1
|
Raghupathy R, McLean RR, Kiel DP, Hannan MT, Sahni S. Higher abdominal adiposity is associated with higher lean muscle mass but lower muscle quality in middle-aged and older men and women: the Framingham Heart Study. Aging Clin Exp Res 2023; 35:1477-1485. [PMID: 37166563 PMCID: PMC10450777 DOI: 10.1007/s40520-023-02427-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/26/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND The objective was to determine if abdominal fat is related to poor muscle health. METHODS This cross-sectional study included 428 males and 534 females with appendicular lean mass (ALM, kg) from dual-energy X-ray absorptiometry (DXA), grip strength (kg), and upper extremity muscle "quality" (grip strength/arm lean mass) measured (1996-2001) in the Framingham Offspring Study. Sex-specific linear regressions associated adiposity measures [waist circumference (WC, cm) and visceral adipose tissue (VAT, cm3), and subcutaneous adipose tissue (SAT, cm3)] as Z-scores with each measure of muscle, adjusting for covariates. Models were further stratified by body mass index (BMI, < 30, ≥ 30 kg/m2). RESULTS Mean (± SD) age was 60 ± 9 years and BMI was 28.9 ± 4.6 kg/m2 (men) and 27.7 ± 5.8 kg/m2, (women). In men, the BMI-stratified analyses showed higher WC was associated with higher ALM (P < 0.0001 each) but with lower muscle quality (P < 0.02) in both BMI groups. Higher SAT was also associated with higher ALM (P = 0.0002) and lower muscle quality (P = 0.0002) in men with BMI < 30, but not in obese men. In women, higher WC, SAT, and VAT were each associated with higher ALM but lower muscle quality, particularly in obese women. Higher SAT (P = 0.05) and VAT (P = 0.04) were associated with higher quadriceps strength in women with BMI < 30 kg/m2 but not in obese women. CONCLUSIONS Higher abdominal fat may be associated with greater lean mass but poorer muscle quality, particularly in obese women. This suggests that adipose tissue may have endocrine influences on muscle, which should be confirmed in longitudinal studies.
Collapse
Affiliation(s)
- Rachana Raghupathy
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Northeast Ohio Medical University, Rootstown, OH, USA
| | - Robert R McLean
- CorEvitas, LLC, Boston, MA, USA
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, Boston, MA, USA
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, Boston, MA, USA
| | - Marian T Hannan
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, Boston, MA, USA
| | - Shivani Sahni
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, Boston, MA, USA.
| |
Collapse
|
2
|
Alhammad SA, Alwadeai KS. All Types Obesity and Physical Inactivity Associated with the Risk of Activity of Daily Living Limitations Among People with Asthma. J Multidiscip Healthc 2022; 15:1573-1583. [PMID: 35909421 PMCID: PMC9326037 DOI: 10.2147/jmdh.s368660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/05/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To examine the association between all types of obesity, physical inactivity, and the risk of activity of daily living limitations in people with asthma. Patients and Methods In this cross-sectional study, data from 2555 people aged between 25 and 74 years were acquired from the National Survey of Midlife Development in the United States Refresher conducted between 2011 and 2014. Self-reported questions were used to specify the presence or absence of asthma and physical inactivity. All participants were categorized as having no asthma or asthma. Obesity was defined based on three distinctive indicators: body mass index, waist circumference, and waist-to-hip ratio. Results Logistic regression analysis showed that people with asthma who had all types of obesity alone or both all types of obesity and physical inactivity were significantly (P <0.0001) almost more than three times more likely to have limitations in the activity of daily living than those without this condition, even after adjusting for all covariates. Moreover, the odds of activity of daily living limitations were 1.69 times increased in asthma patients with physical inactivity alone, but this increase in risk was not significant (P =0.465). In addition, the odds of activity of daily living limitations were significantly (P <0.0001) more than twice independently in people with asthma aged between 60 and 74 years, female, undergraduate level of education, smoking, and having joint/bone underlying diseases. Conclusion The results demonstrated that the presence of all types of obesity is related to a higher risk of activity of daily living limitations in people with asthma than in those without asthma. Having both all types of obesity and physical inactivity are also linked to a greater risk of activity of daily living limitations in these patients.
