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Obese older women at higher risk for mobility limitation after total knee or hip replacement for OA
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Obesity was associated with an increased risk of late-life mobility limitation among older women who underwent total knee or total hip replacement for osteoarthritis, according to recently published study results.
Researchers conducted a prospective study of women (average age at baseline, 69.3 years) from the Women’s Health Initiative who were recruited between 1993 and 1998 and followed through 2012. Total knee replacement (n = 1.867) and total hip replacement (n = 944) for OA were determined by linking initiative data to Medicare claims. The women were followed up to 18 years (median follow-up, 8 years) after undergoing either procedure.
Average age was 76.9 years at THR and 76.8 years at TKR. Study outcomes included women who survived to age 85 years with mobility limitation, survived to age 85 years with intact mobility or died before age 85 years. BMI was categorized as normal weight (≤24.9 k/gm2), overweight (22.5 kg/m2 to 29.9 kg/m2), obese I (30 kg/m2 to 34.9 kg/m2) and obese II (≥35 kg/m2).
Women in the overweight, obese I and obese II categories had a significantly increased risk for survival to age 85 years with mobility limitation when compared with women classified as normal weight. Women in the obese II cohort had the strongest risk (OR = 4.37), as well as an increased risk of death before age 85 years.
There was increased risk of survival to age 85 years with mobility limitation (OR = 1.65), but not death before age 85 years in women with THR and waist circumference (WC) of greater than 88 cm relative to 88 cm or less. Among women with TKR for OA, high BMI, WC and waist-hip ratio had an association with significantly increased risk for late-life mobility limitation and death.
“General and abdominal obesity were associated with increased risk of survival to age 85 [years] with mobility limitation and death before age 85 [years] after undergoing TJR for hip or knee OA among older women,” the researchers concluded. “… Future studies should evaluate whether weight loss before TJR for hip or knee OA improves long-term aging outcomes. At present, these findings support the maintenance of healthy body weight among women with hip or knee OA scheduled to undergo TJR to lessen the burden of mobility loss in late life.” – Bruce Thiel
Disclosures: The researchers report no relevant financial disclosures.
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