Obesity in the elderly - Book Report/Review Example

Obesity among the Elderly Obesity among the Elderly Obesity is at a pandemic and results in significant morbidity and high death rates. There are successful approaches to treat obesity yet general medical practitioners seldom use them. Promoting health is a vital focus in modern healthcare. The prevalence of obesity is increasing gradually amongst the elderly. There is controversy about the likely consequences of obesity amongst the elderly. This paper investigates the scientific debate about the association of obesity in the elderly with illness-specific mortality, a causal relationship between mortality and comorbidity, the definition of obesity amongst the elderly, medical relevance, nursing interventions, medical applicability, and health promotion approaches. Introduction Obesity is a condition comprising excessive body fat that is a risk factor for other health complications. The appropriate definition of obesity in the elderly is the exacerbation of the age-associated decrease in bodily function that results in overall weakness. Over two in three adults are overweight or obese in the United States. Over one in three adults are obese. In the United States, over one in 20 adults are extremely obese. An estimated 33% of American children and teenagers between 6 and 19 years old are overweight or obese. As of 2009, over 70% of adults in the United States are categorized as overweight or obese in contrast to less than 25% four decades ago (Cetin and Nasr, 2014). Certain populations are more vulnerable to obesity than others are. Tatiana Andreyeva says infrequent physical activity relates to higher rates of obesity, especially among women. The disparity in protected rates of obesity between the most and least frequently physically active women is nearly double (Andreyeva, 2006). This vulnerability to low education in nearly a fifth amongst women and a sixth in men. Ethnic populations differed in the prevalence of obesity because of their different levels of healthcare services. Alter et al. discovered that healthcare costs turned obesity into a separate risk factor in terms of raising the odds of developing health complications in the future (Alter et al., 2012). In the elderly, there is a stronger connection between obesity and employment willingness amongst women particularly for retirement purposes. Nearly a tenth of illness prevalence can be traced to obesity, which surpasses other comorbidity risk factors such as smoking and ageing (Alter et al.). The CDC reported that over the 23% of aged adults over 65 years old were obese between 2007 and 2010. During this period, the frequency of obesity was more in the elderly between 65 and 74 years of age in contrast to those over 75 in both sexes. Prevalence of obesity in women between 65 and 74 years old was more in those over 75 years from all ethnicities (Villareal et al., 2005). However, in non-Hispanic African-American women, an estimated one in were obese in both age sets. For the elderly, Healthy People 2020 is unclear because its goals for the obese are not age-specific. However, Healthy People 2020’s experts are free to choose goals that are more applicable to specific health promotion initiatives such as for the elderly (Chernoff, 2001). The Association of Obesity with Comorbidity and Disability in the Elderly Zamboni et al., found out that the metabolic syndrome is a morbidity that should be considered when assessing the impact of obesity on the elderly (Zamboni et al., 2005). Obesity and body fat distribution relate to changes in metabolic processes in the elderly. The waists both men and women freely correlate with CVD risk factors. This correlation meant that the distribution of body fat in the elderly subjects accounted for their difference in waist sizes and BMI values (Villareal et al., 2005). BMI, waist perimeter, and health complication risk factors such as blood pressure and blood sugar levels in aged participants played equal roles in leading to obesity. In older adult subjects, obesity and body fat distribution do not just relate to specific metabolic irregularities, but the coexistence of metabolic changes, which Zamboni et al., refer to as a Metabolic Syndrome (Zamboni et al.). According to Zamboni et al., the Metabolic Syndrome is a consequence of morbidity more amongst the elderly than in young obese people. The frequency of the Metabolic Syndrome rises with ageing from an estimated 4% at 20 years to nearly 50% at 60 years old (Zamboni et al.). The age-associated rise in body fat and more notably, intestinal fat is possibly the key instrumental aspect of the rise in the frequency of the Metabolic Syndrome in the elderly. Peptides generated by adipocytes, on top of the total intestinal fat, may account for the high frequency of the Metabolic Syndrome in older adults. The study article cited former