Functional Assessment of Older Obese Patients Candidates for Bariatric Surgery

Abstract

Introduction: Obesity in the elderly is associated with exacerbation of functional decline that occurs with aging and therefore to loss of independence and autonomy impairing quality of life. Objective: To describe profile functionality in obese elderly referred to a bariatric surgery program. Methods: Patients with age 60 and BMI 35 underwent comprehensive geriatric assessment that evaluates co morbidities, medication use, and pain, mability to perform basic activities of daily living (ADL), instrumental activities of daily living (IADL) and the "Timed Upand Go" test (TUG) whose cut-off point was 10 seconds. Results: 60 subjects with a mean age of 64.1 years (60–72) and 75% women. They had an average 121.1kg (72.7-204) and mean BMI 47.2 kg/m2 (35–68.9). About 80% of patients had a BMI 40 and almost half (47.5%) reported some difficulty in IADL. 31 (77.5%) complained of daily pain. TUG test was compromised (>10 sec.) in half the population and the need for auxiliary instrument for walking in 10 patients (25%). No correlation was found between BMI and impairment of IADL or ADL in this study. Moreover, there was a significant association between impairment of IADL and TUG, 2 (1) = 8.12 (p <0.05), as well as impairment of IADL and complaint of pain daily, 2 (1) = 6.16 (p <0.05), and use of auxiliary instrument for walking, 2 (1) = 5.64 (p <0.05). Conclusion: The prevalence of functional limitation in elderly candidates for bariatric surgery is high as well as complaints of dailypain. The association between impairment of IADL and use of auxiliary instrument and difficulty for walking emphasizes and demonstrates the importance of functional assessment in planning strategies for obesity treatment. Functional impairment should be cons idered a comorbidity in surgical indication.