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Independent contribution of overweight/obesity and physical inactivity to lower health-related quality of life in community-dwelling older subjects

Unabhängiger Einfluss von Übergewicht/Korpulenz und geringer Bewegungsaktivität auf die Gesundheit und Lebensqualität älterer Personen, die zu Hause leben

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Abstract

The study examined the association of nutritional status, obesity and physical activity (PA) with health-related quality of life (HRQL) in the elderly, and whether this relationship persists after controlling for confounders attributable to comorbidities, functional status and cognitive function. A total of 300 community-dwelling persons (177 women and 123 men) between 66 and 79 years of age were randomly chosen from all inhabitants of one district of the city of Lodz (Poland). HRQL was assessed with the Euroqol 5D questionnaire. PA was assessed by two questionnaires: the Seven Day Recall PA Questionnaire and the Stanford Usual Activity Questionnaire. Comorbidities, nutritional state (Mini Nutritional Assessment questionnaire – MNA), physical disability, cognitive function and psychological state were also assessed. In bivariate relationships body mass index (BMI), waist-to-hip ratio (WHR) and the percentage of body fat were negatively related to several HRQL scores both in women and men. Similarly, many HRQL scores were positively related to PA indices in both genders. In multivariate relationships, after adjustments for age, gender, smoking status, number of medications taken, comorbidities and geriatric physical and cognitive function, BMI predicted lower mobility while the percentage of body fat independently contributed to more frequent pain/discomfort and anxiety/depression problems. An adequate MNA added to a higher usual activity score, while a higher Stanford Moderate PA Index predicted better overall perceived health state. These results indicate that excess body fatness and sedentary lifestyle have, together with several functional and medical comorbidities, an independent contribution to inferior HRQL in communitydwelling older subjects.

Zusammenfassung

Die Untersuchung prüfte den Einfluss des Ernährungszustandes, des Übergewichts und der Bewegungsaktivität auf Gesundheit und Lebensqualität (HRQL) bei älteren Personen, und ob dieser Zusammenhang weiter besteht, wenn die Störungen eliminiert werden, die mit dem begleitend auftretenden Krankheiten, dem funktionellen Zustand und der Erkenntnisfunktionen verbunden sind. An der Untersuchung nahmen 300 durch Los ausgewählte ältere (177 weibliche und 123 männliche) zu Hause lebende Einwohner der Stadt Lodz im Alter von 66 bis 79 teil. Gesundheit und Lebensqualität wurden mittels Euroqol 5DFragebogen beurteilt. Die Bewegungsaktivität wurde aufgrund zweier Fragebögen bewertet: Dem siebentägigen Fragebogen über die Bewegungsaktivität (SDPAR) und dem Fragebogen über die gewöhnlichen Tätigkeiten (Stanford Usual Activity Questionnaire). Der Ernährungszustand wurde gemäß der MNA-Skala (Mini Nutritional Assessment) eingeschätzt. Der Beurteilung unterlagen ebenfalls: begleitende Auftreten von Krankheiten, Behinderungen, die funktionelle Leistungsfähigkeit und der psychische Zustand der Gefragten. In der einfaktoriellen Analyse der Varianten ANOVA, BMI, waren die Kennziffer des Umfangs der Taille und Hüften (WHR), und der prozentuale Gehalt an Fettgewebe entsprechend reziprok zu manchen Ergebnissen der Lebensqualität sowohl bei den Frauen als auch bei den Männern. Eine ähnlich große Zahl von Ergebnissen dieser Lebensqualität wies eine proportionale (positive) Abhängigkeit von den Kennzahlen der physischen Aktivität für beide Geschlechter aus. In der multifaktoriellen Analyse, unter Berücksichtigung von Alter, Geschlecht, Rauchen, der Menge von eingenommenen Arzneimitteln, sowie der psychischen und körperlichen Aktivität, beeinträchtigte der BMI die Mobilität (Beweglichkeit). Der prozentuelle Gehalt des Fettgewebes dagegen beeinflusste ein öfteres Schmerzempfinden/Discomfort bzw. Unruhe/Depression. Die entsprechende Beurteilung des Ernährungszustandes MNA verursachte ein höheres Aktivitätsergebnis als gewöhnlich, wobei der höhere ‘Stanfort Moderater PA-Koeffizient’ den besseren allgemeinen Gesundheitszustand bestimmte. Diese Ergebnisse bedeuten, dass das Übergewicht und die sitzende Lebensweise samt funktionell und medizinisch begleitenden Auftreten von Krankheiten einen unabhängigen Einfluss auf die Gesundheit und Lebensqualität der zu Hause lebenden älteren Personen haben.

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Kostka, T., Bogus, K. Independent contribution of overweight/obesity and physical inactivity to lower health-related quality of life in community-dwelling older subjects. Z Gerontol Geriatr 40, 43–51 (2007). https://doi.org/10.1007/s00391-006-0374-6

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