Retired, Rested, and Gaining: A Health Assessment Case Study of a 71-Year-Old Man With Obesity, Prediabetes, and Slowing Mobility
Student Name
RN to BSN Program, Aspen University
N495: Health Assessment
Instructor Name
Month Day, Year
Retired, Rested, and Gaining: A Health Assessment Case Study of a 71-Year-Old Man With Obesity, Prediabetes, and Slowing Mobility
Middle and later adulthood are when the effects of diet and activity accumulate into chronic disease, and they are also when changes in both still pay off. This case study assesses a composite 71-year-old man seen for a routine wellness visit, calculates and interprets his body mass index, selects screening tools for nutrition, glucose, and mobility, and develops outcomes, nursing interventions, and referrals. The patient and all details are invented for teaching.
Case Presentation
Mr. B. is a 71-year-old retired electrician who lives with his wife in a two-story home. Since retiring four years ago he has gained about 25 pounds. He describes his days as "reading, TV, and projects that don't get finished." He eats three meals a day, often with seconds at dinner, drinks two regular sodas daily, and snacks in the evening. He walks the dog around the block most days, about 10 minutes. His history includes hypertension, treated with lisinopril, and osteoarthritis of both knees. At a visit six months ago his hemoglobin A1c was 6.1 percent. He does not smoke and drinks one or two beers on weekends.
Today his height is 5 feet 9 inches (1.75 meters), his weight is 210 pounds (95.3 kilograms), his waist circumference is 43 inches, and his blood pressure is 138/84 mmHg. He reports that climbing the stairs to the bedroom has become harder and that he now holds the rail. He says his wife worries about his weight, and he would like to "be able to keep up with the grandkids at the lake this summer."
Body Mass Index
Body mass index is weight in kilograms divided by height in meters squared. For Mr. B., 95.3 kg divided by 1.75 m squared (3.06) equals 31.1 kg/m2, which falls in the obesity range of 30.0 to 34.9, class 1. His waist circumference of 43 inches exceeds the 40-inch threshold commonly used to identify increased cardiometabolic risk in men, which suggests that his excess weight is carried centrally.
Body mass index has known limits in older adults. It does not distinguish fat from muscle, and older adults tend to lose muscle mass, so a given index can hide sarcopenia. For that reason, Mr. B.'s assessment adds measures of nutrition quality and physical function rather than relying on weight alone.
Screening Tools
Three screening tools fit Mr. B.'s situation. First, glucose status: his previous A1c of 6.1 percent is in the prediabetes range of 5.7 to 6.4 percent, so a repeat A1c is indicated to confirm the category and establish a baseline. Second, nutrition: the Mini Nutritional Assessment short form screens older adults for malnutrition and risk of malnutrition in six questions covering intake, weight change, mobility, stress, neuropsychological problems, and body mass index, and it has been validated as a practical tool in several settings (Kaiser et al., 2009). In an older adult with obesity it helps detect poor diet quality or unintended changes that weight alone would miss.
Third, mobility: the Timed Up and Go test asks the person to rise from a standard chair, walk 3 meters, turn, walk back, and sit down, and it was developed as a quick measure of basic functional mobility in older adults (Podsiadlo & Richardson, 1991). Mr. B. completed it in 13 seconds, using his arms to push up from the chair. A time of 12 seconds or more is widely used as a threshold for increased fall risk, and his reliance on his arms suggests reduced lower-extremity strength.
Outcomes
Outcomes were set with Mr. B. and tied to his goal of keeping up with his grandchildren. Within six months, he will lose 5 to 7 percent of his body weight, about 10 to 15 pounds. Within three months, he will increase moderate-intensity activity to at least 150 minutes per week and add muscle-strengthening activity on two days per week, consistent with national physical activity guidelines for older adults, which also recommend balance training (Piercy et al., 2018). Within three months, his Timed Up and Go time will fall below 12 seconds without using his arms. At six months, his A1c will be at or below its baseline value.
