Purpose: Reviews adult emergency department (ED) visits for patients age 65 and older
during one calendar year; determine the prevalence of weight classifications; identifies trends
between BMI and discharge/admitting diagnoses, vital signs, and severity index.Methods: The
electronic medical records system and data from the ED billing service was
reviewed for an urban academic institution with an annual volume of 125,000 for patients age > 65. Using a
random number table, a retrospective cohort of 328 elderly patients was
selected for review, representing a convenience sample of 2.6% of elderly ED
visits. Body Mass Index (BMI) was calculated, using the Center for Disease
Control (CDC) formula
with underweight (<18.5), normal (18.5 - 24.9), overweight (25 - 29.9), and obese (≥30). Results: The majority of the cohort in
this study was African-American and Hispanic (60% and 27% respectively), and
there were a higher percentage of females than males (60% and 40% respectively). Approximately
29% of the patients were classified as normal weight, 35% classified as
overweight, and 36% as obese. The older the patient, the more likely that
patient belonged to a lower
weight classification (p < 0.01). Those presenting with neurological, pulmonary or gastrointestinal
complaints were more likely to be of a higher weight classification (p < 0.05). Patients who were hypertensive
on arrival to the ED
were more likely to be in a higher weight classification (p < 0.01). Conclusion: Those patients with a higher weight classification had a strong correlation
with selected abnormal vital signs and disease presentations. EDs are important
sources of care for the elderly. EDs can serve as a previously untapped
resource for screening and early referral exercise programs aimed at improving
physical function/ functional status and quality of life in the elderly patient population.
Cite this paper
H. Prendergast, E. Waintraub, B. Bunney, L. Gehm, C. Tyo, A. Marquez, J. Williams, A. Bailey, D. Marquez, M. Edison and M. Mackey, "The Aging Waistline: Impact of the Geriatric Obesity Epidemic on an Urban Emergency Department: Original Communication," International Journal of Clinical Medicine
, Vol. 4 No. 5, 2013, pp. 268-272. doi: 10.4236/ijcm.2013.45047
 N. Samaras, T. Chevalley, D. Samaras, et al., “Older Patients in the Emergency Department: A Review,” Annals of Emergency Medicine, Vol. 56, No. 3, 2010, pp. 261-269. doi:10.1016/j.annemergmed.2010.04.015
 D. C. Roberts, M. P. McKay and A. Shaffer, “Increasing rates of Emergency Department Visits for Elderly Patients in the United States, 1993-2003,” Annals of Emergency Medicine, Vol. 51, No. 6, 2008, pp. 769-774.
 B. M. Singal, J. R. Hedges, E. W. Rousseau, et al., “Geriatric Patient Emergency Visits. Part I: Comparison of Visits by Geriatric and Younger Patients,” Annals of Emergency Medicine, Vol. 21, 1992, pp. 802-807.
 Federal Interagency Forum on Aging-Related Statistic, “Older Americans 2008: Key-Indicators of Well-Being,” US Government Printing Office, Washington DC, 2008.
 D. K. Houston, B. J. Nicklas and Z. A. Claire, “Weighty Concerns: The Growing Prevalence of Obesity among Older Adults,” Journal of the American Dietetic Association, Vol. 109, No. 11, 2009, pp. 1886-1895.
 K. M. Flegal, M. D. Carroll, R. J. Kuczmarski, et al., “Overweight and Obesity in the United States: Prevalence and Trends, 1960-1994,” International Journal of Obesity and Related Metabolic Disorders, Vol. 22, No. 1, 1998, pp. 39-47.
 E. A. Finkelstein, I. C. Fiebelkorn and G. Wang, “National Medical Spending Attributable to Overweight and Obesity: How Much, and Who’s Paying?” Health Affairs, Vol. W3, 2003, pp. 219-226.
 CDC, “Overweight and Obesity, Ecnomic Consequences,” 2010. http://www.cdc.gov/obesity/causes/economics.html
 United Health Foundation, the American Public Health Association and Partnership for Prevention, “The Future Costs of Obesity: National and State Estimates of the Impact of Obesity on Direct Health Care Expenses,” 2009.
 D. T. Villareal, C. M. Apovian, R. F. Kushner, et al., “Obesity in Older Adults: Technical Review and Position Statement of the American Society for Nutrition and NAASO, the Obesity Society,” American Journal of Clinical Nutrition, Vol. 82, No. 5, 2005, pp. 923-934.
 H. M. Salihu, S. M. Bonnema and A. P. Alio, “Obesity: What Is an Elderly Population Growing Into,” Maturitas, Vol. 63, No. 1, 2009, pp. 7-12.
 K. M. Flegal, M. D. Carroll and C. L. Ogden, “Prevalence and Trends in Obesity among US Adults, 1999-2008,” Journal of the American Medical Association, Vol. 303, No. 3, 2010, pp. 235-241. doi:10.1001/jama.2009.2014
 J. Kam and D. M. Taylor, “Obesity Significantly Increases the Difficulty of Patient Management in the Emergency Department,” Emergency Medicine Australasia, Vol. 22, 2010, pp. 316-323.
 A. Wolk, G. Gridley, M. Svensson, et al., “A Prospective Study of Obesity and Cancer Risk 91,” Cancer Causes Control, Vol. 12, No. 1, 2001, pp. 13-21.
 S. Iwao, N. Iwao, D. Muller, et al., “Effect of Aging on the Relationship between Multiple Risk Factors and Waist Circumferences,” Journal of the American Geriatrics Society, Vol. 48, 2000, pp. 788-794.
 K. F. Adams, A. Schatzkin, T. B. Harris, et al., “Overweight, Obesity, and Mortality in a Large Prospective Cohort of Persons 50 to 71 Years Old,” The New England Journal of Medicine, Vol. 355, No. 8, 2006, pp. 763-778.
 K. Matsumura, T. Ansai and S. Awano, et al., “Association of Body Mass Index with Blood Pressure in 80Year-Old Subjects,” Journal of Hypertension, Vol. 19, 2001, pp. 2165 and 2168.
 I. Janssen, P. Katzmarzyk and R. Ross, “Waist Circumference and Not Body Mass Index Explains Obesity Related Health Risk,” American Journal of Clinical Nutrition, Vol. 79, 2004, pp. 379-384.
 CDC, “Healthy Weight—It’s Not a Diet, It’s a Lifestyle!” 2010.