体重减轻和运动对肥胖老年人虚弱状况的影响。

Effect of weight loss and exercise on frailty in obese older adults.

作者信息

Villareal Dennis T, Banks Marian, Sinacore David R, Siener Catherine, Klein Samuel

机构信息

Center for Human Nutrition, Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St Louis, MO 63110, USA.

出版信息

Arch Intern Med. 2006 Apr 24;166(8):860-6. doi: 10.1001/archinte.166.8.860.

DOI:10.1001/archinte.166.8.860

PMID:16636211

Abstract

BACKGROUND

Obesity exacerbates the age-related decline in physical function and causes frailty in older persons. However, appropriate treatment for obese older persons is unknown. We evaluated the effects of weight loss and exercise therapy on physical function and body composition in obese older persons.

METHODS

We screened 40 obese older volunteers and eventually randomized 27 frail obese older volunteers to treatment or control groups. Treatment consisted of 6 months of weekly behavioral therapy for weight loss in conjunction with exercise training 3 times per week. Physical function was evaluated with measurements of frailty (Physical Performance Test, peak oxygen consumption, and Functional Status Questionnaire); strength, gait, and balance tests; body composition with dual-energy x-ray absorptiometry; and quality of life using the Medical Outcomes Survey 36-Item Short-Form Health Survey. Results are reported as mean +/- SD.

RESULTS

Two subjects in the treatment group did not comply with the intervention, and 1 subject in the control group withdrew. Analyses included all 27 subjects originally randomized to the treatment and control groups. The treatment group lost 8.4% +/- 5.6% of body weight, whereas weight did not change in the control group (+0.5% +/- 2.8%; P<.001). Compared with the control group, fat mass decreased (-6.6 +/- 3.4 vs +1.7 +/- 4.1 kg; P<.001), without a change in fat-free mass (-1.2 +/- 2.1 vs -1.0 +/- 3.5 kg; P = .75) in the treatment group. The Physical Performance Test score (2.6 +/- 2.5 vs 0.1 +/- 1.0; P = .001), peak oxygen consumption (1.7 +/- 1.6 vs 0.3 +/- 1.1 mL/min per kilogram; P = .02), and Functional Status Questionnaire score (2.9 +/- 3.7 vs -0.2 +/- 3.9; P = .02) improved in treated subjects compared with control subjects. Treatment also improved strength, walking speed, obstacle course, 1-leg limb stance time, and health survey physical subscale scores (all P<.05).

CONCLUSION

These findings suggest that weight loss and exercise can ameliorate frailty in obese older adults. Trial Registration clinicaltrials.gov Identifier: NCT00146133.

摘要

背景

肥胖会加剧老年人身体机能与年龄相关的衰退，并导致虚弱。然而，针对肥胖老年人的恰当治疗方法尚不清楚。我们评估了减肥和运动疗法对肥胖老年人身体机能和身体成分的影响。

方法

我们筛选了40名肥胖老年志愿者，最终将27名虚弱的肥胖老年志愿者随机分为治疗组或对照组。治疗包括为期6个月的每周一次减肥行为疗法，同时每周进行3次运动训练。通过虚弱测量（身体性能测试、峰值耗氧量和功能状态问卷）、力量、步态和平衡测试来评估身体机能；使用双能X线吸收法测量身体成分；使用医学结局调查36项简短健康调查评估生活质量。结果以均值±标准差表示。

结果

治疗组有2名受试者未遵守干预措施，对照组有1名受试者退出。分析纳入了最初随机分配到治疗组和对照组的所有27名受试者。治疗组体重减轻了8.4%±5.6%，而对照组体重未变化（+0.5%±2.8%；P<0.001）。与对照组相比，治疗组脂肪量减少（-6.6±3.4 vs +1.7±4.1 kg；P<0.001），无脂肪量变化（-1.2±2.1 vs -1.0±3.5 kg；P = 0.75）。与对照组相比，治疗组受试者的身体性能测试得分（2.6±2.5 vs 0.1±1.0；P = 0.001）、峰值耗氧量（1.7±1.6 vs 0.3±1.1 mL/min per kilogram；P = 0.02）和功能状态问卷得分（2.9±3.7 vs -0.2±3.9；P = 0.02）有所改善。治疗还改善了力量、步行速度、障碍课程、单腿站立时间和健康调查身体分量表得分（均P<0.05）。