Work

Weight loss severity and functional decline among the oldest old in a middle-income country: The FIBRA study longitudinal findings

Year: 2022

Type: article

Abstract: Background and objective: Nutritional status is a key modifiable risk factor associated with disability, and further evidence suggests that weight change is also linked to this adverse outcome. Thus, the aim of this study is to evaluate weight loss severity and functional decline in instrumental activities of daily living (IADL) in a seven-year period among a sample of Brazilian oldest old adults. Methods: This is a longitudinal prospective study using data from FIBRA study (Frailty in Older Brazilians), a population-based investigation carried out in 2008/2009, with follow up data collected in 2016/2017 from participants who were 80 years and older in the follow-up in Campinas, Brazil. Of the 167 participants who were interviewed with complete data in 2016-2017, 16 had improved their functional status and were excluded, so the final sample was restricted to 151 participants who maintained or declined functional status. We considered functional decline when a subject had a greater number of IADL dependencies at follow‐up than at baseline. Logistic regression was performed to assess the effect of weight loss, according to severity (moderate weight loss: 5-10% of body weight; severe weight loss >10%) in increasing the number of disabilities, in relation to the group with stable weight, controlling for covariates (gender, age, education and morbidity). An alpha level <5% was adopted. Results: During the follow-up period, 60.3% of the participants kept stable weight, 21.8% had moderate weight loss and 17.9% had severe weight loss. During the follow-up, only severe weight loss was associated to higher risk of functional decline (OR=2.74;p=0.032). Conclusions: weight loss consisted in a risk factor to functional decline in this sample of oldest old, but severity of the loss must be considered as only severe loss was significant. Given that weight loss is expected for the oldest old, it is important to quantify this loss and measure its severity, and also to identify the magnitude of the loss that is associated with functional decline.

Source: Clinical Nutrition ESPEN

DOI: 10.1016/j.clnesp.2022.12.008