research findings that demonstrated how the distribution of body fat correlated with lipid levels positively, which did not relate to BMI and body weight (Chernoff, 2001). The association of obesity with particular disabilities includes the considerable roles played by body weight and BMI in non-chronic physical disabilities in the elderly. Zamboni et al’s article cite previous study findings showing a J-shape relationship between BMI and disability. Participants of this study recorded a more profound disability for both low and high BMI values in both genders (Zamboni, et al., 2005). Another cited study of women aged between 60 and 74 proved that previously recorded high BMI values, including the latest high BMI values were strong signs of disability and disposition to death in middle-aged and old women. The age-associated loss of muscle mass might be accountable for disabilities that are free of more body fat (Villareal et al., 2005). There is a correlation between the mass of body fat and general disability and movement inabilities. However, a reasonable correlation between fat-free muscle mass and particular disabilities exists (Potter & Perry, 2010). Zamboni et al., retested former findings are confirmed these results by recording correlations between the mass of body fat and movement disability even following changes in anticipation of osteoarthritis (Zamboni et al.). Another study assessed its participant’s increasing odds of developing particular disabilities. These likelihoods were in relation to three likely comorbidities: cigarette smoking, BMI values, and working out (Jarvis, 2012). Participant group facing the least risks towards a given disability were older than other groups by around five years. Groups that smoked over 30 sticks daily and did not work out observed BMI values exceeding 26 and faced higher risks of developing a particular disability (Zamboni et al.). These findings prove the association of obesity with comorbidities such as cigarette smoking and physical exercise. The relationship between obesity and disability in the elderly is more pertinent since it has been proven that disability alone is an indicator of premature death (Villareal et al., 2005). Complications During ageing, the bodies of human beings tend to lose their muscle mass by replacing it with fat. This replacement tends to occur when the individual is sick or often inactive physically. During this process, an older adult’s BMI (Body-Mass Index) value might remain the same. However, the adult’s distribution of body fat rises along with the possibility of becoming obese (Cetin and Nasr, 2014). BMI is also an imprecise method of determining obesity in the elderly because of the shrinking in height during ageing. Decreases in height during ageing occur because of osteoporosis and spinal vertebral changes. Researcher Ronni Chernoff advocates scientific findings of the increase in surplus body weight during middle age and its contribution to chronic illnesses. However, this relationship is unclear in obesity amongst the elderly (Chernoff, 2001). In the elderly, the BMI scale is different. An aged person is considered overweight when his or her BMI is between 25 and 29.9, and obese when it is over 30 (Jarvis, 2012). The overweight elderly are vulnerable to death, illness, and functional disability. Health complications associated with obesity in the elderly range from coronary illnesses and diabetes to hypertension and high blood pressure. Obesity is a complicated disorder that does not simply have a cosmetic solution (Cetin and Nasr, 2014). Overall symptoms of obesity include back pain or aching joints, insomnia or heavy breathing, a rapid increase in weight, skin rashes, exhaustion, excessive eating, and even depression. According to Zamboni et al, these symptoms are predictive of pulmonary complications and OSAS (Obstructive Sleep Apnea Syndrome) (Zamboni et al., 2005). Nursing Interventions First, making proper nutritional changes the suitable nursing intervention that can address obesity is a risk factor as a preventative measure. Nurses should not dismiss the obese elderly when drawing up health promotion initiatives (Jarvis, 2012). Second, teaching obese elderly patients to change their lifestyles is a nursing intervention. This adult education should advocate for the need for relevance and justifications associated with the elderly’s experiences, language levels, and a rationale convincing enough to alter their lifestyles (Lewis et al., 2014). Third, promoting healthy diets is a possible and appropriate nursing intervention that requires a comprehensive history of the patient’s eating routines. This history makes it simpler for the nurse to come up with recommendations that the patient can do great in his or her nutrition and conjure a sensible level of agreement. This intervention also involves giving elderly patients the freedom