Loading…
Changes in body weight and health-related quality-of-life in the older adult population
BACKGROUND: No other study has ascertained the short-term impact of weight change on health-related quality-of-life (HRQL) on a national sample of older adults. OBJECTIVE: To examine the relationship between change in body weight and HRQL among the older adult population. METHODS: We carried out a p...
Saved in:
Published in: | International Journal of Obesity 2005-11, Vol.29 (11), p.1385-1391 |
---|---|
Main Authors: | , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-c550t-878298e54c68267a41300f9d008af8a0125a171b27727d3e2b013f57261613c3 |
---|---|
cites | cdi_FETCH-LOGICAL-c550t-878298e54c68267a41300f9d008af8a0125a171b27727d3e2b013f57261613c3 |
container_end_page | 1391 |
container_issue | 11 |
container_start_page | 1385 |
container_title | International Journal of Obesity |
container_volume | 29 |
creator | León-Muñoz, L M Guallar-Castillón, P Banegas, J R Gutiérrez-Fisac, J L López-García, E Jiménez, F J Rodríguez-Artalejo, F |
description | BACKGROUND:
No other study has ascertained the short-term impact of weight change on health-related quality-of-life (HRQL) on a national sample of older adults.
OBJECTIVE:
To examine the relationship between change in body weight and HRQL among the older adult population.
METHODS:
We carried out a prospective study from 2001 to 2003 of a cohort of 2364 persons, representative of the noninstitutionalised Spanish population aged 60 y and over. Weight changes during the period 2001–2003 were self-reported, and HRQL in 2003 was measured with the SF-36 questionnaire. Analyses adjusted for the principal confounders.
RESULTS:
Among nonobese women (body mass index (BMI) 18.5–29.9 kg/m
2
), and compared to those who underwent no important weight change, weight loss was associated with a clinically significant worsening in the role-physical, vitality, and social functioning SF-36 scales. Among obese women (BMI≥30 kg/m
2
), weight gain led to a reduction in HRQL for four of the eight SF-36 scales, while weight loss was associated with worse scores in role-emotional and mental health scales. Results were usually similar for men, though of lower magnitude. In both sexes, weight change was associated with a reduction of over 5 points on several physical and mental scales of the SF-36, which indicates a clinically relevant worsening in HRQL.
CONCLUSION:
Weight change is associated with worse HRQL among the older adults, principally women. From the stance of HRQL, it is desirable to prevent weight gain, especially among the obese, and weight loss, especially among the nonobese. |
doi_str_mv | 10.1038/sj.ijo.0803049 |
format | article |
fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_68814339</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A188448487</galeid><sourcerecordid>A188448487</sourcerecordid><originalsourceid>FETCH-LOGICAL-c550t-878298e54c68267a41300f9d008af8a0125a171b27727d3e2b013f57261613c3</originalsourceid><addsrcrecordid>eNp1kk1v1DAQhi0Eokvhyg0UgegtW38ldo7Vii-pEpdKHC1vMt545bW3dqJq_z0OCSygIh8szTzveGZeI_Sa4DXBTF6n_druwxpLzDBvnqAV4aIuK96Ip2iVY6LEVV1doBcp7THGVYXpc3RB6knc8BX6vum130EqrC-2oTsVD2B3_VBo3xU9aDf0ZQSnB-iK-1E7O5zKYEpnDUyKoYciuA5iobvRDcUxHMcM2-BfomdGuwSvlvsS3X36eLf5Ut5--_x1c3NbtrmVoZRC0kZCxdta0lpoThjGpukwltpIjQmtNBFkS4WgomNAt5gwUwla5xFYyy7R1Vz2GMP9CGlQB5tacE57CGNStZSEM9Zk8N0_4D6M0efWFCUNIzUTMkPvZ2inHSjrTRiibqeK6oZIybnkUmRq_QiVTwcH2wYPxub4X4KrPwTzVlNw47Sn9GjlNoaUIhh1jPag40kRrCbHVNqrbLda7M6Ct8tU4_YA3Rlf_M3AhwXQqdXORO1bm86coFiSn5Nfz1zKqfwf4nk9_336zazwehgj_C75K_8DTXzIcQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>219316378</pqid></control><display><type>article</type><title>Changes in body weight and health-related quality-of-life in the older adult population</title><source>Nature Journals Online</source><creator>León-Muñoz, L M ; Guallar-Castillón, P ; Banegas, J R ; Gutiérrez-Fisac, J L ; López-García, E ; Jiménez, F J ; Rodríguez-Artalejo, F</creator><creatorcontrib>León-Muñoz, L M ; Guallar-Castillón, P ; Banegas, J R ; Gutiérrez-Fisac, J L ; López-García, E ; Jiménez, F J ; Rodríguez-Artalejo, F</creatorcontrib><description>BACKGROUND:
No other study has ascertained the short-term impact of weight change on health-related quality-of-life (HRQL) on a national sample of older adults.
