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Old 01-04-2008, 08:57 PM
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Default Old Age Is Harder for the Overweight

Carrying extra weight can do a number on your knees. (Jodi Hilton for The New York Times)
For people carrying extra pounds, the news last week was good. Obesity doesn’t increase cancer risk, the Journal of the American Medical Association (JAMA) reported.
But that doesn’t mean it’s time to celebrate a fuller figure. The same issue of JAMA reported that old age is a particularly treacherous time for the obese. Obese people over age 60 are twice as likely to have some sort of disability as older people of normal weight, the study found.
Concerns about disability are particularly important as the medical community rethinks health advice for the overweight. Studies show that overweight people have lower death rates than people of normal weight. But just because people are living longer, that doesn’t mean they’re living better, say doctors.
“So they aren’t dying of cancer,’’ said Dr. Pamela Peeke, clinical assistant professor of medicine at the University of Maryland, of the recent reports. “But can they get up out of a chair?’’
It’s long been shown that extra weight takes an added toll on knee and hip joints and increases the risk for arthritis. In the recent JAMA report, University of Pennsylvania researchers studied nearly 10,000 people ages 60 and older, measuring both functional limitations, such as the ability to stoop or kneel easily, as well as limitations in daily activity, such as being able to carry a grocery bag or get dressed.
The study only looked at the disability risk from being obese, which means having a body mass index (B.M.I.) of 30 or higher. But the study authors noted that the cumulative effect of carrying excess weight over a lifetime may pose an added risk. And given that many people gain a few pounds a year, a person who is overweight today may eventually find himself in the obese category.
In the study, a person was considered to have functional limitations if they had trouble with four out of six tasks: walking a quarter of a mile; walking up 10 steps without resting; stooping, crouching or kneeling; lifting or carrying 10 pounds; walking between rooms on the same floor; and standing from an armless chair. A person was counted as having a daily limitation if they had problems with two out of three activities: getting in and out of bed, eating and dressing.
While these may sound like small impairments, the extent to which individuals can function in daily life is central to their quality of life as they age. Simply being able to get in and out of bed easily or to stand up from a chair without assistance can sometimes mean the difference between living independently or needing to go to a nursing home.
Dr. Peeke says people need to rethink their reasons for exercise. While many exercise to manage weight or simply because they enjoy it, those who aren’t regular exercisers need to assess their “functional” fitness to determine how prepared they are for aging.
In her recent book, “Fit to Live,” Dr. Peeke offers simple tests of flexibility, balance and strength to help people determine their level of functional fitness. Here are some of the questions:
Can you climb 20 stair steps in 40 seconds without touching the railing?
From a full standing position, get down flat on the floor. Can you get up again with no help?
Stand with your arms out for balance and lift your leg in front of you, keeping it straight. Can you do it for 10 seconds on each side?
Although the book includes several more tests, the answers will give you a sense of how much you need to work on your functional fitness.
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