Collapse
Affiliation(s)
- Saad A Alhammad
- Department of Rehabilitation Science, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Khalid S Alwadeai
- Department of Rehabilitation Science, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
3
|
Lv D, Shen S, Chen X. Association Between Dynapenic Abdominal Obesity and Fall Risk in Older Adults. Clin Interv Aging 2022; 17:439-445. [PMID: 35418747 PMCID: PMC9001023 DOI: 10.2147/cia.s347053] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background In recent years, dynapenic abdominal obesity has received more and more attention. This article aimed to explore the relationship between dynapenic abdominal obesity and fall risk in older adults. Methods In this cross-sectional study, according to waist circumference (≥90 cm for men and ≥85 cm for women) and handgrip strength (<28 kg for men and <18 kg for women), 551 older adults were divided into four groups: dynapenic abdominal obese (D/AO), dynapenic nonabdominal obese (D/NAO), nondynapenic abdominal obese (ND/AO) and nondynapenic nonabdominal obese (ND/NAO). Fall risk was measured by the Tinetti performance-oriented mobility assessment (POMA). Binary logistic regression was used to explore the relationship between D/AO and fall risk. Results D/AO was related to POMA score (odds ratio [OR]=3.39; 95% confidence interval [CI]: 1.47–7.81; P=0.004) after adjusting the confounding variables. However, D/NAO (OR=1.51; 95% CI:0.69–3.32; P=0.302) and ND/AO (OR=1.48; 95% CI:0.74–2.99; P=0.272) were not associated with POMA score. Conclusion This study suggests that older adults with D/AO have a higher risk of falls. Therefore, it is necessary to strengthen the attention to D/AO and relevant interventions should be implemented.
Collapse
Affiliation(s)
- Danmei Lv
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, 310013, People’s Republic of China
| | - Shanshan Shen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, 310013, People’s Republic of China
| | - Xujiao Chen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, 310013, People’s Republic of China
- Correspondence: Xujiao Chen, Department of Geriatrics, Zhejiang Hospital, Lingyin Road #12, Hangzhou, 310013, People’s Republic of China, Email
| |
Collapse
|
4
|
Hunsucker S, Reed DB. Obesity and Work-Related Injuries Among Farmers in Kentucky, Tennessee, and West Virginia. Workplace Health Saf 2021; 69:573-579. [PMID: 34259589 DOI: 10.1177/21650799211026678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Obesity is a recognized risk factor for work-related injuries (WRI). Despite the inherent safety hazards associated with farm work, research on obesity among farmers is limited giving little guidance to occupational health providers on obesity as a risk factor in farm WRI. This study evaluated the association between obesity and farm WRI. METHODS Cross-sectional data were collected from farmers (n = 100) in Kentucky, Tennessee, and West Virginia. Data included a survey (demographic data, farm factors, health indicators, occurrences of work-related injuries consistent with the definition of Occupational Safety and Health Administration [OSHA] recordable injuries) and direct anthropometric measures (height, weight, and waist circumference). Logistic regression was used to model any work-related injury, injuries consistent with the definition of OSHA recordables (herein called OSHA-recordable injuries), and recurrent injuries occurring during farm work performance on body mass index (BMI) and waist circumference. FINDINGS Twenty-five percent of the participants reported any injuries, and 18% reported OSHA-recordable injuries. Farmers with a BMI ≥30 kg/m2 had 3 times the risk for OSHA-recordable injuries and 5 times the risk for recurrent injuries. No significant relationship was identified between waist circumference and farm WRI. CONCLUSION This study provides evidence that increased BMI is a safety risk for farmers. Prospective studies with a larger sample are needed. Occupational health nurses and providers should educate farmers on the potential safety risk of obesity and implement weight management programs addressing obesity in farmers.
Collapse
|
5
|
Chua KY, Lin X, Wang Y, Chong YS, Lim WS, Koh WP. Visceral fat area is the measure of obesity best associated with mobility disability in community dwelling oldest-old Chinese adults. BMC Geriatr 2021; 21:282. [PMID: 33910516 PMCID: PMC8082923 DOI: 10.1186/s12877-021-02226-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/06/2021] [Indexed: 01/23/2023] Open
Abstract
Background Although obesity can be clinically defined by body mass index (BMI), waist circumference, percent body fat, or visceral fat area, it is unclear which specific measure is best associated with mobility disability in oldest-old adults. Methods Among 589 Chinese participants aged 85 years and older in a population-based cohort in Singapore, we measured waist circumference, computed BMI, estimated appendicular skeletal muscle mass, percent body fat, and visceral fat area using bioelectrical impedance analysis, and evaluated mobility disability using the Loco-Check questionnaire. We computed areas under the receiver operating characteristic curves (AUCROC) to compare how well these measures discriminated between those with and without mobility disability. Logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the associations between obesity defined by these measures and mobility disability. Results Compared to BMI, which had an AUCROC (95% CI) of 0.68 (0.64–0.72) for the discrimination of mobility disability, only visceral fat area had a significantly higher discriminative performance [AUCROC (95% CI) of 0.71 (0.67–0.75) (Padjusted = 0.002)]. The optimal cut-offs of visceral fat area for the discrimination of mobility disability were ≥ 104 cm2 in men and ≥ 137 cm2 in women. In fully adjusted models, only obesity defined by visceral fat area was significantly associated with mobility disability [OR (95% CI) of 2.04 (1.10–3.77)]; obesity defined by the other measures were not associated with mobility disability after adjusting for visceral fat. Conclusion In oldest-old adults, visceral fat area was the best discriminator for obesity associated with mobility disability. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02226-6.
