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Adipositas im Alter

Klinische Relevanz und Therapieoptionen

Obesity in the elderly

Clinical relevance and therapy options

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Zusammenfassung

Die Prävalenz von Übergewicht und Adipositas nimmt auch in der älteren Bevölkerung zu. Aus epidemiologischen Untersuchungen geht hervor, dass das Körpergewicht während des Erwachsenenalters kontinuierlich ansteigt mit Spitzenwerten um das 65. Lebensjahr und einer Tendenz zur Abnahme des altersbezogenen Durchschnittsgewichts bei Höherbetagten. Übergewicht und Adipositas korrelieren vor allem mit einer Zunahme des kardiometabolischen Risikos, aber auch orthopädischer Problemen, funktioneller Einschränkungen und Immobilität. Das Mortalitätsrisiko steigt bei älteren Menschen erst im Adipositasbereich an. Eine Gewichtsreduktion bei älteren Patienten wird deshalb bei einer Adipositas mit beeinträchtigenden Komorbiditäten empfohlen. Als primäres Behandlungsziel gilt die Verbesserung der Lebensqualität. Die Kombination von Ernährungsempfehlungen und einem individuell angepassten Bewegungsprogramm ist von Vorteil, um das Risiko der Entwicklung einer Malnutrition, Sarkopenie und Osteoporose zur verringern. Für medikamentöse Therapieformen zur Gewichtsreduktion bei Adipositas liegt keine Studienevidenz für ältere Patienten vor.

Abstract

The prevalence of obesity is increasing, also in the elderly population. During advancing age in adulthood body weight continues to increase up to peak values at about 65 years of age followed by a decline in older age. Overweight and obesity are related to an increase in the cardiometabolic risk, but also to an increased incidence of degenerative joint disease, functional limitations, and immobility. An increase in mortality risk was demonstrated for BMI values > 30 kg/m2, which are in the range of obesity. It is therefore suggested to consider weight reduction in obese elderly primarily with respect to weight-related comorbidities and functional limitations that may benefit from weight loss. The central aim of weight loss in the obese elderly is to improve quality of life. Nutritional recommendations combined with individually adapted exercise programs are helpful to prevent malnutrition, sarcopenia, and osteoporosis. No data are available about the safety of drug therapy for weight reduction in the elderly.

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  1. Abteilung für Innere Medizin, Landeskrankenhaus Hochzirl, Anna-Dengel-Haus, 6170, Zirl, Österreich

    M. Lechleitner

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Lechleitner, M. Adipositas im Alter. Z Gerontol Geriat 46, 398–402 (2013). https://doi.org/10.1007/s00391-013-0511-y

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  • DOI: https://doi.org/10.1007/s00391-013-0511-y

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