The following is a summary of “Trends in Obesity Prevalence among US Older Adults in the Last Two Years of Life, 1998–2018,” published in the November 2022 issue of Pain Management by Harris, et al.

Over the years, obesity has become more common in the US. It was difficult to predict the temporal patterns in body mass index categories in the final two years of life. For a study, researchers sought to determine the trends in body mass categories over the past 20 years while accounting for other demographic changes.

They conducted a cross-sectional analysis of survey data obtained prospectively from decedents who passed away between 1998 and 2018 for the nationally representative Health and Retirement Study (HRS). They divided the BMI into five groups and computed the percentage of deceased people who fell into each category during four epochs (1998–2003, 2004–2008, 2009–2013, 2014–2018). They looked at patterns in regression models that controlled for the following variables that were frequently linked to BMI: sex, age, race, ethnicity, education, and tobacco use. Survey wave groups were modeled as orthogonal polynomials.

About 14,797 decedents were included in the analytic cohort. Those classified as having mild-to-moderate obesity in the last two years of life increased from 12.4% to 14.8% (linear trend P< 0.001), a 19% increase over the 1998-2003 and 2014-2018 time periods. From 1.9% to 4.3%, there was a 126% rise in severe obesity (linear trend, P< 0.001). After adjusting for demographic characteristics, the prevalence of underweight dropped from 9.9% to 5.9%, a 40% drop (linear trend P< 0.001). Except for mild-to-moderate obesity, adjusted quadratic temporal trends for the BMI category were not significant.

While being underweight has reduced, severe obesity had climbed significantly. It was crucial to evaluate how the current and future palliative services and end-of-life care systems addressed body size and weight as obesity grew in later years of life.

Reference: jpsmjournal.com/article/S0885-3924(22)00967-8/fulltext