84 Menopause International Vol. 13 No. 2 June 2007 Original article Home care needs of extremely obese elderly European women L W Sørbye,* M Schroll, † H Finne-Soveri, ‡ P V Jónnson, § G Ljunggren,** E Topinkova †† and R Bernabei ‡‡ for the AdHOC Project Research Group *Diakonhjemmet University College, Oslo, Norway; † Bispebjerg Hospital, København, Denmark; ‡ STAKES/CHESS, Helsinki, Finland; § Landspitali University Hospital, Reykjavík, Iceland; ** Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Hradec Králové, Czech Republic; †† Forum/Centrum fõr Vårdutveckling, Stockholm, Sweden; ‡‡ Centro Medicina Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy Correspondence: Liv Wergeland Sørbye, RN MA, Diakonhjemmet University College, Postboks 184, 0319 Oslo, Norway. Email: soerbye@diakonhjemmet.no Abstract Objective. To examine the health and needs of extremely obese women aged over 65 years receiving home care in Europe. Study design. A cross-sectional assessment study based on the Aged in Home Care (AdHOC) project recruited 2974 women aged 65 or over who were receiving home care at 11 sites in European countries. Extreme obesity was defined as ‘Obesity of such a degree as to interfere with normal activities, including respiration’. Main outcome measures: Resident Assessment Instrument for Home Care (RAI-HC version 2.0); Activity of Daily Living Scale; Instrumental Activity of Daily Living Scale; the Minimum Data Set Cognitive Performance Scale; and a health profile. Results: One hundred and twenty women (4.0%) were extremely obese. They were younger than their thinner counterparts, with a median age of 78.3 versus 83.3 years, and they more often had multiple health complaints and needed more help with mobility outside the home. The extremely obese had received home care longer than the non-extremely obese (median 28.7 versus 36.6 months). Extremely obese women also needed more help with personal care than the other group and, due to lower age, they were less cognitively impaired. Conclusions: Extreme obesity is a problem that increasingly affects home care of elderly women. Keywords: Ageing, extreme obesity, female health, home care, Resident Assessment Instrument Menopause International 2007; 13: 84–87 Introduction Average life span has increased continuously in the industrialized world. 1 Over the last few decades, there has been an unprecedented increase in the prevalence of obesity, especially in economically developed countries. Of 93,290 female US veterans aged 18 and over, 37.4% were classified as obese, 2 defined as a body mass index (BMI) of 30 kg/m 2 or more. Obesity is associated with an increased risk of health problems such as diabetes, hypertension, dyslipidaemia, breathlessness, sleep apnoea, gall bladder disease, coronary heart disease or heart failure and osteoarthritis. 3,4 It is becoming an increasingly recognized health issue in the elderly and is associated with more requirements for care. 5–7 The aim of this study was to examine the health and needs of extremely obese women aged over 65 years receiving home care in 11 European countries. Methods A cross-sectional study was undertaken using the population recruited for the European Aged in Home Care (AdHOC) project (all aged 65 years and over). The participants lived in urban settings and were already receiving home care services at the start of the study: 1036 men and 2974 women from 11 European countries were involved (Figure 1). The total refusal rate was 13%. 8 Participants were assessed using the Resident Assess- ment Instrument for Home Care (RAI-HC), version 2.0. 9,10 The assessors observed and talked with the clients; additional information was gathered from written documentation, other team members or next of kin. ‘Extreme obesity’ was defined as ‘Obesity of such a degree as to interfere with normal activities, including respiration’. 11 This corresponds to the World Health Organization’s classes 2 (BMI 35–39.9 )