Effect of age on quality of life after gastric bypass: data from the Scandinavian Obesity Surgery Registry.

Background: Whether patients aged 60 years or older should be recommended bariatric surgery is still controversial.

Objective: To assess the effect of age on health-related quality of life (QoL) over time after gastric bypass.

Setting: Data from the Swedish national registry for bariatric surgery.

Methods: Data of 57,215 patients undergoing gastric bypass were retrieved from the Scandinavian Obesity Surgery Register with a follow-up rate at 1,2, and 5 years at 89%, 69%, and 59%, respectively. Patients were divided into 5-years age intervals. Odds ratios for the relative mean changes in QoL were compared by logistic regression.

Results: Preoperatively, patients aged 60 years or older scored better on mental aspects (Mental Component Summary score, MCS) of RAND-36 (Short Form Health Survey (higher values better)) as well as OP (Obesity related Problem scale (lower values better)) better than the entire cohort of patients (MCS: mean [95% CI], 46.2 [45.5-46.9] versus 43.5 [43.4-43.7], respectively; OP: mean [95% CI], 55.3 [54.0-56.6] versus 64.1 [63.9-64.4], respectively), whereas the Physical Component Summary (PCS) scores of patients aged 60 years or older were lower (mean [95% CI], 32.3 [31.7-32.8] for the ≥60-yr cohort versus 36.4 [36.2-36.5] for the entire cohort; P < .001 for all). In all age groups, MCS was improved at 1 and 2 years but decreased to baseline at 5 years. The postoperative improvements in PCS and OP were sustained in all age groups. Although the relative increases for PCS and OP in patients aged ≥60 years were somewhat lower compared with the entire cohort at 5 years, the values were well above baseline levels (mean [95% CI], 41.0 [40.0-42.0] versus 32.3 [31.7-32.8] and 22.2 [20.3-24.0] versus 55.3 [54.0-56.6], respectively; P < .001).

Conclusion: Mental QoL is transiently improved after bariatric surgery without marked differences between age groups. However, patients aged ≥60 years report pronounced and sustained improvements in physical and obesity-specific QoL 5 years postoperatively. These observations support previous studies that older patients should not be denied bariatric surgery from a risk-benefit perspective, solely based on age.