Body mass index and symptoms and quality of life indicators of individuals aging with disabilities

Introduction: People with disabilities (PWD) may find it more difficult to eat a healthy diet, control their weight, and be physically active. Health risks of obesity for PWD are well known, but the effects of obesity on secondary conditions and QoL has not been well established. Methods: PROMIS measures of fatigue, pain interference, physical and social function, depression, and sleep and wake disturbance were completed by individuals with muscular dystrophy (339), multiple sclerosis (579), post-polio syndrome (443), and spinal cord injury (488) (total N=1849) participating in an ongoing longitudinal survey of people aging with a disability. Self-reported weight and height were used to calculate BMI. T-scores by BMI categories were compared to the PROMIS US population norms. Results: The mean BMI of respondents was 26.4 kg/m2 with 5.3% classified as underweight (<18.5), 41.6% normal-weight (18.5<25), 29.7% overweight (25<30), and 23.4% obese (≥30). Overweight and obese respondents tended to be older than normal weight individuals (p<0.05) and of male gender (p<0.0001). Compared to the US general population, individuals with disabilities reported a higher symptom burden and poorer QoL on all measures (all p<0.0001). Compared to the normal weight group obese individuals reported worse functioning on all QoL domains except depression (all p<0.05). In comparison to the overweight group the obese group also reported worse physical and social functioning, more fatigue and depression. Conclusion: Obesity in PWD is associated with a higher symptom burden and self-reported QoL. This should be considered when designing and deploying interventions to reduce obesity.