Quality of Life and Mental Health in Older Adults with Obesity and Frailty: Associations with a Weight Loss Intervention

Abstract

Objective: To examine the bi-directional associations of a weight loss intervention with quality of life and mental health in obese older adults with functional limitations.

Design: Combined-group analyses of secondary variables from the MEASUR-UP randomized controlled trial.

Setting: Academic medical center.

Participants: Obese community-dwelling men and women (N = 67; age ≥60; BMI ≥30) with functional limitations (Short Physical Performance Battery [SPPB] score of 4-10 out of 12).

Intervention: Six-month reduced calorie diet at two protein levels.

Measurements: Weight, height, body composition, physical function, medical history, and mental health and quality of life assessments (Center for Epidemiologic Studies Depression Scale [CES-D]; Profile of Mood States [POMS], Pittsburgh Sleep Quality Index [PSQI]; Perceived Stress Scale [PSS]; Satisfaction with Life Scale [SWLS]; and Short Form Health Survey [SF-36]) were acquired at 0, 3 and 6 months.

Results: Physical composite quality of life (SF-36) improved significantly at 3 months (β = 6.29, t2,48 = 2.60, p = 0.012) and 6 months (β = 10.03, t2,48 = 4.83, p < 0.001), as did several domains of physical quality of life. Baseline depression symptoms (CES-D and POMS) were found to predict lower amounts of weight loss; higher baseline sleep latency (PSQI) and anger (POMS) predicted less improvement in physical function (SPPB).

Conclusion: The significant bi-directional associations found between a weight loss intervention and mental health/quality of life, including substantial improvements in physical quality of life with obesity treatment, indicate the importance of considering mental health and quality of life as part of any weight loss intervention for older adults.

Trial registration: ClinicalTrials.gov NCT01715753.

Keywords: Obesity; mental health; older adults; quality of life; weight reduction.

Conflict of interest statement

Dr. Payne reports grants from National Institutes of Health, during the conduct of the study; Dr. Starr reports grants from United States (U.S.) Department of Veterans Affairs Rehabilitation Research and Development Service Program (CDA-2/ IK2 RX002348), grants from United States National Institutes of Health 5T32 AG000029, during the conduct of the study; Ms. Orenduff has nothing to disclose; Ms. Mulder has nothing to disclose; Dr. McDonald reports grants from Beef Checkoff Program, during the conduct of the study; grants from Dairy Management, Inc., grants from National Pork Board, outside the submitted work; Dr. Spira agreed to serve as a consultant to Awarables, Inc. in support of an NIH grant outside the submitted work; Dr. Pieper has nothing to disclose; and Dr. Bales reports grants from National Cattlemen’s Beef Association, during the conduct of the study.