Weight Loss Interventions in Older Adults with Obesity: A Systematic Review of Randomized Controlled Trials Since 2005

被引:101
作者
Batsis, John A. [1 ,2 ,3 ,4 ,5 ,6 ,7 ]
Gill, Lydia E. [4 ,5 ,6 ]
Masutani, Rebecca K. [3 ,4 ,5 ]
Adachi-Mejia, Anna M. [3 ,6 ,7 ]
Blunt, Heather B. [8 ]
Bagley, Pamela J. [8 ]
Lopez-Jimenez, Francisco [9 ]
Bartels, Stephen J. [3 ,4 ,5 ,6 ,7 ]
机构
[1] Dartmouth Hitchcock Med Ctr, Sect Gen Internal Med, Lebanon, NH 03766 USA
[2] Dartmouth Hitchcock Med Ctr, Weight & Wellness Ctr, Lebanon, NH 03766 USA
[3] Dartmouth Coll, Geisel Sch Med Dartmouth, 1 Med Ctr Dr, Lebanon, NH 03756 USA
[4] Dartmouth Coll, Dartmouth Ctr Hlth, 1 Med Ctr Dr, Lebanon, NH 03756 USA
[5] Dartmouth Coll, Dartmouth Ctr Aging, 1 Med Ctr Dr, Lebanon, NH 03756 USA
[6] Dartmouth Inst Hlth Policy & Clin Practice, Lebanon, NH USA
[7] Hlth Promot Res Ctr Dartmouth, Lebanon, NH USA
[8] Dartmouth Coll, Biomed Lib, Hanover, NH 03755 USA
[9] Mayo Clin, Dept Med, Div Cardiovasc Dis, Rochester, MN USA
基金
美国国家卫生研究院;
关键词
obesity; weight loss; interventions; systematic review; LIFE-STYLE INTERVENTION; QUALITY-OF-LIFE; PHYSICAL-ACTIVITY; FUNCTIONAL DECLINE; BARIATRIC SURGERY; BODY-COMPOSITION; RISK-FACTORS; MUSCLE MASS; EXERCISE; OVERWEIGHT;
D O I
10.1111/jgs.14514
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
030301 [社会学]; 100201 [内科学];
摘要
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.
引用
收藏
页码:257 / 268
页数:12
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