Collapse
Affiliation(s)
- Kevin Yiqiang Chua
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Xinyi Lin
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.,Singapore Clinical Research Institute, Singapore, Singapore
| | - Yeli Wang
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - Wee-Shiong Lim
- Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| |
Collapse
|
6
|
Baker JF, Harris T, Rapoport A, Ziolkowski SL, Leonard MB, Long J, Zemel B, Weber DR. Validation of a description of sarcopenic obesity defined as excess adiposity and low lean mass relative to adiposity. J Cachexia Sarcopenia Muscle 2020; 11:1580-1589. [PMID: 32931633 PMCID: PMC7749601 DOI: 10.1002/jcsm.12613] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/22/2020] [Accepted: 07/22/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND This study aims to assess the construct validity of a body composition-defined definition of sarcopenic obesity based on low appendicular lean mass relative to fat mass (ALMIFMI ) and high fat mass index (FMI) and to compare with an alternative definition using appendicular lean mass index (ALMI) and percent body fat (%BF). METHODS This is a secondary analysis of two cohort studies: the National Health and Examination Survey (NHANES) and the Health, Aging, and Body Composition study (Health ABC). Sarcopenic obesity was defined as low ALMIFMI combined with high FMI and was compared with a widely used definition based on ALMI and %BF cut-points. Body composition Z-scores, self-reported disability, physical functioning, and incident disability were compared across body composition categories using linear and logistic regression and Cox proportional hazards models. RESULTS Among 14, 850 participants from NHANES, patients with sarcopenic obesity defined by low ALMIFMI and high FMI (ALMIFMI -FMI) had above-average FMI Z-scores [mean (standard deviation): 1.00 (0.72)]. In contrast, those with sarcopenic obesity based on low ALMI and high %BF (ALMI-%BF) had below-average FMI Z-scores. A similar pattern was observed for 2846 participants from Health ABC. Participants with sarcopenic obesity based on ALMIFMI -FMI had a greater number of disabilities, worse physical function, and a greater risk of incident disability compared with those defined based on ALMI-%BF. CONCLUSIONS Body composition-defined measures of sarcopenic obesity defined as excess adiposity and lower-than-expected ALMI relative to FMI are associated with functional deficits and incident disability and overcome the limitations of using %BF in estimating obesity in this context.
Collapse
Affiliation(s)
- Joshua F. Baker
- Division of RheumatologyPhiladelphia Veterans' Affairs Medical CenterPhiladelphiaPAUSA
- Division of Rheumatology, School of MedicineUniversity of Pennsylvania8 Penn Tower Building,PhiladelphiaPAUSA
- Center for Clinical Epidemiology and BiostatisticsUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Tamara Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research ProgramNIA, NIHBethesdaMDUSA
| | | | | | - Mary B. Leonard
- Department of Medicine and PediatricsStanford UniversityPalo AltoCAUSA
| | - Jin Long
- Department of Medicine and PediatricsStanford UniversityPalo AltoCAUSA
| | - Babette Zemel
- Children's Hospital of PhiladelphiaPhiladelphiaPAUSA
| | - David R. Weber
- Division of Endocrinology and DiabetesGolisano Children's Hospital, University of RochesterRochesterNYUSA
| |
Collapse
|
7
|
