Exceso de peso y discapacidad en las personas mayores de la Argentina

Malena Monteverde Doctora en Economía. Posdoctorada en Demografía. Investigadora Asistente, Centro de Investigaciones y Estudios sobre Cultura y Sociedad (CIECS), Universidad Nacional de Córdoba (UNC), CONICET, Argentina. image/svg+xml
Publicado: 4 diciembre 2015 Open Access
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Resumen


El objetivo del presente trabajo es analizar la relación entre el exceso de peso y la condición de discapacidad en las personas mayores de la Argentina y evaluar en qué medida podría estar operando algún factor protector que reduzca o atenúe el efecto del exceso de peso sobre la pérdida de capacidades funcionales en las personas mayores de 64 años. Para ello se utilizan los microdatos de la Encuesta Nacional de Factores de Riesgo 2009. Con el objeto de medir la asociación entre sobrepeso, obesidad y la condición de discapacidad, así como la interacción de la condición de peso y la edad, se estiman modelos de regresión logística. Los resultados indican que, si bien el sobrepeso y la obesidad tendrían un efecto neto positivo sobre la presencia de discapacidades, este sería menor entre las personas de 64 años y más. Los resultados sugieren que entre las personas mayores existe algún factor protector, que si bien no revierte la relación directa entre exceso de peso y discapacidad, parece atenuarla.


Referencias bibliográficas


1. Verbrugge LM, Lepkowski JM, Imanaka Y. Comorbidity and its impact on disability. The Milbank Quarterly. 1989;67(3/4):450-484.

2. Elo I, Preston S. Effects of early-life conditions on adult mortality: a review. Population Index. 1992;58(2):186-212.

3. Barker D. Mothers, babies and health in later life. Second Edition. London: Churchill Livingstone; 1998.

4. Fried LP, Bandeen-Roche K, Kasper JD, Guralnik JM. Association of comorbidity with disability in older women: The women's health and aging study. Journal of Clinical Epidemiology. 1999;52(1):27-37.

5. Couzin J. Quirks of fetal environment felt decades later. Science. 2002;296(5576):2167-2169.

6. Palloni A, McEniry M, Davila AL, García-Gurucharri A. The influence of early conditions on health status among elderly Puerto Ricans. Social Biology. 2005;52(3-4):132-163.

7. Kuh D, Hardy R, Butterworth S, Okell L, Richards M, Wadsworth M, Cooper C, Sayer AA. Developmental origins of midlife physical performance: evidence from a British birth cohort. American Journal of Epidemiology. 2006;164(2):110-121.

8. Guralnik JM, Butterworth S, Wadsworth MEJ, Kuh D. Childhood socioeconomic status predicts physical functioning a half century later. Journals of Gerontology Series A, Biological Sciences and Medical Sciences. 2006;61(7):694-701.

9. Monteverde M, Pelaez E, Celton D. Level of educaction and disability among the elderly from Buenos Aires. Población y Salud en Mesoamérica. 2012;10(1):1-17.

10. Monteverde-Verdenelli M, Peranovich-Celton A, Zepeda-Ortega A. Comparación de la prevalencia de discapacidades basada en autoreportes en países de América Latina. Población y Salud en Mesoamérica. 2014;12(1):1-11.

11. World Health Organization. WHO Global Infobase [Internet]. 20 ene 2011 [citado 14 feb 2014]. Disponible en: https://goo.gl/poRWpg.

12. Kain J, Vio F, Albala C. Obesity trends and determinant factors in Latin America. Cadernos de Saúde Pública. 2003;19(Supl 1):S77-S86.

13. Martorell M, Kettel-Khan L, Hughes M, Grummer-Strawn L. Obesity in Latin American women and children. Journal of Nutrition. 1998;128:1464-1473.

14. Peña M, Bacallao J. Obesity and poverty a new public health change (Scientific Publication 576). Washington DC: PAHO; 2000.

15. Aranceta J, Perez-Rodrigo C, Serra-Majem L, Ribas L, Quiles-Izquierdo J, Vioque J, Foz M, Spanish Collaborative Group for the Study of Obesity. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO'97 study. European Journal of Clinical Nutrition. 2001;55:430-435.

16. Popkin B, Richards M, Monteiro C. Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. Journal of Nutrition. 1996;126:3009-3016.

17. Popkin B. The nutrition transition and its health implications in lower-income countries. Public Health Nutrition. 1998;1:5-22.

18. Hoffman DJ, Sawaya AL, Verreschi I, Tucker KL, Roberts SB. Why are nutritionally stunted children at increased risk of obesity? Studies of metabolic rate and fat oxidation in shantytown children from São Paulo, Brazil. American Journal of Clinical Nutrition. 2000;72(3):702-707.

19. Schroeder DG, Martorell R, Flores R. Infant and child growth and fatness and fat distribution in Guatemalan adults. American Journal of Epidemiology. 1999;149:177-185.

20. Florencio T, Ferreira H, Tojal A, Cavalcante J, Sawaya A. Obesity and undernutrition in a very low income population in the city of Maceió, northeastern Brazil. British Journal of Nutrition. 2001;86:277-283.

21. Palloni A, McEniry M, Wong R, Pelaez M. The tide to come: Elderly health in Latin America and the Caribbean. Journal of Aging and Health. 2006;18(1):180-206.

22. Sicheiri R, Siquiera K, Moura A. Obesity and abdominal fatness associated with undernutrition early in life in a survey in Rio de Janeiro. International Journal of Obesity and Related Metabolic Disorders. 2000;24:614-618.

