TOPLINE:

GLP-1s appeared safe and effective for managing obesity in adults aged 65 years or older with or without type 2 diabetes (T2D), producing comparable weight loss and glycemic control to that seen in younger adults with obesity.

METHODOLOGY:

• Older adults with obesity face increased risk for musculoskeletal, cardiometabolic, and mental health comorbidities, yet most trials of GLP‑1s have excluded or underreported older participants.
• Researchers conducted a systematic review and meta-analysis of trials and observational studies to compare the safety and efficacy of GLP-1s in adults aged 65 years or older with obesity and with or without T2D vs younger adults with obesity.
• They performed a meta-analysis of five post hoc analyses of clinical trials involving 1261 participants, of whom 284 were older adults (43% women).
• The safety assessment focused on serious adverse events (hospitalization, disability, or death), nausea, diarrhea, vomiting, constipation, and hypoglycemia. Efficacy outcomes included changes in A1c levels and body weight.

TAKEAWAY:

• No statistically significant difference in the incidence of serious adverse events was observed between older and younger adults receiving GLP-1s.
• Nausea tended to be less common in older adults, but the difference did not reach statistical significance. The rates of vomiting and diarrhea were also similar between age groups.
• Older adults had higher odds of constipation (pooled log odds ratio [LOR], 0.72; P = .02) and hypoglycemia (pooled LOR, 0.97; P < .001) than younger adults.
• Change in A1c levels did not differ significantly between older and younger adults, and weight loss was essentially the same in both groups.

IN PRACTICE:

“The comparable efficacy in weight loss and glycemic control, coupled with a generally tolerable safety profile, suggests that age alone should not preclude the use of GLP-1s. However, clinicians must consider the increased risk of constipation and hypoglycemia among older patients,” the authors wrote.

SOURCE:

The study, led by Inés Rego de Figueiredo, Centro Clínico Académico de Lisboa, Lisbon, Portugal, was published online in Obesity.

LIMITATIONS:

Most studies were conducted in Japan and used a lower BMI cutoff (25 or higher) than the global standard (30 or higher). The small number of studies and relatively small sample sizes of older adults may have reduced statistical power. Most studies included patients with T2D, so it was difficult to separate effects on obesity from effects on diabetes. 

DISCLOSURES:

The authors reported no study funding and declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.