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Obesity affects a large proportion of older adults, contributing to poor physical and mental health outcomes. Yet, weight loss (WL) interventions have been under-studied in this population due to concerns about exacerbating age-related reductions in muscle mass, bone density, and physical function. Thus, the potential influence of WL interventions on mental health and quality of life is mostly unknown. We assessed these attributes in a group of community-dwelling, obese (BMI ≥30 kg/m2) older adults (≥60 yr; n = 67) with mild to moderate physical impairment (SPPB score 4–10 out of 12) who were participating in a 6-month WL intervention (-500 kcal/day deficit; 2 diet groups [0.8 g versus 1.2 protein/kg body wt/day]). Significant weight loss and improved SPPB scores (ps < 0.05) were achieved by both groups. Mixed model analysis of the combined groups revealed short-term improvements in mental composite quality of life (SF-36), positive affect (CES-D), and total mood disturbance (POMS) at 3 months and sustained improvement of physical composite quality of life and its subdomains at both 3 and 6 months (ps < 0.05). Conversely, higher baseline depression (CES-D and POMS) and anger (POMS) and longer sleep latency (PSQI) were associated with less successful WL and blunted functional benefit. These findings demonstrate the potential benefits to mental health and quality of life of intentional WL in obese older adults and underscores the need for evaluation of mental health when considering a WL intervention for obese older adults.

Background Anemia is associated with poorer sleep in children, and clinically, anemia is linked to insomnia. However, the association between anemia and insomnia in older adults is understudied. Methods We examined the cross-sectional association between anemia and insomnia in 1,053 adults (71.4 ± 10.6 years) in the Baltimore Longitudinal Study of Aging. Participants were classified as nonanemic, non-iron-deficient anemic, or iron-deficient anemic based on hemoglobin, ferritin, transferrin saturation, and mean cell volume. Insomnia symptoms were evaluated by the Women's Health Initiative Insomnia Rating Scale (WHIIRS). A total score (range 0-20) was generated, and participants were also classified as having 0, 1, or 2+ symptoms. Results Overall, 10.5% of participants had non-iron-deficient anemia, 0.9% had iron-deficient anemia, and 88.5% had no anemia. Due to its low prevalence, the iron-deficient anemic group was dropped from analyses. In models adjusted for demographics, number of medical conditions, and Center for Epidemiologic Studies Depression Scale score, non-iron-deficient anemic individuals had significantly higher WHIIRS total scores, indicating greater insomnia severity, compared to those without anemia (predicted adjusted mean WHIIRS of 7.24 [95% confidence interval (CI): 6.40-8.08] vs 5.92 [95% CI: 5.65-6.19]). They also had twice the risk of reporting ≥2 insomnia symptoms (vs 0 symptoms; relative risk ratio = 2.20, 95% CI: 1.25-3.89). Conclusions Results suggest that individuals with non-iron-deficient anemia are more likely to experience insomnia symptoms than those who are nonanemic. These results may have implications for insomnia treatment or the identification of underlying frailty in individuals with sleep problems.