23. Barker D. Fetal and infant origins of adult disease. London: British Medical Journal Publishing; 1994.

24. Popkin B, Horton S, Soown K. The nutrition transition and prevention of diet-related diseases in Asia and the Pacific. Food and Nutrition Bulletin. 2001;22(Supl 4):S11-S21.

25. Popkin B. The nutrition transition and obesity in the developing world. Journal of Nutrition. 2001;131(3):871S-873S.

26. Linetzky B, De Maio F, Ferrante D, Konfino J, Boissonnet C. Sex-stratified socio-economic gradients in physical inactivity, obesity, and diabetes: evidence of short-term changes in Argentina. International Journal of Public Health. 2013;58(2):277-284.

27. De Maio FG, Linetsky B, Virgolini M. An average/deprivation/inequality (ADI) analysis of chronic disease outcomes and risk factors in Argentina. Population Health Metrics. 2009;7:8.

28. Fleischer NL, Diez Roux AV, Alazraqui M, Spinelli H, De Maio F. Socioeconomic gradients in chronic disease risk factors in middle-income countries: evidence of effect modification by urbanicity in Argentina. American Journal of Public Health. 2011;101(2):294-301.

29. Sohan AS, Ottenbacher KJ, Markides KS, Kuo YF, Eschbanch K, Goodwin JS. The effect of obesity on disability vs mortality in older Americans. Archives of Internal Medicine. 2007;167:774-780.

30. Vincent HK, Vincent KR. Obesity and inpatient rehabilitation outcomes following knee arthroplasty: A multicenter study. Obesity. 2008;16(1):130-136.

31. World Health Organization. Obesity: preventing and managing the global epidemic (Technical Report Series 894). Geneva: World Health Organization; 2000.

32. Caballero B, Wang J. Commentary: obesity and mortality - light at the end but still a long tunnel. International Journal of Epidemiology. 2006;39:21-22.

33. Barrera G, Bunout D, Gatta´s V, de la Maza MP, Leiva L, Hirsch S. A high body mass index protects against femoral neck osteoporosis in healthy elderly subjects. Nutrition. 2004;20(9):769-771.

34. Nakaoka D, Sugimoto T, Kaji H, Kanzawa M, Yano S, Yamauchi M, Sugishita T, Chihara K. Determinants of bone mineral density and spinal fracture risk in postmenopausal Japanese women. Osteoporos Int. 2001;12:548-555.

35. Wu F, Ames R, Clearwater J, Evans MC, Gamble G, Reid IR. Prospective 10-year study of the determinants of bone density and bone loss in normal postmenopausal women, including the effect of hormone replacement therapy. Clinical Endocrinology (Oxford). 2002;56(6):703-711.

36. Kato I, Toniolo P, Zeleniuch-Jacquotte A, Shore RE, Koenig KL, Akhmedkhanova A, Ribolic E. Diet, smoking and anthropometric indices and postmenopausal bone fractures: a prospective study. International Journal of Epidemiology. 2000;29(1):85-92.

37. Galvard H, Elmstahl S, Elmstahl B, Samuelsson SM, Robertsson E. Differences in body composition between female geriatric hip fracture patients and healthy controls: body fat is more important as explanatory factor for the fracture than body weight and lean body mass. Aging (Milano). 1996;8(4):282-286.

38. Albala C, Yañez M, Devoto E, et al. Obesity as a protective factor for postmenopausal osteoporosis. International Journal of Obesity and Related Metabolic Disorders. 1996;20(11):1027-1032.

39. Karsenty G. Leptin controls bone formation through a hypothalamic relay. Recent Progress in Hormone Research. 2001;56:401-415.

40. Instituto Nacional de Estadística y Censos. Encuesta Nacional de Factores de Riesgo 2009: Documento para la utilización de la base de datos usuario [Internet]. 2010 [citado 14 feb 2014]. Disponible en: http://goo.gl/gBav9s.

41. World Health Organization. Obesity and overweight [Internet]. 2012 [citado 21 ago 2012]. Disponible en: http://goo.gl/ZiddVI.

42. World Health Organization. BMI classification [Interet]. 2006 [citado 1 nov 2012]. Disponible en: http://goo.gl/tVO4TY.

43. Correa MJC, Sierra LE. Intervalos de confianza para el parámetro de la distribución binomial. Revista Colombiana de Estadística. 2001;24(1):59-72.

44. Freedman DA. On the so-called "Huber Sandwich Estimator" and "Robust Standard Errors". The American Statistician. 2006;60(4):299-302.

45. Beckera J, Nora DB, Gomes I, Stringaria FF, Seitensusa R, Panossoa JS, Ehlers JAC. An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome. Clinical Neurophysiology. 2002;113(9):1429-1434.

46. Schieman S, Turner HA. Age, disability, and the sense of mastery. Journal of Health and Social Behavior. 1998;39(3):169-186.

47. Monteverde M, Noronha K, Palloni A. Obesity and excess mortality among the elderly in the United States and Mexico. Demography. 2010;47(1):79-96.

48. Díaz-García J, González-Zapata LI, Estrada-Restrepo A. Comparación entre variables antropométricas y mediciones reales. Archivos Latinoamericanos de Nutrición. 2012;62(2):112-118.

49. Bender R, Jockel KH, Trautner C, Spraul M, Berger M. Effect of age on excess mortality in obesity. Journal of the American Medical Association. 1999;281:1498-1504.

50. Stevens J, Cai J, Pamuk E, Williamson D, Thun M, Word J. The effect of age on the association between body-mass index and mortality. New England Journal of Medicine. 1998;338:1-7.