Yaseri M, Alipoor E, Hafizi N, Maghsoudi-Nasab S, Shivappa N, Hebert JR, Hosseinzadeh-Attar MJ. Dietary Inflammatory Index Is a Better Determinant of Quality of Life Compared to Obesity Status in Patients With Hemodialysis. J Ren Nutr 2020; 31:313-319. [PMID: 32952007 DOI: 10.1053/j.jrn.2020.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/29/2020] [Accepted: 07/26/2020] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the relationships among obesity, anthropometries, and the dietary inflammatory index (DII) with different aspects of quality of life (QoL) in patients undergoing hemodialysis. DESIGN AND METHODS In 83 patients representing a range of body weights, QoL (based on short form 36), DII (extracted from dietary recalls), malnutrition-inflammation score, and anthropometric measurements were assessed. RESULTS Obese patients had lower physical health score (mean difference [MD] 9.1, 95% confidence interval [CI] 0.3-17.8, P = .04), physical functioning (MD 10.5, 95% CI 0.7-20.2, P = .04), and bodily pain scores (MD 16.0, 95% CI 3.6-28.4, P = .01) than normal weight group. Patients with abdominal obesity and those with the highest body fat percentage had also lower QoL in many aspects, irrespective of body mass index. The physical (MD 13.2, 95% CI 2.05-24.3, P = .02) and mental (MD 18.4, 95% CI 7.51-29.2, P = .001) health scores, and physical functioning (MD 13.5, 95% CI 1.8-25.2, P = .02), role-physical (MD 25.8, 95% CI 3.0-48.6, P = .03), role-emotional (MD 22.1, 95% CI 5.4-52.8, P = .02), vitality (MD 18.4, 95% CI 7.6-29.3, P = .001), mental health (MD 11.7, 95% CI 3.06-20.4, P = .009), and social functioning (MD 14.2, 95% CI 1.13-27.2, P = .03) were considerably lower in patients with the highest versus the lowest DII. QoL did not differ between normal-weight and obese patients with low DII (P = .26), and between normal-weight and obese patients with high DII (P = .13). Obese patients with low DII also had better QoL than normal-weight subjects with high DII scores. CONCLUSIONS A diet with higher proinflammatory potential was associated with decreased QoL, irrespective of obesity status. Adherence to a low-DII diet might protect against some obesity-associated complications, a finding that needs further investigations.
Collapse
Affiliation(s)
- Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Alipoor
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Nadia Hafizi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Maghsoudi-Nasab
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina; Department of Nutrition, Connecting Health Innovations, LLC, Columbia, South Carolina
| | - James R Hebert
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina; Department of Nutrition, Connecting Health Innovations, LLC, Columbia, South Carolina
| | - Mohammad Javad Hosseinzadeh-Attar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
8
|
Tam BT, Morais JA, Santosa S. Obesity and ageing: Two sides of the same coin. Obes Rev 2020; 21:e12991. [PMID: 32020741 DOI: 10.1111/obr.12991] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/30/2019] [Indexed: 02/06/2023]
Abstract
Conditions and comorbidities of obesity mirror those of ageing and age-related diseases. Obesity and ageing share a similar spectrum of phenotypes such as compromised genomic integrity, impaired mitochondrial function, accumulation of intracellular macromolecules, weakened immunity, shifts in tissue and body composition, and enhanced systemic inflammation. Moreover, it has been shown that obesity reduces life expectancy by 5.8 years in men and 7.1 years in women after the age of 40. Shorter life expectancy could be because obesity holistically accelerates ageing at multiple levels. Besides jeopardizing nuclear DNA and mitochondrial DNA integrity, obesity modifies the DNA methylation pattern, which is associated with epigenetic ageing in different tissues. Additionally, other signs of ageing are seen in individuals with obesity including telomere shortening, systemic inflammation, and functional declines. This review aims to show how obesity and ageing are "two sides of the same coin" through discussing how obesity predisposes an individual to age-related conditions, illness, and disease. We will further demonstrate how the mechanisms that perpetuate the early-onset of chronic diseases in obesity parallel those of ageing.
