Profiling obesity phenotypes and trajectories in older adults of the Quebec NuAge cohort on nutrition and successful aging: A cluster analysis.

ABSTRACT

Obesity in older adults results from several interacting factors. Consequently, interventions have shown mitigated effects. We determined (a) the different subgroups of older adults with obesity based on clusters of associated comorbidities and (b) the trajectory of these clusters to assess their stability over 3 years and factors contributing to transitions. Obese men (n = 193; body mass index [BMI] = 33.15 ± 2.69 kg/m2 ) and women (n = 220; BMI = 33.71 ± 3.71 kg/m2 ) aged between 68 and 82 years were studied. Outcome variables were body composition, strength, physical capacity (PC), nutrition, psychological and physical health and social participation. Cluster analyses, stratified by sex, were used to identify obesity profiles at baseline and follow-up. Three profiles were identified, based on general health (GH), psychological health (PH) and PC Cluster 1 healthy obese (GH+, PH+, PC+); Cluster 2 obese with low PC (GH+/-, PH+/-, PC-); Cluster 3 unhealthy obese (GH-, PH-, PC-). After 3 years, 61.2% and 70.2% of men and women remained in their initial cluster, compared to 20.4% and 13.7% who transitioned towards a worse health cluster and 18.3% and 16.0% who transitioned towards a more favourable cluster, partly explained by changes in physical health for men and physical health and PH for women. The results of this study show that targeting physical function in men and physical health and PH functions in women could prevent further health decline in older adults with obesity. Further studies are needed to investigate the role of these clusters in the prediction of cardiometabolic complications and mortality.