Combination of exercise and weight loss improves functional status as we age.  

Elderly Couple Walking on Beach

Most of the elderly fear losing independence as they age.  As we age, human naturally lose some functional status.  Functional status refers to the ability of the elderly to function on their own without assistance.  It is believed that obesity and a lack of exercise increases the risk of frailty in older adults and thus, increases the risk of lower function.  

Prior research has shown that being of a more moderate to slightly overweight may lower your risk of death as we age.   It is reasonable to assume that losing weight may reduce your ability to remain independent if it increases the ability to fight off illnesses. The basis of this belief is that weight loss would accelerate the age-related loss of muscle and bone mass and resultant sarcopenia and osteopenia resulting in a lower immunity and higher rate of fractures.  The problem is that research does not appear to back this up and recent research from the New England Journal Of Medicine appear to show the opposite[1].  

The clinical trial in this study involved 160 obese elderly adults.   The researchers evaluated the effectiveness of several exercise modes in reversing frailty and preventing a reduction in muscle and bone mass induced by weight loss.  All of the participants were randomly assigned to a weight-management program plus one of four programs: aerobic training, resistance training, combined aerobic and resistance training, or to a control group that had no weight-management or exercise program. The researchers used a test called a Physical Performance Test at baseline and 6 months.  The researchers also looked at frailty measures, body composition, bone mineral density, and physical functions.

So what did the researchers find?  A total of 141 participants completed the program. The Physical Performance Test score increased significantly more in the combination exercise group than in the aerobic and resistance groups.  The scores increased more in all exercise groups than in the control group also.  Strength increased more in the combination and resistance groups than in the aerobic group.  Body weight decreased by 9% in all exercise groups but did not change significantly in the control group (hmm, go figure).  Lean body mass decreased less in the combination and resistance groups than in the aerobic group, as did bone mineral density at the total hip. 

The bottom line:  Weight loss plus combined aerobic and resistance exercise was the most effective in improving functional status of obese older adults. Weight loss did not increase frailty or loss of independence/function.  This is yet another reason to add exercise to your daily routine.