Benefits and Risks of Weight-Loss Treatment for Older, Obese Women

Background: A key issue in the treatment of obesity in older adults is whether the health benefits of weight loss outweigh the potential risks with respect to musculoskeletal injury. Objective: To compare change in weight, improvements in metabolic risk factors, and reported musculoskeletal adverse events in middle-aged (50-59 years) and older (65-74 years), obese women. Materials and methods: Participants completed an initial 6-month lifestyle intervention for weight loss, comprised of weekly group sessions, followed by 12 months of extended care with biweekly contacts. Weight and fasting blood samples were assessed at baseline, month 6, and month 18; data regarding adverse events were collected throughout the duration of the study. Results: Both middle-aged (n = 162) and older (n = 56) women achieved significant weight reductions from baseline to month 6 (10.1 +/- 0.68 kg and 9.3 +/- 0.76 kg, respectively) and maintained a large proportion of their losses at month 18 (7.6 +/- 0.87 kg and 7.6 +/- 1.3 kg, respectively); there were no significant differences between the two groups with respect to weight change. Older women further experienced significant reductions in systolic blood pressure, HbA(1c), and C-reactive protein from baseline to month 6 and maintained these improvements at month 18. Despite potential safety concerns, we found that older women were no more likely to experience musculoskeletal adverse events during the intervention as compared with their middle-aged counterparts. Conclusion: These results suggest that older, obese women can experience significant health benefits from lifestyle treatment for obesity, including weight loss and improvements in disease risk factors. Further investigation of the impact of weight loss on additional health-related parameters and risks (eg, body composition, muscular strength, physical functioning, and injuries) in older adults is needed.National Heart, Lung and Blood Institute R18HL73326University of FloridaDivision of Statistics and Scientific Computatio

Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial

BACKGROUND: Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women. METHODS: Participants (N = 34) were generally healthy, obese, older adult women (age range 55-79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength. RESULTS: Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups. CONCLUSION: Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments

Sleep-Related Problems in Youth with TouretteÕs Syndrome and Chronic Tic Disorder

This study reports the prevalence and symptom correlates of sleep related problems (SRPs) in a sample of young people with TouretteÕs Syndrome (TS) or Chronic Tic Disorder. Fifty-six young people (and one of their parents) with a tic disorder were administered the Yale Global Tic Severity Scale. Children completed the Pediatric Quality of Life Inventory and Multidimensional Anxiety Scale for Children. Parents completed the Pediatric Quality of Life Inventory -Parent Proxy and Child Behavior Checklist. Overall, SRPs were widely endorsed, with 80.4% experiencing at least one SRP and 19.7% experiencing four or more. SRPs were negatively associated with quality of life and positively associated with internalising and externalising behaviours. Children with comorbid anxiety disorders had more SRPs than those without. We conclude by recommending that SRPs be assessed in young people with tics (particularly when comorbid anxiety is present), and highlight the role of psychotherapeutic and pharmacological intervention in reducing SRPs. Key Practitioner Message: • Sleep related problems (SRPs) are relatively common in young people with tic disorders and suggest the need for SRPs to be included in the comprehensive assessment and management of young people with tics • SRPs were positively linked to both anxiety and internalising and externalising behaviours and negatively related to child-and parent-rated quality of life • Should SRPs be present and clinically meaningful, treatment per evidence-based guidelines may be warrante