Effect of Body Weight on Mental Health in the Elderly

Lee, Jung Hyun

Abstract

The growing prevalence of obesity in the older population constitutes a national public health crisis. Furthermore, underweight and undernutrition is a common, but is an under-recognized problem associated with increasing age. First of all, obesity in the elderly is a growing concern. Obesity in older persons is predominately caused by a decrease in physical activity, an alteration in metabolic rate, or an increase in the efficiency by which fat is stored. Obesity in the late ages can also cause physical and functional problems. Excess body weight and modest weight gain even during the middle ages may be associated with co-morbidities later on. These include hypertension, diabetes mellitus, cardiovascular disease, and osteoarthritis. Obesity in older persons may also have profound functional and psychosocial consequences. Thus, obesity treatment in the older population needs to focus on interventions that address psychosocial concerns as well. Through middle age there is a doubling in body fat, however, body fat typically decreases after the age of 65 year, even in healthy individuals. Significant unexplained weight loss becomes increasingly common after the age of 65. As many as 10-20% of older people at home and as many as 30-50% of institutionalized elderly individuals reported to suffer from protein-energy malnutrition. Despite its high prevalence, however protein-calorie malnutrition in older persons is rarely recognized and even more rarely treated appropriately. This so-called 'anorexia of the elderly' is associated with increased morbidity and mortality. Negative energy balance resulting from low energy intake relative to energy expenditure is thought to be the usual cause of the loss of body fat in old age. Active identification and nutritional support improve clinical outcome. Compared with normal-weight people, both underweight and obese older adults reported impaired quality of life. Obesity was associated with a lower health perception and poorer physical and social functioning compared to the norm. Underweight older individuals reported impairment in physical, social, and mental well-being. Thus, the focus must be on achieving a more healthful weight to promote improved health, function, and quality of life.