Hi Readers, as I shared in my previous blog posting, 90%
of older adults DO NOT have Alzheimer’s Disease [AD], yet AD gets enormous
media attention and older adults are overly concerned about it, sometimes
ignoring other more pressing health matters.
The CDC (2016) has identified the leading causes of death in older
adults in this order, indicating that heart disease and cancer are by far more
prevalent than AD:
“Heart disease 507,138k
Malignant neoplasms [Cancer] 419.389k
Chronic lower respiratory diseases 131,804k
Cerebrovascular diseases 120,156k
Alzheimer’s disease 109,495k” (CDC, 2016, p. 133)
Hidden within these statistics
is the issue of overweight and obesity among older adults. Among adults,
BMI of 18.5-24.9 is normal, 25-29.9 is overweight, and 30+ is obese (CDC,
2016). Obesity is defined as, “an unhealthy excess of body fat, which increases
the risk of medical illness and premature mortality” (Amarya, Singh, &
Sabharwal, 2014, p. 63). According to the CDC (2016), there are three
subcategories of obesity, as shown below:
·
“Class 1: BMI of 30 to 34.9
·
Class 2: BMI of 35 to 39.9
·
Class 3: BMI of 40 or higher. Class 3 obesity is sometimes
categorized as “extreme” or “severe” obesity” (para. 4).
While there have been some recent studies linking overweight and
longer life among older adults, those findings are disputed. What we DO
know and agree on is that OBESITY among older adults may lead to declining
health status, increased health care spending, chronic morbidities
[hypertension and stroke, Type 2 diabetes, metabolic syndrome, arthritis,
urinary incontinence, and cancer], leading to loss of mobility, dependence,
institutionalization, and early death (Amarya et al., p. 63). About 35% of
older adults are obese, making this a major health crisis far more prevalent
than Alzheimer’s Disease. Sadly, many of my clients who have sought
advice on preventing and delaying Alzheimer’s Disease have been obese. In
counseling older clients, practitioners must sometimes tell them what they do
not want to hear, that obesity is the problem and not Alzheimer’s Disease.
A former client, age 75, laughed at me when at the end of our talk
about retaining independence and healthy aging, I spoke to her about
obesity, as “Helen” was at least 100 pounds overweight [Class 3 Obesity BMI]
and sedentary. “I am the healthiest fat person you have ever known” was
her response, and then she told me about participating in water aerobics three
times per week. I reminded Helen that she had recurring congestive heart
failure, hypertension, and arthritis, and that she was at risk of having a
major health event and loss of independence if she did not take steps to lose
weight and make some lifestyle changes. Because Helen was trying to
decide on moving to assisted living or remain at home, I recommended finding a
suitable assisted living soon and prepare her house for sale as proactive
strategies. Helen disagreed with my
assessments and huffed out of the office.
Sadly, Helen’s son phoned me about six months later and told me
that his mother had a massive stroke and could not speak, suffered short-term
memory loss, and she was moved to an assisted living facility with 24/7
supervision on the West Coast near her children. He and his four
siblings were disposing of her home and personal belongings, as the prognosis
was bleak. A year later, “Roger” phoned
to tell me that Helen’s health status had declined and she died in a nursing
home.
Although I could not convince Helen to change her habits toward a
healthier lifestyle, and she got angry with me, I did everything I could as a
gerontologist to give her professional and honest advice toward maintaining her
independence and optimum aging. This is an example of always telling
clients the truth, although it may not be accepted.
References:
Amarya, S., Singh, K., & Sabharwal, M. (2014). Health
consequences of obesity in the elderly. Journal of Clinical
Gerontology and Geriatrics, 5(3), 63-67. doi:10.1016/j.jcgg.2014.01.004
CDC (2016). Defining adult overweight and obesity.
Retrieved from https://www.cdc.gov/obesity/adult/defining.html
CDC, National Center for Health Statistics [NCHS],
(2015). Prevalence of obesity among older adults in the United
States, 2007-2010. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db106.htm
CDC, National Center for Health Statistics. Health,
United States, 2016: With Chartbook on long-term trends in health.
Hyattsville, MD 2017 https://www.cdc.gov/nchs/data/hus/hus16.pdf#020
