Korean J Fam Pract 2020; 10(6): 436-442  https://doi.org/10.21215/kjfp.2020.10.6.436
Association between Functional Decline and Weight Change in Elderly Population
Young Joon Lee, Jeong Ho Shin* 
Department of Family Medicine, Osan Hankook Hospital, Osan, Korea
Jeong Ho Shin
Tel: +82-31-379-8594, Fax: +82-31-379-8563
E-mail: immortalsoul@hanmail.net
ORCID: https://orcid.org/0000-0002-3354-8107
Received: July 22, 2020; Accepted: September 17, 2020; Published online: December 20, 2020.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Functional decline in the elderly is a major problem contributing toward a low quality of life and increasing economic and social costs. Several risk factors such as weight loss are associated with functional decline. This study aimed to investigate how weight changes in aged people affect functional decline.
Methods: Using the 5th–6th panel data sets from the Korean Longitudinal Study of Aging (KLoSA), we selected the consecutive respondents who showed no decline in activities of daily living (ADL) in the 5th panel data. We defined functional decline as the presence of one or more deficits in the ADL items. Data were analyzed by the t-test, Chi-square test, and multivariate logistic regression analysis. In addition, we also examined the relationship between weight changes and instrumental activities of daily living (I-ADL).
Results: A total of 4,256 respondents (mean age, 75.35 years) were included in the study, of whom were 1,738 (42.87%) male and 2,316 (57.13%) female. A total of 202 (4.75%) respondents showed a decline in ADL. Multivariate logistic regression analysis showed that weight gain was irrelevant to functional decline (all P-values >0.05). However, in cases of weight loss, there were significantly increased risks of ADL and I-ADL impairment (all P-values <0.001).
Conclusion: The results indicate that weight loss in the elderly is related to an increased risk of functional decline. Thus, when we see elderly patients who complain of weight loss, we should determine its cause and administer an appropriate treatment before it leads to actual functional impairment.
Keywords: Weight loss; Aged; Activities of Daily Living; Korean Longitudinal Study of Aging
References
  1. Jeong HS, Song YM, Lee KS. Aging and health care expenditure. Korean J Health Econ Policy 2007; 13: 95-116.
  2. Lee YS. 2018 Statistics of the Aged [Internet]. Daejeon: Statistics Korea; 2018. [cited 2018 Nov 20].
    Available from: http://kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&aSeq=370779
  3. Cheong CL, Lee TJ. Population ageing and increasing health care expenditures- counting on death related costs by age group. Korean J Health Econ Policy 2017; 23: 127-48.
  4. Lee HZ, Yom YH. Age difference in the trajectory of medical service utilization, medical expenses and health outcome among the elderly: a latent growth model analysis. Health Soc Welf Rev 2017; 37: 287-324.
    CrossRef
  5. Beswick AD, Rees K, Dieppe P, Ayis S, Gooberman-Hill R, Horwood J, et al. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet 2008; 371: 725-35.
    CrossRef
  6. Eklund K, Wilhelmson K. Outcomes of coordinated and integrated interventions targeting frail elderly people: a systematic review of randomised controlled trials. Health Soc Care Community 2009; 17: 447-58.
    Pubmed CrossRef
  7. Colón-Emeric CS, Whitson HE, Pavon J, Hoenig H. Functional decline in older adults. Am Fam Physician 2013; 88: 388-94.
  8. Stuck AE, Walthert JM, Nikolaus T, Büla CJ, Hohmann C, Beck JC. Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med 1999; 48: 445-69.
    CrossRef
  9. Mehta KM, Yaffe K, Covinsky KE. Cognitive impairment, depressive symptoms, and functional decline in older people. J Am Geriatr Soc 2002; 50:1045-50.
    Pubmed KoreaMed CrossRef
  10. Kim SH, Cho B, Won CW, Hong YH, Son KY. Self-reported health status as a predictor of functional decline in a community-dwelling elderly population: nationwide longitudinal survey in Korea. Geriatr Gerontol Int 2017;17: 885-92.
    Pubmed CrossRef
  11. Volpato S, Bianchi L, Cherubini A, Landi F, Maggio M, Savino E, et al. Prevalence and clinical correlates of sarcopenia in community-dwelling older people: application of the EWGSOP definition and diagnostic algorithm. J Gerontol A Biol Sci Med Sci 2014; 69: 438-46.
