ReviewObesity and Physical Frailty in Older Adults: A Scoping Review of Lifestyle Intervention Trials
Section snippets
Oxidative Stress and Inflammation
Age-associated increases in markers of oxidative stress, accumulation of oxidative damage, and systemic inflammation are well recognized. These observed changes led to the oxidative stress theory of aging, which hypothesizes that oxidative stress and the related inflammation cause cellular and molecular damage when reactive oxygen species (ROS) overwhelm antioxidant defenses, leading to progressive deleterious changes over time.33 The ROS imbalance not only leads to structural damage to
Approach and Methods
The purpose of this scoping review was to assess the breadth of scientific evidence linking excess adiposity in older adults with detrimental effects on function; to accomplish this, we reviewed the impact of lifestyle interventions, namely weight loss diets and exercise regimens, on these parameters. We used the 5-stage methodological framework of Arksey and O'Malley43 to conduct this scoping review. The steps followed were (1) identify the research questions; (2) identify relevant studies;
Overview
The flow chart shown in Figure 1 illustrates the process by which 21 studies were selected from the original 212 papers identified by the literature search. The most common reason for excluding studies was that they did not meet the criteria of being a prospective lifestyle intervention trial. The 21 papers represented 20 distinct major trials; in 1 case, 2 articles were written about different aspects of the same subjects within the same trial.
The characteristics, outcomes, and key findings
Interventions Affecting Physical Function
This scoping review has confirmed robust beneficial effects of lifestyle interventions on physical function and body composition in obese older adults. Improvements in an array of functional measures were identified in WL arms, EX arms, and WL+ EX arms. Notwithstanding the functional improvements observed with WL, however, it should be noted that LBM was not preserved in WL interventions, a potentially negative consequence for frail older adults.70 More research is needed to determine the
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Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number T32AG000029. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Research reported in this publication was also supported by Donald W. Reynolds Foundation FD∼AGE Grant and the Health Resources and Services Administration Fellowship Grant, Grant Number D01HP08791.
The authors declare no conflicts of interest.