Obesity rise linked to disability increase among elderly in Latin America and the Caribbean

The UTMB study drew on data from a Pan-American Health Organization and National Institute on Aging survey that covered more than 6,000 people over age 65 in six cities: Bridgetown, Barbados; São Paulo, Brazil; Santiago, Chile; Havana, Cuba; Mexico City, Mexico; and Montevideo, Uruguay. Across the board, the investigators found that obese seniors were more likely to have significant trouble walking, bathing, dressing, eating, getting in and out of bed and using the toilet.

In this survey, a subject was defined as obese if he or she had a body mass index (weight in kilograms divided by height in meters squared) equal or greater than 30.

"This greater prevalence of obesity is a new thing in Latin America and the Caribbean, the result of people moving from rural to urban areas and shifting their nutritional habits and other aspects of their lives to a more Western pattern," said UTMB assistant professor Soham al Snih, lead author of "Obesity and Disability: Relation Among Older Adults Living in Latin America and the Caribbean," which appeared in the June 15 issue of the American Journal of Epidemiology. "At the same time, we're seeing a substantial increase in life expectancy. The close relationship that we found between obesity and disability in older adults suggests that we really need to work to prevent these populations from becoming obese."

Without major efforts to promote healthy eating and exercise in Latin American and Caribbean populations, al Snih said, current trends will produce large numbers of people who are especially vulnerable to chronic medical conditions such as diabetes, cardiovascular disease and arthritis -- conditions that could increase the degree of disability among the elderly, and which will severely strain the health care resources of poorer countries.

"We need to reorient people to better nutrition, we need to screen for these diseases and do as much as we can to prevent them, and we need to involve these populations in exercise and increase their activity level," al Snih said. "It's very important, because otherwise it will cost much more in the long run."

In addition to highlighting the connection between increasing obesity rates and increasing disability among elders, al Snih noted that the UTMB study provides a rare look at the prevalence of obesity in various populations of older adults in Latin America and the Caribbean, where much public health data focuses instead on childhood through middle age. Current rates of obesity among the elderly ranged from a low of 13.3 percent in Havana to a high of 37.6 percent in Montevideo. (According to the National Health and Nutrition Survey of 2007-2008, the U.S. obesity rate for men over 60 is 37.1 percent; for women over 60 it is 33.6 percent).

Other researchers contributing to this paper include professors Kenneth Ottenbacher, Kyriakos Markides and Dr. James Goodwin, assistant professor James Graham and associate professor Young-Fang Kuo. The National Institute on Aging, the National Institute of Child Health and Human Development, the National Institute of Allergy and Infectious Diseases, and the Office of the Director, National Institutes of Health provided support for this study.