According to background information in the article, the percentage of the U.S. population with a body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 30 kg/m2 or greater, increased from an estimated 12 percent in 1991 to approximately 20 percent a decade later. Although some bariatric centers believe the risks of gastric bypass surgery outweigh the benefits in elderly patients, with the increase of life expectancy and the quality of life in older adults, the authors suggest the benefits of such surgery may need to be reconsidered.
Shawn D. St. Peter, M.D., and colleagues from the Mayo Clinic Scottsdale, Scottsdale, Ariz., compared the results of laparoscopic Roux-en-Y gastric bypass surgery in 110 patients younger than sixty years with 20 patients 60 years or older. The researchers examined patients' conditions and medications related to obesity both before and after the operation. In the younger group, the average age was 45 years, while in the older group, the average age was 62.5 years. At the time of operation, the average BMI was 46.4 kg/m2 in the older group and 48.2 kg/m2 in the younger group.
The researchers found that during an average follow-up time of approximately 10 months, weight loss was greater in younger patients (average = 96.96 lbs.), although the difference was not significant (older patients lost an average of 86.35 lbs.). Both the younger and older groups experienced a significant decrease in obesity-related diseases, including high blood pressure and diabetes. Before the operation, older patients had an average of 4.6 such diseases, while younger patients had 3.7, compared to post-operative follow-up, with older and younger patients having 2.9 and 1.4 of these related conditions, respectively. Both groups also had significant reductions in medication after surgery, with the older group decreasing from an average of 4.85 to 2.7 medications; and the younger group decreasing from 2.7 to 1.1 medications.
"Patients of advanced age can safely undergo...gastric bypass with operative results nearly identical to those of younger patients," the authors write. "Younger patients can be expected to demonstrate greater weight loss. Similarly, younger patients can be expected to experience more resolution of their comorbid [related] conditions. However, the older patients still demonstrate considerable improvement of their comorbidities, as evidenced by the greater overall reduction in medications seen at follow-up."
(Arch Surg. 2005; 140: 165 - 168. Available post-embargo at www.archsurg.com)
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