מתוך medicontext.co.il
By Karla Gale
WESTPORT, CT (Reuters Health) – Even a small amount of weight loss is associated with increased risk of mortality in older individuals, a new study shows.
"Older people tend to have a decreased appetite and to become less active, and they just start to fade away," Dr. Anne B. Newman told Reuters Health. "I think that is what we were seeing here, an early slipping into frailty."
Dr. Newman, of the University of Pittsburgh in Pennsylvania, and associates assessed weight changes over a 3-year period among 4714 community-dwelling individuals over the age of 64. As reported in the October issue of the Journal of the American Geriatrics Society, weight loss of at least 5% was observed in 16.2% of men and 18.7% of women.
The age- and gender-adjusted hazard ratio regarding mortality for weight loss was 2.09 in subjects with weight loss compared with those whose weight remained stable. For those who gained weight, the hazard ratio was 1.11.
The risk of mortality did not decline among those whose weight loss was attributed to dieting. Even after excluding those who had been hospitalized or were newly diagnosed with cardiovascular disease or cancer, the researchers found that the hazard ratio was 2.22 for those who lost weight. "Those with weight loss are on a trajectory of decline, even those without any of the most common serious health events," the authors write.
"Older people are at risk of losing more of their strength and their health with dieting," Dr. Newman pointed out. "It's absolutely critical that weight loss or weight control be based on increasing activity rather than cutting the calories. "
She added that the elderly tend to consume fewer calories than younger people. "So if they cut calories more than they are already, they're going to miss key nutrients and vitamins," she said.
Dr. Newman's group recommends that weight should be monitored closely in elderly individuals, "including in those who are thin or appear to be at ideal weight."
If weight loss exceeds 5% or 10% in 6 months, then a full physical exam is in order, Dr. Newman said. For more subtle weight loss, she recommended "a similar approach, but with more attention on issues such as appetite, ability to get food, ability to chew, and having other people to eat with."
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