Lingying Wang, Hong Zhu, Hongxiu Chen, Ziyi Hu, Mei Feng, Menglin Tang, Xiuying Hu
Department of Critical Care Medicine, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, 610041, China.
Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041, China.
BMC Public Health. 2025 Jan 2;25(1):6. doi: 10.1186/s12889-024-21234-w.
The influence of Body Mass Index (BMI) on the functional capacity for daily activities in older adults is a significant concern. Our study is designed to delineate the longitudinal relationship between BMI and the ability of daily living activities among older adults.
Two researchers conducted a comprehensive literature search and independent screening of articles in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), the Database for Chinese Technical Periodicals (VIP), and Wanfang, covering the period from January 2000 to May 2024. Studies were selected based on predefined inclusion and exclusion criteria, and relevant data were extracted for subsequent meta-analysis using the Cochrane Collaboration's Review Manager 5.3 software.
After rigorous selection, four longitudinal studies were incorporated into our meta-analysis. The findings indicated that underweight older adults exhibited a higher likelihood of experiencing difficulties with basic activities of daily living (BADL) (odds ratio [OR] = 1.33, 95% confidence interval [CI]: [1.03, 1.72]; P = 0.03). Conversely, overweight older adults were found to have a reduced likelihood of BADL (odds ratio [OR] = 0.81, 95% confidence interval [CI]: [0.79, 0.83]; P < 0.001). However, overweight and obese older adults demonstrated an increased likelihood of challenges with Instrumental Activities of Daily Living (IADL) (odds ratio [OR] = 1.58, 95% confidence interval [CI]: [1.25, 2.00]; P < 0.01).
Our longitudinal meta-analysis substantiates the correlation between underweight status and the impairment of BADL in older adults, irrespective of gender. It also reveals that overweight older adults have a lower risk of BADL difficulties, yet a higher risk of IADL challenges, which is further exacerbated in obesity. The early identification and management of BMI in this population could be instrumental in preventing a decline in ADL. Recognizing the role of BMI categories in this context is essential for developing targeted preventative strategies for the elderly, while also accounting for other modifiable risk factors such as pain and depression.
体重指数（BMI）对老年人日常活动功能能力的影响是一个重大问题。我们的研究旨在描绘老年人BMI与日常生活活动能力之间的纵向关系。
两名研究人员在PubMed、Embase、Web of Science、中国知网（CNKI）、维普中文科技期刊数据库（VIP）和万方数据库中进行了全面的文献检索和独立筛选，涵盖2000年1月至2024年5月期间。根据预先定义的纳入和排除标准选择研究，并使用Cochrane协作网的Review Manager 5.3软件提取相关数据用于后续的荟萃分析。
经过严格筛选，四项纵向研究被纳入我们的荟萃分析。研究结果表明，体重过轻的老年人在基本日常生活活动（BADL）方面出现困难的可能性更高（优势比[OR]=1.33，95%置信区间[CI]：[1.03，1.72]；P=0.03）。相反，超重的老年人BADL的可能性降低（优势比[OR]=0.81，95%置信区间[CI]：[0.79，0.83]；P<0.001）。然而，超重和肥胖的老年人在工具性日常生活活动（IADL）方面面临挑战的可能性增加（优势比[OR]=1.58，95%置信区间[CI]：[1.25，2.00]；P<0.01）。
我们的纵向荟萃分析证实了体重过轻状态与老年人BADL受损之间的相关性，无论性别如何。它还表明，超重的老年人BADL困难风险较低，但IADL挑战风险较高，肥胖时这种情况会进一步加剧。在这一人群中早期识别和管理BMI可能有助于预防日常生活活动能力下降。认识到BMI类别在这种情况下的作用对于制定针对老年人的有针对性的预防策略至关重要，同时还要考虑其他可改变的风险因素，如疼痛和抑郁。
