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Minimally Invasive Bariatric Surgery pp 411–416Cite as

43 Bariatric Surgery in the Elderly

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Abstract

The elderly comprise the fastest-growing segment of the population in the United States. As the obesity epidemic continues, the number of people entering their late 60s who are obese is also climbing. Elderly patients, once thought to be at excessive risk for bariatric surgery, are now increasingly undergoing bariatric operations. Because comorbid disease may be more advanced in this population, thorough preoperative evaluation and careful patient selection are required to achieve good outcomes in this group of patients. This chapter reviews the current evidence regarding obesity and outcomes of bariatric surgery in the elderly.

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Author information

Authors and Affiliations

  1. General and Bariatric Surgery, Mercy Clinic and Hospital, 4140 W. Memorial Road, Suite 621, Oklahoma City, OK, 73014, USA

    Elizabeth A. Hooper M.D.

  2. Department of Bariatric and Minimally Invasive Surgery, South Eastern Medical Center, 2934 North Elm Street, Suite E, Lumberton, NC, 28358, USA

    Bamdad Farhad D.O.

  3. Department of Surgery, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA

    Julie J. Kim M.D.

Authors
  1. Elizabeth A. Hooper M.D.
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  2. Bamdad Farhad D.O.
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  3. Julie J. Kim M.D.
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Corresponding author

Correspondence to Julie J. Kim M.D. .

Editor information

Editors and Affiliations

  1. Cleveland Clinic Lerner College of Medicine, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Stacy A. Brethauer

  2. Cleveland Clinic Lerner College of Medicine, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Philip R. Schauer

  3. Department of Surgery, Health Sciences Center, University of Virginia Health System, Charlottesville, Virginia, USA

    Bruce D. Schirmer

Review Questions and Answers

Review Questions and Answers

  1. 1.

    Which of the following patients has the lowest frailty index?

    1. A.

      Fifty-nine years old female with a history of HTN, CHF, and DM that lives by herself but is unable to cook for herself and requires monthly financial assistance from her daughter.

    2. B.

      Sixty-seven years old male with a history of anxiety and depression that lives at a nursing home and does not require assistance with any of his daily activities but uses a walker.

    3. C.

      Fifty-three years old well-nourished male with normal affect and good sense of humor that lives with his family and requires assistance with bathing, toileting, and getting dressed.

    4. D.

      Fifty-nine years old male with h/o bipolar disorder. He is stable on medications and lives in a group home and requires assistance with feeding and bathing.

    • The answer is A.

    • Using the Katz ADL scoring patient A received 6 out of a possible 6 points and therefore has the lowest frailty index. Although patient B can perform all essential daily activities independently, his mobility (transferring) is somewhat restricted as he has to use a walker so would receive 5 points. Patient C and D both require assistance with multiple daily activities and received 3 and 4 points respectively, giving each a higher frailty score than patient A.

  2. 2.

    Unintentional weight loss in the elderly is:

    1. A.

      Associated with decreased risk of mortality

    2. B.

      May represent confounding conditions such as cancer, failure to thrive or worsening of underlying comorbid conditions

    3. C.

      Associated with decreased fat mass

    4. D.

      Has a similar benefit as intentional weight loss

    • The answer is B.

    • Unintentional weight loss in the elderly may represent confounding conditions such as cancer, failure to thrive or worsening of underlying comorbid conditions and can be associated with a higher risk of mortality.

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Hooper, E.A., Farhad, B., Kim, J.J. (2015). 43 Bariatric Surgery in the Elderly. In: Brethauer, S., Schauer, P., Schirmer, B. (eds) Minimally Invasive Bariatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1637-5_43

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  • DOI: https://doi.org/10.1007/978-1-4939-1637-5_43

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1636-8

  • Online ISBN: 978-1-4939-1637-5

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