Independent contribution of overweight/obesity and physical inactivity to lower health-related quality of life in community-dwelling older subjects

The study examined the association of nutritional status, obesity and physical activity (PA) with health-related quality of life (HRQL) in the elderly, and whether this relationship persists after controlling for confounders attributable to comorbidities, functional status and cognitive function. A total of 300 community-dwelling persons (177 women and 123 men) between 66 and 79 years of age were randomly chosen from all inhabitants of one district of the city of Lodz (Poland). HRQL was assessed with the Euroqol 5D questionnaire. PA was assessed by two questionnaires: the Seven Day Recall PA Questionnaire and the Stanford Usual Activity Questionnaire. Comorbidities, nutritional state (Mini Nutritional Assessment questionnaire - MNA), physical disability, cognitive function and psychological state were also assessed. In bivariate relationships body mass index (BMI), waist-to-hip ratio (WHR) and the percentage of body fat were negatively related to several HRQL scores both in women and men. Similarly, many HRQL scores were positively related to PA indices in both genders. In multivariate relationships, after adjustments for age, gender, smoking status, number of medications taken, comorbidities and geriatric physical and cognitive function, BMI predicted lower mobility while the percentage of body fat independently contributed to more frequent pain/discomfort and anxiety/depression problems. An adequate MNA added to a higher usual activity score, while a higher Stanford Moderate PA Index predicted better overall perceived health state. These results indicate that excess body fatness and sedentary lifestyle have, together with several functional and medical comorbidities, an independent contribution to inferior HRQL in community dwelling older subjects.