Collapse
Affiliation(s)
- Bjorn T Tam
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Quebec, Montreal, Canada.,Metabolism, Obesity, and Nutrition Lab, PERFORM Centre, Concordia University, Quebec, Montreal, Canada
| | - Jose A Morais
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Quebec, Montreal, Canada.,Division of Geriatric Medicine and Research Institute, McGill University Health Centre, Quebec, Montreal, Canada
| | - Sylvia Santosa
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Quebec, Montreal, Canada.,Metabolism, Obesity, and Nutrition Lab, PERFORM Centre, Concordia University, Quebec, Montreal, Canada.,Research Centre, Centre intégré universitarie de santé et de services sociaux du Nord-de-I'Île-de-Montréal, Hôpital du Sacré-Cœur de Monréal (CIUSS-NIM, HSCM), Quebec, Montreal, Canada
| |
Collapse
|
9
|
Rossi AP, Urbani S, Fantin F, Nori N, Brandimarte P, Martini A, Zoico E, Mazzali G, Babbanini A, Muollo V, Zamboni M. Worsening Disability and Hospitalization Risk in Sarcopenic Obese and Dynapenic Abdominal Obese: A 5.5 Years Follow-Up Study in Elderly Men and Women. Front Endocrinol (Lausanne) 2020; 11:314. [PMID: 32695067 PMCID: PMC7339917 DOI: 10.3389/fendo.2020.00314] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/24/2020] [Indexed: 12/25/2022] Open
Abstract
Background/Objectives: A general lack of studies comparing the effect of both dynapenic abdominal obesity and sarcopenic obesity on worsening disability and hospitalization risk should be recognized. The aim of the current study was to evaluate, with a 5.5-year follow-up, the prognostic value of sarcopenic obesity and dynapenic abdominal obesity definitions on worsening disability and hospitalization risk in a sample of older adults. Subjects/Methods: In 177 women and 97 men aged 68-78 years, the following outcomes were evaluated at baseline: appendicular skeletal muscle mass (ASMM), percent fat mass (FM%), leg isometric strength, body mass index (BMI), lipid profile, vitamin D3, albumin, fibrinogen, glycemia, physical activity level, income, smoking status, and comorbidities. The rate of reported disabilities and hospitalization were also assessed at baseline, 1, 2, 3, and 5.5-years follow-up. The study population was classified into: (i) non-sarcopenic/obese (NS/O), sarcopenic/non-obese (S/NO), sarcopenic/obese (S/O), non-sarcopenic/non-obese (NS/NO, reference category) according to relative ASMM/FM% tertiles; (ii) non-dynapenic/abdominal obese (ND/AO), dynapenic/non-abdominal obese (D/NAO), dynapenic/abdominal obese (D/AO), non-dynapenic/non-abdominal obese (ND/NAO, reference category) according to muscle strength/waist circumference tertiles. Results: The prevalence of D/AO and S/O was 12.0 and 8.0%, respectively. Only 2 subjects were both D/NAO and S/O (0.8%). D/NAO subjects showed a worsening disability risk of 1.69 times (95% CI: 1.11-2.57), ND/AO subjects showed a 2-fold increased risk (95% CI: 1.34-2.98), while being D/AO more than trebled the risk, even after adjustment for confounding factors (HR: 3.39, 95%; CI: 1.91-6.02). By dividing the study population according to the relative ASMM/FM% tertiles, no groups showed an increased risk of worsening disability. The hospitalization risk, even after adjustment for potential confounders, was 1.84 (95% CI: 1.06-3.19) for D/AO. Dividing the study population according to the relative ASMM/FM% tertiles, no groups showed increased risk of hospitalization. Conclusions: Our results showed that dynapenic abdominal obesity and sarcopenic obesity seem to indicate two distinct phenotypes associated with different health risk profiles. The distribution of participants in waist circumference and muscle strength tertiles allowed for a more accurate risk stratification for worsening disability and hospitalization.
Collapse
Affiliation(s)
- Andrea P. Rossi
- Division of Geriatric, Department of Medicine, University of Verona, Verona, Italy
- *Correspondence: Andrea P. Rossi
| | - Silvia Urbani
- Division of Geriatric, Department of Medicine, University of Verona, Verona, Italy
| | - Francesco Fantin
- Division of Geriatric, Department of Medicine, University of Verona, Verona, Italy
| | - Nicole Nori
- Division of Geriatric, Department of Medicine, University of Verona, Verona, Italy
| | - Piero Brandimarte
- Division of Geriatric, Department of Medicine, University of Verona, Verona, Italy
| | - Angela Martini
- Division of Geriatric, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Zoico
- Division of Geriatric, Department of Medicine, University of Verona, Verona, Italy
| | - Gloria Mazzali
- Division of Geriatric, Department of Medicine, University of Verona, Verona, Italy
| | - Alessio Babbanini
- Division of Geriatric, Department of Medicine, University of Verona, Verona, Italy
| | - Valentina Muollo
- Department of Medicine, Clinical and Experimental Biomedical Sciences, University of Verona, Verona, Italy
| | - Mauro Zamboni
- Division of Geriatric, Department of Medicine, University of Verona, Verona, Italy
| |
Collapse
|
10
|
Ponti F, Santoro A, Mercatelli D, Gasperini C, Conte M, Martucci M, Sangiorgi L, Franceschi C, Bazzocchi A. Aging and Imaging Assessment of Body Composition: From Fat to Facts. Front Endocrinol (Lausanne) 2019; 10:861. [PMID: 31993018 PMCID: PMC6970947 DOI: 10.3389/fendo.2019.00861] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/25/2019] [Indexed: 01/10/2023] Open
Abstract
