The Aging Waistline: Impact of the Geriatric Obesity Epidemic on an Urban Emergency Department: Original Communication

DOI: 10.4236/ijcm.2013.45047   PDF   HTML     3,328 Downloads   4,758 Views  

Abstract

Purpose: Reviews adult emergency department (ED) visits for patients age 65 and older during one calendar year; determine the prevalence of weight classifications; identifies trends between BMI and discharge/admitting diagnoses, vital signs, and severity index.Methods: The electronic medical records system and data from the ED billing service was reviewed for an urban academic institution with an annual volume of 125,000 for patients age > 65. Using a random number table, a retrospective cohort of 328 elderly patients was selected for review, representing a convenience sample of 2.6% of elderly ED visits. Body Mass Index (BMI) was calculated, using the Center for Disease Control (CDC) formula with underweight (<18.5), normal (18.5 - 24.9), overweight (25 - 29.9), and obese (≥30). Results: The majority of the cohort in this study was African-American and Hispanic (60% and 27% respectively), and there were a higher percentage of females than males (60% and 40% respectively). Approximately 29% of the patients were classified as normal weight, 35% classified as overweight, and 36% as obese. The older the patient, the more likely that patient belonged to a lower weight classification (p < 0.01). Those presenting with neurological, pulmonary or gastrointestinal complaints were more likely to be of a higher weight classification (p < 0.05). Patients who were hypertensive on arrival to the ED were more likely to be in a higher weight classification (p < 0.01). Conclusion: Those patients with a higher weight classification had a strong correlation with selected abnormal vital signs and disease presentations. EDs are important sources of care for the elderly. EDs can serve as a previously untapped resource for screening and early referral exercise programs aimed at improving physical function/ functional status and quality of life in the elderly patient population.

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H. Prendergast, E. Waintraub, B. Bunney, L. Gehm, C. Tyo, A. Marquez, J. Williams, A. Bailey, D. Marquez, M. Edison and M. Mackey, "The Aging Waistline: Impact of the Geriatric Obesity Epidemic on an Urban Emergency Department: Original Communication," International Journal of Clinical Medicine, Vol. 4 No. 5, 2013, pp. 268-272. doi: 10.4236/ijcm.2013.45047.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] N. Samaras, T. Chevalley, D. Samaras, et al., “Older Patients in the Emergency Department: A Review,” Annals of Emergency Medicine, Vol. 56, No. 3, 2010, pp. 261-269. doi:10.1016/j.annemergmed.2010.04.015
[2] D. C. Roberts, M. P. McKay and A. Shaffer, “Increasing rates of Emergency Department Visits for Elderly Patients in the United States, 1993-2003,” Annals of Emergency Medicine, Vol. 51, No. 6, 2008, pp. 769-774. doi:10.1016/j.annemergmed.2007.09.011
[3] B. M. Singal, J. R. Hedges, E. W. Rousseau, et al., “Geriatric Patient Emergency Visits. Part I: Comparison of Visits by Geriatric and Younger Patients,” Annals of Emergency Medicine, Vol. 21, 1992, pp. 802-807. doi:10.1016/S0196-0644(05)81025-X
[4] Federal Interagency Forum on Aging-Related Statistic, “Older Americans 2008: Key-Indicators of Well-Being,” US Government Printing Office, Washington DC, 2008. http://www.agingstats.gov/agingstatsdotnet/Main_Site/Data/2010_Documents/Docs/OA_2010.pdf
[5] D. K. Houston, B. J. Nicklas and Z. A. Claire, “Weighty Concerns: The Growing Prevalence of Obesity among Older Adults,” Journal of the American Dietetic Association, Vol. 109, No. 11, 2009, pp. 1886-1895. doi:10.1016/j.jada.2009.08.014
[6] K. M. Flegal, M. D. Carroll, R. J. Kuczmarski, et al., “Overweight and Obesity in the United States: Prevalence and Trends, 1960-1994,” International Journal of Obesity and Related Metabolic Disorders, Vol. 22, No. 1, 1998, pp. 39-47.
[7] E. A. Finkelstein, I. C. Fiebelkorn and G. Wang, “National Medical Spending Attributable to Overweight and Obesity: How Much, and Who’s Paying?” Health Affairs, Vol. W3, 2003, pp. 219-226.
[8] CDC, “Overweight and Obesity, Ecnomic Consequences,” 2010. http://www.cdc.gov/obesity/causes/economics.html
[9] United Health Foundation, the American Public Health Association and Partnership for Prevention, “The Future Costs of Obesity: National and State Estimates of the Impact of Obesity on Direct Health Care Expenses,” 2009.
[10] D. T. Villareal, C. M. Apovian, R. F. Kushner, et al., “Obesity in Older Adults: Technical Review and Position Statement of the American Society for Nutrition and NAASO, the Obesity Society,” American Journal of Clinical Nutrition, Vol. 82, No. 5, 2005, pp. 923-934. doi:10.1016/j.maturitas.2009.02.010
[11] H. M. Salihu, S. M. Bonnema and A. P. Alio, “Obesity: What Is an Elderly Population Growing Into,” Maturitas, Vol. 63, No. 1, 2009, pp. 7-12.
[12] K. M. Flegal, M. D. Carroll and C. L. Ogden, “Prevalence and Trends in Obesity among US Adults, 1999-2008,” Journal of the American Medical Association, Vol. 303, No. 3, 2010, pp. 235-241. doi:10.1001/jama.2009.2014
[13] J. Kam and D. M. Taylor, “Obesity Significantly Increases the Difficulty of Patient Management in the Emergency Department,” Emergency Medicine Australasia, Vol. 22, 2010, pp. 316-323.
[14] A. Wolk, G. Gridley, M. Svensson, et al., “A Prospective Study of Obesity and Cancer Risk 91,” Cancer Causes Control, Vol. 12, No. 1, 2001, pp. 13-21.
[15] S. Iwao, N. Iwao, D. Muller, et al., “Effect of Aging on the Relationship between Multiple Risk Factors and Waist Circumferences,” Journal of the American Geriatrics Society, Vol. 48, 2000, pp. 788-794.
[16] K. F. Adams, A. Schatzkin, T. B. Harris, et al., “Overweight, Obesity, and Mortality in a Large Prospective Cohort of Persons 50 to 71 Years Old,” The New England Journal of Medicine, Vol. 355, No. 8, 2006, pp. 763-778. doi:10.1056/NEJMoa055643
[17] K. Matsumura, T. Ansai and S. Awano, et al., “Association of Body Mass Index with Blood Pressure in 80Year-Old Subjects,” Journal of Hypertension, Vol. 19, 2001, pp. 2165 and 2168.
[18] I. Janssen, P. Katzmarzyk and R. Ross, “Waist Circumference and Not Body Mass Index Explains Obesity Related Health Risk,” American Journal of Clinical Nutrition, Vol. 79, 2004, pp. 379-384.
[19] CDC, “Healthy Weight—It’s Not a Diet, It’s a Lifestyle!” 2010. http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html

  
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