Marihart Cindy L, Brunt Ardith R, Geraci Angela A
Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA.
SAGE Open Med. 2014 Apr 23;2:2050312114530917. doi: 10.1177/2050312114530917. eCollection 2014.
The aging population is growing exponentially worldwide. Associated with this greater life expectancy is the increased burden of chronic health conditions, many of which are exacerbated by the continued rise in obesity. In the US, the prevalence of obesity in adults aged 60 years and older increased from 23.6% to 37% in 2010.
This review examines bariatric surgery as a treatment option for obese adults > 60 years old. The most common types of weight-loss surgery are laparoscopic adjustable gastric banding, vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and the duodenal switch.
A comprehensive literature search found 349 articles that referred to bariatric surgery in older adults. Of these, 70 relevant articles on bariatric surgery for older adults were utilized for this article.
Weight-loss surgery procedures were found to be equally safe for both older adults and their younger counterparts. Pre-surgical psychological assessment is critical for positive outcomes for older adults. Benefits of bariatric surgery include a decrease in comorbidities, chronic disease risk, and medication use coupled with improved mobility and quality of life outcomes. Side effects include surgical failure, changes in psychological status, and increased physical and mental stress.
Bariatric surgery can offer patients an effective and long-lasting treatment for obesity and related diseases. There does not appear to be any one bariatric procedure that is recommended for older adults, so individual needs should be taken into consideration when exploring options. Costs range from US$17,000 for laparoscopic procedures to US$26,000 for open gastric surgeries. Estimated savings start accruing within 3 months of surgery making bariatric surgery a serious cost saving consideration.
全球老龄化人口正在呈指数级增长。随着预期寿命的延长，慢性健康问题的负担也在增加，其中许多问题因肥胖率的持续上升而加剧。在美国，60岁及以上成年人的肥胖患病率从2010年的23.6%上升至37%。
本综述探讨减肥手术作为60岁以上肥胖成年人的一种治疗选择。最常见的减肥手术类型有腹腔镜可调节胃束带术、垂直袖状胃切除术、Roux-en-Y胃旁路术和十二指肠转位术。
全面的文献检索发现349篇提及老年人减肥手术的文章。其中，70篇关于老年人减肥手术的相关文章被用于撰写本文。
发现减肥手术对老年人和年轻人同样安全。术前心理评估对老年人取得积极治疗效果至关重要。减肥手术的益处包括合并症、慢性病风险和药物使用减少，同时行动能力和生活质量得到改善。副作用包括手术失败、心理状态改变以及身心压力增加。
减肥手术可为患者提供一种有效且持久的肥胖及相关疾病治疗方法。似乎没有任何一种减肥手术是专门推荐给老年人的，因此在探索手术方案时应考虑个体需求。费用从腹腔镜手术的17000美元到开放式胃部手术的26000美元不等。预计在手术后3个月内开始节省费用，这使得减肥手术成为一个值得认真考虑的节省成本的选择。
