Los Angeles [US], February 4 : In older adults, unexplained rapid weight loss may be a sign of an underlying disease and linked to a higher risk of fractures and falls, as well as a worse prognosis over the long run, a study said.
The present therapies involve modifying inefficient dietary and physical activity behaviours, as there is an inadequate understanding of the elements that may contribute to rapid weight loss.
Dr Cassandra Smith, a postdoctoral research fellow at Edith Cowan University (ECU), found that a higher chance of rapid weight loss was linked to abdominal aortic calcification (AAC), a sign of severe blood vessel disease, in a study involving 929 older women.
Over the course of five years of observations, rapid weight loss is defined as a fall in body weight of more than five per cent within any 12-month period.
"Rapid weight loss, when it occurs in older women can be a sign of bad things to come such as early institutionalisation, cognitive decline, Alzheimer's disease, and pose a higher risk for falls and fractures," Dr Smith said.
During a five-year observation, 39.4 per cent of the patients had rapid weight loss, which was associated with a 49 per cent increase in the risk of dying in the next 9.5 years. This risk of dying increased to 87 per cent in women who experienced rapid weight loss of more than 10 per cent in a 12-month interval.
When looking at the one-in-two women that had moderate to extensive AAC, they were 36 per cent and 58 per cent more likely to have rapid weight loss over the five years. The results remained similar after adjusting for dietary factors, blood pressure and cholesterol. Importantly this link was still seen in women meeting protein energy and physical activity recommendations.
Dr Smith said the explanations for the relationship between AAC and rapid weight loss remained unclear. One hypothesis is that AAC could limit blood flow to the gut, which could affect the absorption of nutrients.
"This has the potential to change how we treat those older individuals who present with rapid weight loss," Dr Smith said.
"The traditional approach would be to increase protein and energy intake, but data is showing us that it could actually be a vascular disease that is driving that weight loss, in which case using the traditional approaches may not help with body composition."
"Given the poor outcomes commonly associated with rapid weight loss in older adults, AAC may be a tool to identify those older women with the highest risk. It also opens the door to an opportunity for cardiovascular disease risk screening and to consider disease in other vascular beds or organs that may be influencing body composition."
"The next steps of this research are to replicate these findings in other cohorts, to perform studies with blood flow measures and the capacity to track macronutrient absorption."
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