    Pubmed KoreaMed CrossRef
  12. Bowen ME. The relationship between body weight, frailty, and the disablement process. J Gerontol B Psychol Sci Soc Sci 2012; 67: 618-26.
    Pubmed KoreaMed CrossRef
  13. Ritchie CS, Locher JL, Roth DL, McVie T, Sawyer P, Allman R. Unintentional weight loss predicts decline in activities of daily living function and lifespace mobility over 4 years among community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2008; 63: 67-75.
    Pubmed CrossRef
  14. Payette H, Coulombe C, Boutier V, Gray-Donald K. Nutrition risk factors for institutionalization in a free-living functionally dependent elderly population. J Clin Epidemiol 2000; 53: 579-87.
    CrossRef
  15. Sahyoun NR, Serdula MK, Galuska DA, Zhang XL, Pamuk ER. The epidemiology of recent involuntary weight loss in the United States population. J Nutr Health Aging 2004; 8: 510-7.
  16. Bales CW, Ritchie CS. Sarcopenia, weight loss, and nutritional frailty in the elderly. Annu Rev Nutr 2002; 22: 309-23.
    Pubmed CrossRef
  17. Jung HW, Yoo HJ, Park SY, Kim SW, Choi JY, Yoon SJ, et al. The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly. Korean J Intern Med 2016; 31: 594-600.
    Pubmed KoreaMed CrossRef
  18. Korean Longitudinal Study of Aging (KLoSA) [Internet]. Eumseong: Korea Employment Information Service; c2015. [cited 2018 Nov 10].
    Available from: https://survey.keis.or.kr/klosa/klosa01.jsp
  19. Alley DE, Metter EJ, Griswold ME, Harris TB, Simonsick EM, Longo DL, et al. Changes in weight at the end of life: characterizing weight loss by time to death in a cohort study of older men. Am J Epidemiol 2010; 172: 558-65.
    Pubmed KoreaMed CrossRef
  20. Thompson Martin C, Kayser-Jones J, Stotts N, Porter C, Froelicher ES. Nutritional risk and low weight in community-living older adults: a review of the literature (1995-2005). J Gerontol A Biol Sci Med Sci 2006; 61: 927-34.
    Pubmed CrossRef
  21. Morley JE. Weight loss in older persons: new therapeutic approaches. Curr Pharm Des 2007; 13: 3637-47.
    Pubmed CrossRef
  22. Alibhai SM, Greenwood C, Payette H. An approach to the management of unintentional weight loss in elderly people. CMAJ 2005; 172: 773-80.
    Pubmed KoreaMed CrossRef
  23. Evans WJ, Morley JE, Argilés J, Bales C, Baracos V, Guttridge D, et al. Cachexia: a new definition. Clin Nutr 2008; 27: 793-9.
    Pubmed CrossRef
  24. Ali S, Garcia JM. Sarcopenia, cachexia and aging: diagnosis, mechanisms and therapeutic options- a mini-review. Gerontology 2014; 60: 294-305.
    Pubmed KoreaMed CrossRef
  25. Kyle UG, Zhang FF, Morabia A, Pichard C. Longitudinal study of body composition changes associated with weight change and physical activity. Nutrition 2006; 22: 1103-11.
    Pubmed CrossRef
  26. Melton LJ 3rd, Khosla S, Crowson CS, O'Connor MK, O'Fallon WM, Riggs BL. Epidemiology of sarcopenia. J Am Geriatr Soc 2000; 48: 625-30.
    CrossRef
  27. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010;39: 412-23.
    Pubmed KoreaMed CrossRef
  28. Arnold AM, Newman AB, Cushman M, Ding J, Kritchevsky S. Body weight dynamics and their association with physical function and mortality in older adults: the Cardiovascular Health Study. J Gerontol A Biol Sci Med Sci 2010; 65: 63-70.
    Pubmed KoreaMed CrossRef
  29. Jindai K, Nielson CM, Vorderstrasse BA, Quiñones AR. Multimorbidity and functional limitations among adults 65 or older, NHANES 2005-2012. Prev Chronic Dis 2016; 13: E151.
    Pubmed KoreaMed CrossRef
  30. Barrett TM, Liebert MA, Schrock JM, Cepon-Robins TJ, Mathur A, Agarwal H, et al. Physical function and activity among older adults in Jodhpur, India. Ann Hum Biol 2016; 43: 488-91.
    Pubmed CrossRef

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