Obesity and depressive symptoms in elderly Koreans: evidence for the "Jolly Fat" hypothesis from the Ansan Geriatric (AGE) Study

Abstract

The current study is to examine the association between obesity and depressive symptoms and to test the validity of "Jolly Fat" hypothesis in elderly Koreans. A total of 1229 elderly (60-85 years old) Koreans selected from the Ansan Geriatric Study participated in this study. Body mass index (BMI) was calculated from the measured weights and heights of subjects. Overweight and obese were defined as BMI > or =23 and > or =25, respectively. Depressive symptoms were measured using the 30-item Korean version of the Geriatric Depression Scale (K-GDS), with a cutoff point of 18. The prevalence of depressive symptoms in elderly Korean women was higher than in men (20.9% vs. 9.2%, p<0.001). Among elderly women, higher mean values of obesity indexes, such as weight, BMI, waist circumference, waist-hip ratio, and body fat mass, were found in normal subjects than in those with depressive symptoms. No such differences were found in elderly men. Obese elderly women were less likely to suffer from depressive symptoms compared to those with apparently normal weight (odds ratio (OR)=0.63, 95% CI: 0.41-0.96). This inverse association was evident after adjustment for confounders, such as age, education, personal expenses, smoking, alcohol consumption, regular exercise, self-perceived health, presence of chronic disease, and cognitive function. Our data are consistent with the "Jolly Fat" hypothesis being valid only in women, but not in men, among elderly Koreans. A causal relationship between obesity and depressive symptoms should be evaluated in future studies in elderly Korean women.