Volume 70, Issue 5 p. 1442-1449
Clinical Investigation

The relationship between multimorbidity, obesity and functional impairment in older adults

David H. Lynch BMBS

Corresponding Author

David H. Lynch BMBS

Division of Geriatric Medicine and Center for Aging and Health, University of North Carolina, Chapel Hill, North Carolina, USA

Correspondence

David H Lynch, Division of Geriatric Medicine and Center for Aging and Health, University of North Carolina, 5003 Old Clinic/CB #7550, Chapel Hill, NC 27599, USA.

Email: [email protected]

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Curtis L. Petersen PhD

Curtis L. Petersen PhD

The Dartmouth Institute for Health Policy, Dartmouth College, Hanover, New Hampshire, USA

Quantitative Biomedical Sciences Program, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA

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Marco M. Fanous BS

Marco M. Fanous BS

Division of Geriatric Medicine and Center for Aging and Health, University of North Carolina, Chapel Hill, North Carolina, USA

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Hillary B. Spangler MD

Hillary B. Spangler MD

Division of Geriatric Medicine and Center for Aging and Health, University of North Carolina, Chapel Hill, North Carolina, USA

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Anna R. Kahkoska MD, PhD

Anna R. Kahkoska MD, PhD

Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA

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Daniel Jimenez MD, PhD

Daniel Jimenez MD, PhD

Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA

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John A. Batsis MD

John A. Batsis MD

Division of Geriatric Medicine and Center for Aging and Health, University of North Carolina, Chapel Hill, North Carolina, USA

Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA

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First published: 03 February 2022
Citations: 12

Funding information: National Center for Advancing Translational Sciences, Grant/Award Number: KL2TR002490; National Institute on Aging, Grant/Award Number: K23 AG051681

Abstract

Background

Declining mortality rates and an aging population have contributed to increasing rates of multimorbidity (MM) in the United States. MM is strongly associated with a decline in physical function. Obesity is an important risk factor for the development of MM, and its prevalence continues to rise. Our study aimed to evaluate the associations between obesity, MM, and rates of functional limitations in older adults.

Methods

We analyzed body mass index (BMI) and self-reported comorbidity data from 7261 individuals aged ≥60 years from the National Health and Nutrition Examination Surveys 2005–2014. Weight status was defined based on standard BMI categories. MM was defined as 2 or more comorbidities, while functional limitations were self-reported. Adjusted logistic regression quantified the association between standard BMI categories and MM. We also examined the difference in the prevalence of limitations between those with and without MM.

Results

The overall proportion of individuals with concomitant MM and obesity was 27.0%. Compared to a normal BMI, older adults with obesity had higher odds of MM (Prevalence odds ratio 1.79, 95% CI 1.49, 2.12). Overall, 67.5% of patients with MM also reported a functional limitation, with rates of functional limitation increasing with increasing BMI. When evaluating functional limitations in those with MM by BMI class, 90% of patients classified as severely obese (BMI ≥40 kg/m2) with MM also had a concomitant functional limitation.

Conclusions

Compared to normal weight status, obesity is associated with an increased burden of MM and functional limitation among older adults. Our results underscore the importance of identifying and addressing obesity, MM, and functional limitation patterns and the need for evidence-based interventions that address all three conditions in this population.

CONFLICT OF INTEREST

The author declares that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.