Background Obesity is a risk factor for frailty and muscle weakness, so weight loss in obese older adults may prevent frailty and functional decline. Objective To assess the safety and efficacy of a multimodal weight-loss intervention in improving functional performance and reducing frailty risk in obese older adults. Design Randomized controlled trial with 2 parallel arms. SETTING AND PARTICIPANTS: Community-dwelling obese adults aged 65–75 years with body mass index (BMI) 30–39 kg/m 2 . INTERVENTION: 6-month multimodal intervention based on diet and a physical activity program. Control group: Usual care. Main and Secondary Outcome Measures Frailty (Fried criteria) rate and functional performance at 6, 12, and 24 months of follow-up, respectively. Intermediate Outcome Measures Weight loss, body composition changes, and metabolic and inflammatory biomarker changes. Results N=305. The study intervention increased gait speed at 12 and 24 months of follow-up, but had no significant effect on frailty prevention. It was effective in reducing weight, BMI, fat mass, interleukin 6, and insulin resistance and improving self-reported quality of life. Conclusions The study intervention was not demonstrated to be effective in preventing frailty in obese people aged 65–75 years at 24 months of follow-up. However, it allowed weight loss and a reduction in inflammatory and insulin resistance markers, which could have a long-term effect on frailty that requires further research.

Objective: Ghrelin is a hormone secreted mainly in the stomach which stimulates appetite and food intake. Endocrine factors are among the causes of anorexia in elderly people. The main objective of the present study was to examine the effect of age on ghrelin levels in non-institutionalized elderly people. Design and setting: Observational, cross-sectional, population-based study. Participants: A random sample of men aged 70 yr or older was taken from the municipal census. Measurements: All participants underwent a physical examination which measured weight and height, grip strength, functional capacity (according to the Barthel Index) and nutritional status (according to the short form of the Mini Nutritional Assessment). Blood was taken for basic biochemical analysis, determination of somatotropic, corticotropic, and gonadotropic hormones, and for measurement of ghrelin and cholecystokinin. Results: 152 men with a mean (SD) age of 76.7 (5.4) yr were recruited. Mean ghrelin levels were 1143 (401) pg/ml. A weak negative correlation was found between ghrelin levels and age (r=−0.16, p=0.057). Multiple linear regression analysis showed a significant and independent effect of age (β=−12.1, p=0.049), body mass index (BMI) (β=−22.0, p=0.021), and creatinine levels (β=407.7, p=0.002) on ghrelin. No correlations with age and BMI were found for cholecystokinin. Conclusions: There is a slight decrease in ghrelin levels with age in older men aged 70 yr or more, although the clinical relevance of this finding remains unclear.