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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

Interventions to achieve long-term weight loss in obese older people: a systematic review and meta-analysis

Review published: 2010.

Bibliographic details: Witham MD, Avenell A.  Interventions to achieve long-term weight loss in obese older people: a systematic review and meta-analysis. Age and Ageing 2010; 39(2): 176-184. [PubMed: 20083615]

Quality assessment

The authors concluded that although reductions in weight were found for weight loss interventions in older people, there was a lack of high-quality evidence to support their efficacy. Although there were limitations in the review, overall the authors? conclusions appeared to reflect the evidence and are likely to be reliable. Full critical summary

Abstract

PURPOSE: the prevalence of obesity is rapidly increasing in older adults. Information is required about what interventions are effective in reducing obesity and influencing health outcomes in this age group.

DESIGN: systematic review and meta-analysis.

DATA SOURCES: thirteen databases were searched, earliest date 1966 to December 2008, including Medline, CINAHL, PsycINFO, the Cochrane database and EMBASE.

STUDY SELECTION: we included studies with participants' mean age > or = 60 years and mean body mass index > or = 30 kg/m(2), with outcomes at a minimum of 1 year. Data were independently extracted by two reviewers and differences resolved by consensus.

DATA EXTRACTION: nine eligible trials were included. Study interventions targeted diet, physical activity and mixed approaches. Populations included patients with coronary artery disease, diabetes mellitus and osteoarthritis.

RESULTS: meta-analysis (seven studies) demonstrated a modest but significant weight loss of 3.0 kg [95% confidence interval (CI) 5.1-0.9] at 1 year. Total cholesterol (four studies) did not show a significant change: -0.36 mmol/l (95% CI -0.75 to 0.04). There was no significant change in high-density lipoprotein, low-density lipoprotein or triglycerides. In one study, recurrence of hypertension or cardiovascular events was significantly reduced (hazard ratio 0.65, 95% CI 0.50-0.85). Six-minute walk test did not significantly change in one study. Health-related quality of life significantly improved in one study but did not improve in a second study.

CONCLUSIONS: although modest weight reductions were observed, there is a lack of high-quality evidence to support the efficacy of weight loss programmes in older people.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2012 University of York.

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