Nursing Interventions
Interventions begin with the most modifiable behaviors. The nurse shares why modest change matters. In the large federal trial known as the Diabetes Prevention Program, adults with prediabetes who lost a small share of their weight and walked most days developed diabetes far less often, 58 percent less than the placebo group, and the benefit was largest among participants 60 or older (Knowler et al., 2002). Mr. B. chooses two starting changes: replacing regular soda with sparkling water and limiting dinner to one plate. The nurse uses teach-back to confirm he can read a nutrition label for added sugar.
For activity, the nurse builds on his daily dog walk, increasing it by five minutes each week toward 30 minutes, five days a week, and teaches three simple strength and balance exercises that protect his knees: sit-to-stand from a chair without arms, wall push-ups, and standing on one foot near a counter. Tying the chair-rise exercise directly to his Timed Up and Go result gives him a way to see his own progress at the next visit. His wife is invited to join the walks, since the module's theme is aging families and shared change is easier to sustain.
Referrals
Three referrals support the plan. A registered dietitian can provide individualized medical nutrition therapy and, because Mr. B. has prediabetes, may help him enroll in a recognized diabetes prevention lifestyle program, which Medicare covers for eligible beneficiaries. A physical therapist can evaluate his knees and lower-extremity strength and design a progressive program, given his Timed Up and Go result. Finally, his primary care provider should review the repeat A1c and his blood pressure, which remains above goal, and consider whether his antihypertensive regimen needs adjustment. The nurse will follow up by phone in four weeks to check on the walks, the soda, and the exercises.
Conclusion
Mr. B.'s assessment shows how retirement can quietly change diet and activity until obesity, prediabetes, and declining mobility appear together. Calculating his body mass index identified class 1 obesity, and targeted tools added what weight alone could not: a glucose status to confirm, a nutrition screen, and a mobility test that revealed rising fall risk. Outcomes built around his own goal, evidence-based lifestyle interventions that include his wife, and referrals matched to each finding give him a realistic path to being the grandfather who keeps up at the lake.
References
Kaiser, M. J., Bauer, J. M., Ramsch, C., Uter, W., Guigoz, Y., Cederholm, T., Thomas, D. R., Anthony, P., Charlton, K. E., Maggio, M., Tsai, A. C., Grathwohl, D., Vellas, B., & Sieber, C. C. (2009). Validation of the Mini Nutritional Assessment short-form (MNA-SF): A practical tool for identification of nutritional status. The Journal of Nutrition, Health & Aging, 13(9), 782-788. https://doi.org/10.1007/s12603-009-0214-7
Knowler, W. C., Barrett-Connor, E., Fowler, S. E., Hamman, R. F., Lachin, J. M., Walker, E. A., & Nathan, D. M. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6), 393-403. https://doi.org/10.1056/NEJMoa012512
Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., George, S. M., & Olson, R. D. (2018). The Physical Activity Guidelines for Americans. JAMA, 320(19), 2020-2028. https://doi.org/10.1001/jama.2018.14854
Podsiadlo, D., & Richardson, S. (1991). The timed "Up & Go": A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
How this N 495 Module 1 example is structured
N495 Module 1 typically asks for an aging adult case study in APA format: calculate the patient's BMI, identify appropriate screening tools, establish outcomes, create nursing interventions and identify referrals. Aspen revises courses and your classroom's case is the one that counts. This example shows the BMI arithmetic with units, explains the limits of BMI in older adults, justifies each screening tool with its validation source, writes outcomes that are measurable and tied to the patient's goal, and matches every referral to a finding.
N495 Module 1 questions, answered
What does N495 Module 1 usually ask for?
Commonly an aging adult case study: calculate the patient's body mass index, identify appropriate screening tools, establish outcomes, create interventions and identify referrals, written in APA format. The module's discussion typically addresses nutrition and exercise for middle-aged and aging families.
How should I show the BMI calculation?
Write the formula, insert the patient's weight in kilograms and height in meters with units, show the result and classify it. The sample converts pounds and inches, calculates 31.1 kg/m2 and classifies it as class 1 obesity, then adds waist circumference.
Which screening tools fit an older adult case?
Choose tools that match the problems in the case and cite their source. The sample uses A1c for glucose status, the Mini Nutritional Assessment short form for nutrition and the Timed Up and Go for mobility and fall risk, and interprets each result against an accepted threshold.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.