Impact of Age on Obesity-related Comorbidity After Gastric Bypass

OBJECTIVE: To evaluate the resolution of obesity-related comorbidities after gastric bypass in relation to age. SUMMARY BACKGROUND DATA: Previous studies have shown that age >60 years is associated with a significant, but small, increased risk of complications after gastric bypass. The effect in terms of improvement of obesity-related comorbidities in this group of patients is not studied. METHODS: Data on 57,215 patients operated with primary gastric bypass between May 2007 and December 2018 was extracted from the Scandinavian Obesity Surgery Registry. Odds ratio and 95% confidence interval for resolution of comorbidities in 5-years age groups at 1, 2, and 5 years postoperatively was calculated by logistic regression with the entire cohort of patients as reference. Resolution was defined as no longer in need for pharmacological (or continuous positive airway pressure) treatment. RESULTS: Follow-up rates in all eligible patients were 89%, 69%, and 59% at 1, 2, and 5 years, respectively, and 64% in patients >60 years at 5 years. At baseline, the prevalence of most comorbidities was higher in patients above 60 years. In this group of patients, the preoperative prevalence of diabetes, hypertension, dyslipidemia and obstructive sleep apnea syndrome was reduced at 5years by 45%, 10%, 24%, and 62%, respectively. Compared to all patients, the odds ratio (95% confidence interval) for resolution of these comorbidities in patients above 60 years at five years were 0.70 (0.57-0.86) 0.45 (0.37-0.53), 0.80 (0.63-1.01), and 0.54 (0.40-0.72). CONCLUSIONS: Although to somewhat lower rates compared to younger patients, marked and sustained improvements in obesity-related comorbidities are seen after gastric bypass in patients >60 years. This, together with the finding that bariatric surgery is safe in this group of patients, suggests that age should not be considered an exclusion criterion by itself.