to change their diets the proper explanation and guideline (Villareal et al., 2005). Evidence-based Practice Articles i. Summary. Ronni Chernoff states that numerous correctable health aspects can be evaluated through screening procedures (Chernoff, 2001). As the post-war generation continues ageing, the likely pressure on the structures will increase since the most profound use of healthcare amenities take place while in their sixties through eighties. ii. Review. There is an unwillingness to build health promotion activities for the elderly due to a perception that they would not adhere to such plans or alter their ways of life. Acknowledging this unwillingness is a first step towards changing the delivery of care to the elderly with obesity. The application of a range of adult education models and hypothesis should cause changes in behavior that result in a healthier lifestyle and allow health teachers to be effective in achieving change. i. Summary. John Orzano and John G. Scott incorporated Evidence-Based recommendations from scientific literature tackling obesity in the elderly. This incorporation offered a basis for the diagnosis and treatment of obesity in the elderly. The basis included experiment features for BMI values and NNT (Number Needed to Treat) for applicable treatment (Orzano and Scott, 2004). ii. Review. The information presented in this article might change the delivery of care to the obese elderly by identifying the suitable and relevant elements of care. The study also found out that using BMI values are an important indicator screen for obese patients and settle on the proper treatment is preferable. The article is counselling elderly obese to work out and fulfill a goal of increasing energy usage. i. Summary. Zamboni et al’s article is a review of literature supporting the argument that body fat and comparative loss of fat-free weight might turn out to be more or less significant than BMI values when ascertaining health risks related to obesity in the elderly (Zamboni et al., 2005). ii. Review. Information about health promotion activity in this article facilitated the assessment of comorbidity and conducting assessments in the elderly should produce a thorough evaluation of likely negative health consequences of obesity. This assessment should prove that weight loss is advantageous to the obese elderly. Conclusion Obesity in the elderly is the exacerbation of the age-associated decrease in bodily function that results in overall weakness. Assessing comorbidity and the history of body weight of obese elderly patients is necessary to produce a detailed evaluation of the likely negative consequences of obesity. The goals for the obese set by Healthy People 2020 is to encourage health and decrease critical disease risks through the intake of healthy foods and accomplishing and sustaining fit body weights. As a risk factor, obesity is a disabling disorder that leads to early death. Obesity is at a pandemic level in the United States amongst adults and children. There are 400 million obese adults across the world and 1 billion overweight. The association of obesity with comorbidity and disability require more scientific research and cooperative investment by various healthcare systems. References Alter, D. A., Wijeysundera, H. C., Franklin, B., Austin, P. C., Chong, A., Oh, P. I., Tu, J. V., and Stukel, T. A. (2012). Obesity, lifestyle risk-factors, and health service outcomes among healthy middle-aged adults in Canada. BMC Health Services Research, 12, 238. Cetin, D. C. and Nasr, G. (2014). Obesity in the elderly: More complicated than you think. Cleveland Clinic Journal Of Medicine, 81(1), 51-61. Chernoff, R. (2001). Nutrition and Health Promotion in Older Adults. Journals of Gerontology, 56(A-II), 47–53. Jarvis, C. (2012). Physical Examination and Health Assessment (6th ed.). St Louis, Mo: Elsevier: Saunders. Lewis, S., Dirksen, S., Heitkemper. M., Bucher, L., and Camera, I. (2014). Medical surgical nursing (9th ed.). St. Louis: Mosby. Potter, P. & Perry, A.G. (2010). Fundamentals of Nursing (8th ed.). Philadelphia, PA: Mosby, Inc. Orzano, A. J. and Scott, J. G. (2004). Diagnosis and Treatment of Obesity in Adults: An Applied Evidence-Based Review. Clinical Review, 17(5), 359-69. Andreyeva, T. (2006). An International Comparison of Obesity in Older Adults. Pardee RAND Graduate School, p. 4-149. Villareal, D. T., Apovian, C. M., Kushner, R. F., Klein, S., American Society for Nutrition, NAASO, and The Obesity Society. (2005). Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. American Journal Clinical Nutrition, 82(5): 923-34. Zamboni, M., Mazzali, G., Zoico, E., Harris, T. B., Meigs, J. B., Di Francesco, V., Fantin, F., Bissoli, L., and Bosello, O. (2005). Health consequences of obesity in the elderly: a review of four unresolved questions. International Journal of Obesity, 29, 1011-29. Read More