatment. RESULTS: DURING FOLLOW UP (MEDIAN: 3.7 years), 561 deaths occurred. Underweight (BMI<18 kg/m(2)) was associated with significantly increased mortality from all cause mortality (OR: 2.00; 95% CI: 1.43-2.79) and non cardiovascular mortality (OR: 2.76; 95% CI: 1.87-4.07), but not with cardiovascular mortality. For the cause specific analysis, the underweight was associated significantly with neoplasms (OR: 2.15; 95% CI: 1.16-4.00) and respiratory disorders (OR: 3.41; 95% CI: 1.64-7.06). The results for total mortality and specific cause mortality were not influenced by sex, age and smoking status. CONCLUSION: Our study revealed an association between underweight and increased mortality from non-cardiovascular disorders in elderlyhypertensive patients in Chinese community. Overweight and obesity were not associated with all cause or cause specific death.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3742783/pdf/pone.0071223.pdf


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Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

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