The aging process is characterized by the chronic inflammatory status called "inflammaging", which shares major molecular and cellular features with the metabolism-induced inflammation called "metaflammation." Metaflammation is mainly driven by overnutrition and nutrient excess, but other contributing factors are metabolic modifications related to the specific body composition (BC) changes occurring with age. The aging process is indeed characterized by an increase in body total fat mass and a concomitant decrease in lean mass and bone density, that are independent from general and physiological fluctuations in weight and body mass index (BMI). Body adiposity is also re-distributed with age, resulting in a general increase in trunk fat (mainly abdominal fat) and a reduction in appendicular fat (mainly subcutaneous fat). Moreover, the accumulation of fat infiltration in organs such as liver and muscles also increases in elderly, while subcutaneous fat mass tends to decrease. These specific variations in BC are considered risk factors for the major age-related diseases, such as cardiovascular diseases, type 2 diabetes, sarcopenia and osteoporosis, and can predispose to disabilities. Thus, the maintenance of a balance rate of fat, muscle and bone is crucial to preserve metabolic homeostasis and a health status, positively contributing to a successful aging. For this reason, a detailed assessment of BC in elderly is critical and could be an additional preventive personalized strategy for age-related diseases. Despite BMI and other clinical measures, such as waist circumference measurement, waist-hip ratio, underwater weighing and bioelectrical impedance, are widely used as a surrogate measure for body adiposity, they barely reflect the distribution of body fat. Because of the great advantages offered by imaging tools in research and clinics, the attention of clinicians is now moving to powerful imaging techniques such as computed tomography, magnetic resonance imaging, dual-energy X-ray absorptiometry and ultrasound to obtain a more accurate estimation of BC. The aim of this review is to present the state of the art of the imaging techniques that are currently available to measure BC and that can be applied to the study of BC changes in the elderly, outlining advantages and disadvantages of each technique.
Collapse
Affiliation(s)
- Federico Ponti
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- *Correspondence: Aurelia Santoro
| | - Daniele Mercatelli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Chiara Gasperini
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Conte
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Morena Martucci
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Luca Sangiorgi
- Department of Medical Genetics and Rare Orthopedic Disease & CLIBI Laboratory, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Department of Applied Mathematics, Institute of Information Technology, Mathematics and Mechanics (ITMM), Lobachevsky State University of Nizhny Novgorod-National Research University (UNN), Nizhny Novgorod, Russia
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| |
Collapse
|
11
|
Meadows R, Bower JK. Associations of anthropometric measures of obesity with physical limitations in older adults. Disabil Rehabil 2018; 42:1101-1106. [PMID: 30574808 DOI: 10.1080/09638288.2018.1516815] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Physical limitations are associated loss of independence, lower quality of life, greater healthcare costs, and mortality. Changes in body composition during the aging process contribute to the decline in physical functioning. Body mass index is commonly used to quantify adiposity; however, measurements that better capture abdominal obesity may confer better advantage for risk of physical limitations.Methods: We used data from the 2013-2014 National Health and Nutrition Examination Survey to compare the associations of (1) body mass index, (2) sagittal abdominal diameter, and (3) waist circumference with physical limitations in adults 60-80 years (n = 1258). We used weighted logistic regression models to allow for estimates that are representative of the US population.Results: All three anthropometric measures were significantly associated with physical limitations. Abdominal fat measurements (sagittal abdominal diameter and waist circumference) were more strongly associated with physical limitations in men. However, they were not independently associated with physical limitations after controlling for body mass index. All three measurements did not differ in their ability to distinguish presence of physical limitations.Conclusions: Our data suggest that abdominal fat measurements are not independently associated with physical limitations after accounting for body mass index. Body mass index, waist circumference, and sagittal abdominal diameter are all of equal practical value for identifying older adults at risk for physical limitations.IMPLICATIONS FOR REHABILITATIONOur data suggest that both sagittal abdominal diameter and waist circumference are not independently associated with physical limitations after accounting for body mass index.Strategies to manage overall body weight may be the most effective goal of primary prevention of disability and to support the rehabilitation process.Body mass index, waist circumference, and sagittal abdominal diameter are all of equal practical value for health professionals to identify older adults at higher risk for physical limitations.Practitioners should consider the measures that are most feasible and easiest to obtain in the clinical setting.
