Obesity and Mobility in Advancing Age: Mechanisms and Interventions to Preserve Independent Mobility

Abstract

Obesity and aging adversely affect musculoskeletal health and functional independence through common physiological pathways. Muscle quality and strength decline as muscle issues become infiltrated with fat. Inflammation, insulin resistance and anabolic hormonal deficits develop. Musculoskeletal disease develops over time, causing painful movement. Muscle cell regenerative capacity also declines. The collective result is onset of mobility disability. Pain catastrophizing and kinesiophobia may exacerbate disability and accelerate muscle strength loss and overall fat accumulation. Interventional strategies to prevent mobility disability in the aging, obese population should be multifaceted. Long term success with independent mobility is probable when interventions include weight and pain management techniques, support and coaching, strengthening exercise for lower extremity and thoracic musculature, and special nutritional considerations to promote preservation of muscle mass. © 2013 Springer Science+Business Media New York.