Obesity associated with mobility loss in later life after surgery for OA
medwireNews: Study results suggest that maintaining a healthy bodyweight may reduce the risk for mobility limitation in later life among older women who undergo surgical joint replacement for osteoarthritis (OA).
In an analysis of data from the Women’s Health Initiative Program linked to Medicare claims records, the researchers found that overweight and obese women aged 65–79 years at baseline who underwent total hip replacement had a significantly increased risk for mobility limitation – defined as health limiting their ability to walk one block or climb one flight stairs by “a lot” or “a little” – at the age of 85 years compared with their normal-weight counterparts.
In all, 37.3% of 335 patients with normal bodyweight (BMI≤24.9 kg/m2) experienced impaired mobility at 85 years, compared with 45.9% of 329 overweight women (BMI=25.0–29.9 kg/m2), 57.1% of 189 women with class I obesity (BMI=30.0–34.9 kg/m2), and 51.7% of 87 patients with class II obesity (BMI≥35.0 kg/m2).
These findings translated into odds ratios (ORs) for mobility limitation of 1.53, 2.40, and 4.37 for women in the overweight, class I obesity, and class II obesity groups, respectively, relative to those with normal bodyweight, report the study authors in Arthritis Care & Research.
Women with class II obesity also had a significantly increased risk for death before the age of 85 years than normal-weight participants (adjusted OR=6.08), but mortality risk was not significantly higher among those who were overweight or had class I obesity.
Furthermore, participants who had a waist circumference (WC) of more than 88 cm were significantly more likely to experience mobility limitation than those who had a WC of 88 cm or smaller (adjusted OR=1.48), suggesting an association between abdominal obesity and impaired mobility. However, there was no significant association between waist-to-hip ratio and mobility limitation or death.
The team also identified a relationship between obesity and late-life mobility limitation among patients undergoing total knee replacement (TKR) for OA, but the association varied with age. For women who had their first TKR at the age of 67–74 years, those who had class I or II obesity had a significantly higher risk for mobility limitation than normal-weight women (OR=2.75 and 3.24, respectively), but among the women who were aged 75–79 at the time of surgery, only those with class II obesity had a significantly increased risk (OR=1.99).
However, women in the TKR group who had a WC of greater than 88 cm had a significantly increased risk for mobility impairment than those with a smaller WC regardless of age (OR=1.55–1.88).
Taken together, “these findings support the maintenance of healthy body weight among women with hip or knee OA scheduled to undergo [total joint replacement] to lessen the burden of mobility loss in late life,” say Aladdin Shadyab (University of California San Diego School of Medicine, La Jolla, USA) and fellow researchers.
And they conclude: “Future studies should evaluate whether weight loss before [total joint replacement] for hip or knee OA improves long-term aging outcomes.”
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