Caregiving for Older Adults with Obesity in the United States

Objectives: To determine the difference in receipt of activity of daily living (ADL) assistance between obese and normal-weight older adults. Design: Retrospective cohort study. Setting: National Health and Aging Trends Study, 2011–2015. Participants: U.S. adults aged 65 and older with ADL disability and a body mass index (BMI) of 18.5 kg/m² or greater (N = 5,612). Measurements: BMI was classified as normal weight (18.5–24.9 kg/m²), overweight (25.0–29.9 kg/m²), or obese (≥30.0 kg/m²). Primary outcome was self-reported receipt of help with specific ADLs. Models were adjusted for demographic characteristics (age, sex, race), degree of need (self-reported general health, severity of disability), household resources (income, marriage, people in household, number of children), and cognitive status (dementia, proxy respondent). Results: Obese with disabilities had lower rates of receiving assistance with walking inside (odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.50–0.81), walking outside (OR = 0.76, 95% CI = 0.59–0.97), toileting (OR = 0.68, 95% CI = 0.52–0.89), and getting in and out of bed (OR = 0.67, 95% CI = 0.50–0.87) than normal-weight older adults after adjustment for respondent demographic characteristics. Level of need and cognitive status partially explained the associations. In fully adjusted models, older adults with obesity still had significantly lower odds of receiving assistance in getting in and out of bed than normal weight adults (OR = 0.69, 95% CI = 0.49–0.98). Conclusion: Older adults with obesity are less likely to receive assistance for ADL disabilities than their normal-weight counterparts—an important concern because of ongoing demographic changes in the United States.