Collapse
Affiliation(s)
- Rachel Meadows
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Julie K Bower
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
12
|
「高齢者肥満症診療ガイドライン2018」. Nihon Ronen Igakkai Zasshi 2018. [PMID: 30464154 DOI: 10.3143/geriatrics.55.g1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
|
13
|
Adair LS, Duazo P, Borja JB. How Overweight and Obesity Relate to the Development of Functional Limitations among Filipino Women. Geriatrics (Basel) 2018; 3. [PMID: 30450359 PMCID: PMC6233880 DOI: 10.3390/geriatrics3040063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
As life expectancy and obesity increase in low and middle-income countries, the relationship of weight status to functional outcomes in older adults in these settings requires attention. We examined how overweight (BMI > 25 kg/m2), obesity (BMI > 30 kg/m2), and high waist circumference (WC > 80 cm) related to grip strength, timed up-and-go, and development of limitations in mobility, activities of daily living (ADL), and instrumental activities of daily living (IADL) among Filipino women. We analyzed data from seven rounds of the Cebu Longitudinal Health and Nutrition Survey (1994, n = 2279 to 2015, n = 1568, age 49–78 years) to examine how women’s reports of functional limitations related to their prior WC, and how their grip strength and timed up-and-go related to concurrently measured overweight and obesity, adjusted for age, socioeconomic status, and urbanicity. High WC was associated with higher odds of subsequent mobility and IADL limitations. Chronic disease morbidity (sum of self-reported arthritis, high blood pressure, heart disease, diabetes, and cancer) fully mediated the association of high WC with ADL and IADL limitations, but not physical/mobility limitations. Longer up-and-go times, and higher grip strength were related to overweight and obesity. Results emphasize the need for obesity prevention to reduce chronic diseases and maintain good functional status as women age.
Collapse
Affiliation(s)
- Linda S. Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Correspondence: (L.S.A.); (J.B.B.); Tel.: +1-919-962-6154 (L.S.A.); +63-32-346-0102 (J.B.B.); Fax: +1-919-966-9159 (L.S.A.)
| | - Paulita Duazo
- USC-Office of Population Studies Foundation, Inc., University of San Carlos, Nasipit, Talamban, Cebu City 6000, The Philippines;
| | - Judith B. Borja
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- USC-Office of Population Studies Foundation, Inc., University of San Carlos, Nasipit, Talamban, Cebu City 6000, The Philippines;
- Department of Nutrition and Dietetics, University of San Carlos, Nasipit, Talamban, Cebu City 6000, The Philippines
- Correspondence: (L.S.A.); (J.B.B.); Tel.: +1-919-962-6154 (L.S.A.); +63-32-346-0102 (J.B.B.); Fax: +1-919-966-9159 (L.S.A.)
| |
Collapse
|
14
|
|
15
|
The combination of dynapenia and abdominal obesity as a risk factor for worse trajectories of IADL disability among older adults. Clin Nutr 2017; 37:2045-2053. [PMID: 29033231 PMCID: PMC6013360 DOI: 10.1016/j.clnu.2017.09.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/08/2017] [Accepted: 09/25/2017] [Indexed: 12/30/2022]
Abstract
Background/Objectives The concept of dynapenic obesity has been gaining great attention recently. However, there is little epidemiological evidence demonstrating that dynapenic abdominal obese individuals have worse trajectories of disability than those with dynapenia and abdominal obesity alone. Our aim was to investigate whether dynapenia combined with abdominal obesity can result in worse trajectories of instrumental activities of daily living (IADL) among English and Brazilian older adults over eight and ten years of follow-up, respectively. Methods We used longitudinal data from 3374 participants from the English Longitudinal Study of Ageing (ELSA) and 1040 participants from the Brazilian Health, Well-being and Aging Study (SABE) who were free from disability as assessed by IADL at baseline. IADL disability was defined herein as a difficulty to perform the following: preparing meals, managing money, using transportation, shopping, using the telephone, house cleaning, washing clothes, and taking medications according to the Lawton IADL modified scale. The study population in each country was categorized into non-dynapenic/non-abdominal obese (reference group), abdominal obese, dynapenic and dynapenic abdominal obese according to their handgrip strength (<26 kg for men and <16 kg for women) and waist circumference (>102 cm for men and >88 cm for women). We used generalized linear mixed models with IADL as the outcome. Results The estimated change over time in IADL disability was significantly higher for participants with dynapenic abdominal obesity compared to those with neither condition in both cohorts (ELSA: 0.023, 95% CI = 0.012–0.034, p < 0.001; SABE: +0.065, 95% CI = 0.038–0.091, p < 0.001). Abdominal+obesity was also associated with changes over time in IADL disability (ELSA: +0.009, 95% CI = 0.002–0.015, p < 0.05; SABE: +0.021, 95% CI = 0.002–0.041, p < 0.05), which was not observed for dynapenia. Conclusions Abdominal obesity is an important risk factor for IADL decline but participants with dynapenic abdominal obesity had the highest rates of IADL decline over time among English and Brazilian older adults.
