Case Scenario Name of the University Author Note Introduction- Accumulation of excess body fat may affect movement and flexibility impairment

Running head: NURSING ASSIGNMENT
Case scenario
Name of the Student
Name of the University
Author Note

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Introduction- Being obese or overweight refers to the presence of excess body fat that
is more than the amount of fat, which is considered optimally healthy. According to Williams
et al. (2015) accumulation of excess fat brings about movement and flexibility impairment
and also modifies the body appearance. The case involves a septuagenarian who has been
advised by the GP to start weight bearing exercise and lose weight in order to decrease
pressure on the joints. This essay will critically appraise four pieces of scholarly evidences,
supported by other literature in order to synthesise best evidences for the interventions that
have been suggested by the GP to Frederic Arum.
Body- Time and again it has been proved that loss of weight in individuals who are
obese or overweigh helps in decreasing health risks, thus increasing overall fitness, and
delaying the onset of cardiovascular complications and diabetes mellitus (Thiese et al. 2015).
In addition, management of weight has also been associated with a reduction in risks for high
blood pressure, thus lowering risks of morbidity. The systematic review by Batsis et al.
(2017) supported several geriatric obesity interventions and their role in improving health-
related quality of life and physical function among overweight individuals. The major
strength of this evidence can be accredited to its authorship, since all authors were members
and associates of healthcare department of reputed educational organisations. The research
question was based on identification of geriatric obesity interventions that were effective in
guiding different clinical recommendations. Aging is accompanied by modifications in
composition of the body. Fat free mass that is generally composed of skeletal muscle
demonstrates a reduction by as much as 40% from 20-70 years of age (Ambrosi et al., 2017).
However, with an increase in age, fat mass gets redistributed to the visceral components and
there occurs an imbalance between energy intake and expenditure. Owing to the fact that
there occurs a decrease in energy expenditure among the elderly people, with aging, the fat
mass increases, thus proving the significance of the research question (Bartolomeu et al.,

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2017). The researchers adopted the design of a secondary research. This was a correct
approach since it pooled in information from several investigations that were of a similar
design and analysed those medical literature in order to reach a consensus on the best kind of
treatment for the phenomenon under investigation. Furthermore, a summary of research
articles that were directly related to the research question acted as an important component of
evidence-based practice.
The researchers conducted a thorough search of scholarly evidences from different
electronic databases namely, Medline (PubMed), Web of Science, Cochrane Central Register
of Controlled Trials, EMBASE (Ovid), CINAHL, and PsycINFO (Proquest). Hence, they
adopted a correct search strategy that helped them develop an organised assembly of key
terms that facilitated extraction of accurate articles. In addition, usage of the Preferred
Reporting Items for Systematic Reviews and Meta‐Analyses criteria was another correct
approach since this minimum set of items are typically used for helping researchers report
systematic reviews based on risk-benefit analysis of particular interventions (Moher et al.,
2015). It was reported that more weight loss, increased quality of life, and reduction in bone
and muscle mass were detected, when exercise and dietary modifications were performed
together. Exercise alone enhanced physical function, however produced no impact on body
weight. Nonetheless, the authors stated that exclusion of observational study from the review,
publication bias, and exclusion of people aged between 60-64 years were major limitations
that might have reduced reliability of the findings.
The second research was conducted by Jura and Kozak (2016), where the latter was a
part of of Institute of Animal Reproduction and Food Research, Polish Academy of Science.
However, authorship of Jura could not be determined. The researchers tried to investigate
likenesses and underlying mechanisms associated to ageing and obesity. This was a
significant research problem owing to the fact that with an increase in proportion of people

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aged 65 years or more, the increase in prevalence of obese and overweight people also
increases (). Moreover, with a reduction in resting metabolic rate, physical activity decreases
and there is an upsurge in inactive time, accounting for decrease in aging-related energy
expenditure. The researchers did not identify any gap in literature in the introductory
sections, however, the lack of adequate evidence for the association between aging and
obesity formed the foundation of this research article. This article was also based on a
secondary research design that comprises of a summary, organisation and/or combination of
prevailing research, thus proving cost-effective and time saving (Frasca et al. 2016). Thus,
using already published information suggested the presence of a pre-established degree of
reliability and validity. However, some articles used in the review were out-of-date, thus
leading to bias in the results. A search strategy comprises of a well-developed plan that is
generally used for extracting pertinent articles, by using search terms, limiters and filters
(McGowan et al. 2016). Nonetheless, the authors did not mentioned the research
methodology, which was a major limitation. The results suggested that adipose tissue
inflammation among aged people leads to obesity and causes insulin resistance. In addition,
adiponectin generation and secretion were said to be repressed with the advancement of age
and obesity, besides the excess leptin production that causes insulin resistance. The findings
also highlighted lean mass reduction, upregulation of P53, and brown adipocyte induction as
a biomarker of ageing.
The authorship of the third review by Locher et al. (2016) was clearly elucidated and
most of the authors were members of the University of Alabama and/or the Wake Forest
School of Medicine, thus determining their contribution and accountability. The authors
developed three research aims namely, (i) providing current knowledge status about calorie
restriction recommendation for promoting weight loss, (ii) determining its risks and benefits,
and (iii) evaluating all outcomes. These were significant to the research question since caloric