OBJECTIVE:
To examine the relationship between change in body weight and HRQL among the older adult population.
METHODS:
We carried out a prospective study from 2001 to 2003 of a cohort of 2364 persons, representative of the noninstitutionalised Spanish population aged 60 y and over. Weight changes during the period 2001–2003 were self-reported, and HRQL in 2003 was measured with the SF-36 questionnaire. Analyses adjusted for the principal confounders.
RESULTS:
Among nonobese women (body mass index (BMI) 18.5–29.9 kg/m
2
), and compared to those who underwent no important weight change, weight loss was associated with a clinically significant worsening in the role-physical, vitality, and social functioning SF-36 scales. Among obese women (BMI≥30 kg/m
2
), weight gain led to a reduction in HRQL for four of the eight SF-36 scales, while weight loss was associated with worse scores in role-emotional and mental health scales. Results were usually similar for men, though of lower magnitude. In both sexes, weight change was associated with a reduction of over 5 points on several physical and mental scales of the SF-36, which indicates a clinically relevant worsening in HRQL.
CONCLUSION:
Weight change is associated with worse HRQL among the older adults, principally women. From the stance of HRQL, it is desirable to prevent weight gain, especially among the obese, and weight loss, especially among the nonobese.</description><identifier>ISSN: 0307-0565</identifier><identifier>EISSN: 1476-5497</identifier><identifier>DOI: 10.1038/sj.ijo.0803049</identifier><identifier>PMID: 16103894</identifier><identifier>CODEN: IJOBDP</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Adults ; Aged ; Aging - physiology ; Biological and medical sciences ; Body Weight ; Chronic illnesses ; Epidemiology ; Female ; Health care ; Health Promotion and Disease Prevention ; Humans ; Internal Medicine ; Linear Models ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Mental health ; Metabolic Diseases ; Middle Aged ; Obesity ; Obesity - psychology ; Older people ; Preventive medicine ; Prospective Studies ; Public Health ; Quality of Life ; Questionnaires ; Spain ; Surveys and Questionnaires ; Thinness - psychology ; Weight control ; Womens health</subject><ispartof>International Journal of Obesity, 2005-11, Vol.29 (11), p.1385-1391</ispartof><rights>Springer Nature Limited 2005</rights><rights>2006 INIST-CNRS</rights><rights>COPYRIGHT 2005 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Nov 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c550t-878298e54c68267a41300f9d008af8a0125a171b27727d3e2b013f57261613c3</citedby><cites>FETCH-LOGICAL-c550t-878298e54c68267a41300f9d008af8a0125a171b27727d3e2b013f57261613c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2725,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17208178$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16103894$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>León-Muñoz, L M</creatorcontrib><creatorcontrib>Guallar-Castillón, P</creatorcontrib><creatorcontrib>Banegas, J R</creatorcontrib><creatorcontrib>Gutiérrez-Fisac, J L</creatorcontrib><creatorcontrib>López-García, E</creatorcontrib><creatorcontrib>Jiménez, F J</creatorcontrib><creatorcontrib>Rodríguez-Artalejo, F</creatorcontrib><title>Changes in body weight and health-related quality-of-life in the older adult population</title><title>International Journal of Obesity</title><addtitle>Int J Obes</addtitle><addtitle>Int J Obes (Lond)</addtitle><description>BACKGROUND:
No other study has ascertained the short-term impact of weight change on health-related quality-of-life (HRQL) on a national sample of older adults.
OBJECTIVE:
To examine the relationship between change in body weight and HRQL among the older adult population.
METHODS:
We carried out a prospective study from 2001 to 2003 of a cohort of 2364 persons, representative of the noninstitutionalised Spanish population aged 60 y and over. Weight changes during the period 2001–2003 were self-reported, and HRQL in 2003 was measured with the SF-36 questionnaire. Analyses adjusted for the principal confounders.
