Prevalence of Obesity among Elderly in Urban Field Practice Area

Abstract

Introduction Obesity is a serious worldwide public health problem that is becoming very common in developed and developing countries. Overweight and obesity is associated with an increased risk of multiple health problems, including hypertension, type 2 diabetes, dyslipidemia, degenerative joint disease, depression and some malignancies. The number and proportion of older people who are obese have risen notably in recent decades which is associated with increase in chronic morbidities, functional impairment and which as lead to premature mortality. Apart from aging process, other factors which promote obesity are changes in dietary habits, physical activity and other life style practices due to the influence of industrialization, urbanization and globalization. The elderly population is fastest growing segment throughout the world. In the next 30 years increase in elderly population is up to 300% in Asia and Latin America. All this evidence suggests that the situation is likely to get worse. Throughout the Asia-pacific region, there are differences in obesity prevalence and body fat distribution. The WHO classification for BMI is not suitable for assessment of obesity in Indians and Asians, because it has been found that for a given BMI, Indians has more body fat than other ethnic groups both within and outside Asia. In spite of the clinical and public health significance of obesity in terms of important predictor of morbidity and mortality among elderly population and in light of demographic, nutritional and epidemiological transition, there is still a dearth of information regarding prevalence, influence of dietary factors, physical activity, functional status and assessment of obesity among elderly population in Indian subcontinent. Hence, the present study was undertaken to estimate the prevalence of obesity among urban elderly and to study the socio-demographic and life style factors associated with obesity. Methodology It was cross-sectional study conducted between 1st January to 31st December 2013. A total of 700 individuals aged 60 years and above were interviewed. The study participants, permanent residents of Ashok Nagar Urban field practice area, were selected using a simple random technique by considering inclusion and exclusion criteria. Information regarding socio-demographic characteristics, current morbidity status, physical exercise and dietary habits, was collected using pre-designed, pretested, structured proforma by interview technique. The anthropometric measurements like height, weight, waist circumference and percentage body fat of elderly were performed using standard procedures. Data was analyzed and summarized by using percentages and chi square tests for association. Results In our study, 457 (65.3%) participants belonged to 60-69 years age group. Among them 339 (48.5%) were males and 361 (51.5%) were females. Out of the total, 368 (52.6%) were Hindus and 551(78.7%) were living in nuclear families. Among females, 289 (80.0%) were housewives and among males, 80 (23.6%) were unemployed. Nearly 332 (47.4%) study participants belonged to class III and 202 (28.9%) class IV. According to WHO Asia- Pacific guidelines, the overall prevalence of obesity was 40.5%. The prevalence of obesity among elderly males and females was 38.0%, and 43.0% respectively. The overall prevalence of central obesity was 32.6%. Prevalence of central obesity among elderly males and females was 17.1%, and 47.1% respectively. According to body fat percentage 23.2% elderly were obese. The prevalence of obesity was significantly higher in females, in Hindus, in illiterates, those who had sedentary life style and occupation, whereas the prevalence decreased with increased level of education and level of physical activity, among current smokers and alcoholics. In present study, mean consumption of energy was significantly high among obese subjects. Compared with non obese subjects, obese subjects showed a twofold risk of morbidity and morbidities and were significantly associated with central obesity. There was significant association between BMI and Percentage body fat in females. Conclusion The study highlights the problem of obesity in urban elderly. The prevalence of obesity in elderly was slightly higher, with predominance in women. An ageing population together with social, economic and lifestyle changes have led to dramatic increase in obesity. Obesity (general and central) are significantly associated with morbidity. The BMI (proposed WHO Asia-Pacific guidelines), waist circumference (WHO Guidelines) and percentage body fat (Bioelectrical Impedance Analysis) were found to be reliable indicators in the assessment of obesity among elderly subjects.