RESULTS:
Among nonobese women (body mass index (BMI) 18.5–29.9 kg/m
2
), and compared to those who underwent no important weight change, weight loss was associated with a clinically significant worsening in the role-physical, vitality, and social functioning SF-36 scales. Among obese women (BMI≥30 kg/m
2
), weight gain led to a reduction in HRQL for four of the eight SF-36 scales, while weight loss was associated with worse scores in role-emotional and mental health scales. Results were usually similar for men, though of lower magnitude. In both sexes, weight change was associated with a reduction of over 5 points on several physical and mental scales of the SF-36, which indicates a clinically relevant worsening in HRQL.
CONCLUSION:
Weight change is associated with worse HRQL among the older adults, principally women. From the stance of HRQL, it is desirable to prevent weight gain, especially among the obese, and weight loss, especially among the nonobese.</description><subject>Adults</subject><subject>Aged</subject><subject>Aging - physiology</subject><subject>Biological and medical sciences</subject><subject>Body Weight</subject><subject>Chronic illnesses</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Health care</subject><subject>Health Promotion and Disease Prevention</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Linear Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental health</subject><subject>Metabolic Diseases</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity - psychology</subject><subject>Older people</subject><subject>Preventive medicine</subject><subject>Prospective Studies</subject><subject>Public Health</subject><subject>Quality of Life</subject><subject>Questionnaires</subject><subject>Spain</subject><subject>Surveys and Questionnaires</subject><subject>Thinness - psychology</subject><subject>Weight control</subject><subject>Womens health</subject><issn>0307-0565</issn><issn>1476-5497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNp1kk1v1DAQhi0Eokvhyg0UgegtW38ldo7Vii-pEpdKHC1vMt545bW3dqJq_z0OCSygIh8szTzveGZeI_Sa4DXBTF6n_druwxpLzDBvnqAV4aIuK96Ip2iVY6LEVV1doBcp7THGVYXpc3RB6knc8BX6vum130EqrC-2oTsVD2B3_VBo3xU9aDf0ZQSnB-iK-1E7O5zKYEpnDUyKoYciuA5iobvRDcUxHMcM2-BfomdGuwSvlvsS3X36eLf5Ut5--_x1c3NbtrmVoZRC0kZCxdta0lpoThjGpukwltpIjQmtNBFkS4WgomNAt5gwUwla5xFYyy7R1Vz2GMP9CGlQB5tacE57CGNStZSEM9Zk8N0_4D6M0efWFCUNIzUTMkPvZ2inHSjrTRiibqeK6oZIybnkUmRq_QiVTwcH2wYPxub4X4KrPwTzVlNw47Sn9GjlNoaUIhh1jPag40kRrCbHVNqrbLda7M6Ct8tU4_YA3Rlf_M3AhwXQqdXORO1bm86coFiSn5Nfz1zKqfwf4nk9_336zazwehgj_C75K_8DTXzIcQ</recordid><startdate>20051101</startdate><enddate>20051101</enddate><creator>León-Muñoz, L M</creator><creator>Guallar-Castillón, P</creator><creator>Banegas, J R</creator><creator>Gutiérrez-Fisac, J L</creator><creator>López-García, E</creator><creator>Jiménez, F J</creator><creator>Rodríguez-Artalejo, F</creator><general>Nature Publishing Group UK</general><general>Nature Publishing</general><general>Nature Publishing Group</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T2</scope><scope>7TK</scope><scope>7TS</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20051101</creationdate><title>Changes in body weight and health-related quality-of-life in the older adult population</title><author>León-Muñoz, L M ; Guallar-Castillón, P ; Banegas, J R ; Gutiérrez-Fisac, J L ; López-García, E ; Jiménez, F J ; Rodríguez-Artalejo, F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c550t-878298e54c68267a41300f9d008af8a0125a171b27727d3e2b013f57261613c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adults</topic><topic>Aged</topic><topic>Aging - physiology</topic><topic>Biological and medical sciences</topic><topic>Body Weight</topic><topic>Chronic illnesses</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Health care</topic><topic>Health Promotion and Disease Prevention</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Linear Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental health</topic><topic>Metabolic Diseases</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity - psychology</topic><topic>Older people</topic><topic>Preventive medicine</topic><topic>Prospective Studies</topic><topic>Public Health</topic><topic>Quality of Life</topic><topic>Questionnaires</topic><topic>Spain</topic><topic>Surveys and Questionnaires</topic><topic>Thinness - psychology</topic><topic>Weight control</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>León-Muñoz, L M</creatorcontrib><creatorcontrib>Guallar-Castillón, P</creatorcontrib><creatorcontrib>Banegas, J R</creatorcontrib><creatorcontrib>Gutiérrez-Fisac, J L</creatorcontrib><creatorcontrib>López-García, E</creatorcontrib><creatorcontrib>Jiménez, F J</creatorcontrib><creatorcontrib>Rodríguez-Artalejo, F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Complete (ProQuest Database)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>Agriculture Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database (ProQuest)</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>International Journal of Obesity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>León-Muñoz, L M</au><au>Guallar-Castillón, P</au><au>Banegas, J R</au><au>Gutiérrez-Fisac, J L</au><au>López-García, E</au><au>Jiménez, F J</au><au>Rodríguez-Artalejo, F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in body weight and health-related quality-of-life in the older adult population</atitle><jtitle>International Journal of Obesity</jtitle><stitle>Int J Obes</stitle><addtitle>Int J Obes (Lond)</addtitle><date>2005-11-01</date><risdate>2005</risdate><volume>29</volume><issue>11</issue><spage>1385</spage><epage>1391</epage><pages>1385-1391</pages><issn>0307-0565</issn><eissn>1476-5497</eissn><coden>IJOBDP</coden><abstract>BACKGROUND:
No other study has ascertained the short-term impact of weight change on health-related quality-of-life (HRQL) on a national sample of older adults.
OBJECTIVE:
To examine the relationship between change in body weight and HRQL among the older adult population.
METHODS:
We carried out a prospective study from 2001 to 2003 of a cohort of 2364 persons, representative of the noninstitutionalised Spanish population aged 60 y and over. Weight changes during the period 2001–2003 were self-reported, and HRQL in 2003 was measured with the SF-36 questionnaire. Analyses adjusted for the principal confounders.
RESULTS:
Among nonobese women (body mass index (BMI) 18.5–29.9 kg/m
2
), and compared to those who underwent no important weight change, weight loss was associated with a clinically significant worsening in the role-physical, vitality, and social functioning SF-36 scales. Among obese women (BMI≥30 kg/m
2
), weight gain led to a reduction in HRQL for four of the eight SF-36 scales, while weight loss was associated with worse scores in role-emotional and mental health scales. Results were usually similar for men, though of lower magnitude. In both sexes, weight change was associated with a reduction of over 5 points on several physical and mental scales of the SF-36, which indicates a clinically relevant worsening in HRQL.
CONCLUSION:
Weight change is associated with worse HRQL among the older adults, principally women. From the stance of HRQL, it is desirable to prevent weight gain, especially among the obese, and weight loss, especially among the nonobese.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>16103894</pmid><doi>10.1038/sj.ijo.0803049</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0307-0565 |
ispartof | International Journal of Obesity, 2005-11, Vol.29 (11), p.1385-1391 |
issn | 0307-0565 1476-5497 |
language | eng |
recordid | cdi_proquest_miscellaneous_68814339 |
source | Nature Journals Online |
subjects | Adults Aged Aging - physiology Biological and medical sciences Body Weight Chronic illnesses Epidemiology Female Health care Health Promotion and Disease Prevention Humans Internal Medicine Linear Models Male Medical sciences Medicine Medicine & Public Health Mental health Metabolic Diseases Middle Aged Obesity Obesity - psychology Older people Preventive medicine Prospective Studies Public Health Quality of Life Questionnaires Spain Surveys and Questionnaires Thinness - psychology Weight control Womens health |
title | Changes in body weight and health-related quality-of-life in the older adult population |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T11%3A27%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Changes%20in%20body%20weight%20and%20health-related%20quality-of-life%20in%20the%20older%20adult%20population&rft.jtitle=International%20Journal%20of%20Obesity&rft.au=Le%C3%B3n-Mu%C3%B1oz,%20L%20M&rft.date=2005-11-01&rft.volume=29&rft.issue=11&rft.spage=1385&rft.epage=1391&rft.pages=1385-1391&rft.issn=0307-0565&rft.eissn=1476-5497&rft.coden=IJOBDP&rft_id=info:doi/10.1038/sj.ijo.0803049&rft_dat=%3Cgale_proqu%3EA188448487%3C/gale_proqu%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c550t-878298e54c68267a41300f9d008af8a0125a171b27727d3e2b013f57261613c3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=219316378&rft_id=info:pmid/16103894&rft_galeid=A188448487&rfr_iscdi=true |