Collapse
|
16
|
The Effects of Body Mass Index on Balance, Mobility, and Functional Capacity in Older Adults. TOPICS IN GERIATRIC REHABILITATION 2017. [DOI: 10.1097/tgr.0000000000000144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
17
|
Abstract
OBJECTIVE To assess the role of abdominal obesity in the incidence of disability in older adults living in São Paulo, Brazil, in a 5-year period. DESIGN Longitudinal study, part of the SABE Study (Health, Wellbeing and Aging). We assessed the disability incidence in the period (reported difficulty in at least one activity of daily living (ADL) in 2010) in relation to abdominal obesity in 2006 (waist circumference ≥102 cm in men and ≥88 cm in women). We used Poisson regression to evaluate the association between obesity and disability incidence, adjusting for sociodemographic and clinical factors including BMI. SETTING São Paulo, Brazil. SUBJECTS Older adults (n 1109) who were independent in ADL in 2006. In 2010, 789 of these were located and re-interviewed. RESULTS The crude disability incidence (at least one ADL) was 27·1/1000 person-years in the period. The incidence rate was two times higher in participants with abdominal obesity compared with those without (39·1/1000 and 19·4/1000 person-years, respectively; P<0·001). This pattern was observed in all BMI levels. In regression models, abdominal obesity remained associated with disability incidence (incidence rate ratio=1·90; P<0·03), even after controlling for BMI, gender, age, low grip strength, cognitive impairment, physical inactivity and chronic diseases. CONCLUSIONS Abdominal obesity was strong risk factor for disability, showing a more significant effect than BMI, and thus should be an intervention target for older adults. Waist measure is simple, cost-effective and easily interpreted, and therefore can be used in several settings to identify individuals at higher risk of disability.
Collapse
|
18
|
Germain CM, Vasquez E, Batsis JA. Physical Activity, Central Adiposity, and Functional Limitations in Community-Dwelling Older Adults. J Geriatr Phys Ther 2017; 39:71-6. [PMID: 25794309 DOI: 10.1519/jpt.0000000000000051] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Obesity and physical inactivity are independently associated with physical and functional limitations in older adults. The current study examines the impact of physical activity on odds of physical and functional limitations in older adults with central and general obesity. METHODS Data from 6279 community-dwelling adults aged 60 years or more from the Health and Retirement Study 2006 and 2008 waves were used to calculate prevalence and odds of physical and functional limitation among obese older adults with high waist circumference (waist circumference ≥88 cm in females and ≥102 cm in males) who were physically active versus inactive (engaging in moderate/vigorous activity less than once per week). Logistic regression models were adjusted for age, sex, race/ethnicity, education, smoking status, body mass index, and number of comorbidities. RESULTS Physical activity was associated with lower odds of physical and functional limitations among older adults with high waist circumference (odds ratio [OR], 0.59; confidence interval [CI], 0.52-0.68, for physical limitations; OR, 0.52; CI, 0.44-0.62, for activities of daily living; and OR, 0.44; CI, 0.39-0.50, for instrumental activities of daily living). CONCLUSIONS Physical activity is associated with significantly lower odds of physical and functional limitations in obese older adults regardless of how obesity is classified. Additional research is needed to determine whether physical activity moderates long-term physical and functional limitations.
Collapse
Affiliation(s)
- Cassandra M Germain
- 1Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina. 2Department of Epidemiology and Biostatistics, School of Public Health, University at Albany (SUNY), One University Place, Albany, Rensselaer, New York. 3Department of Medicine, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | | |
Collapse
|
19
|
Danon-Hersch N, Fustinoni S, Bovet P, Spagnoli J, Santos-Eggimann B. Association between Adiposity and disability in the Lc65+ Cohort. J Nutr Health Aging 2017; 21:799-810. [PMID: 28717810 DOI: 10.1007/s12603-016-0813-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To examine the longitudinal association between body mass index (BMI) and waist circumference (WC) with mortality and incident disability in Lc65+ cohort. DESIGN Population-based cohort of non-institutionalized adults with up to 8.9 years of follow-up. SETTING City of Lausanne, Switzerland. PARTICIPANTS 1,293 individuals aged 65 to 70 at baseline (58% women). MEASUREMENTS BMI, WC and covariates were measured at baseline in 2004-2005. Vital status was obtained up to the 31st December 2013 and difficulty with basic activities of daily living (BADL) was reported in a self-administered questionnaire sent to participants every year. Main outcomes were total mortality and disability, defined as difficulty with BADL for ≥2 years or institutionalization. Cox regression was used with BMI/WC quintiles 2 as the reference. RESULTS 130 persons died over a median follow-up of 8.47 years (crude mortality rate, men: 16.5/1,000 person-years, women: 9.7/1,000 person-years). In Cox regression adjusted for age, sex, education, financial situation, smoking and involuntary weight loss (IWL) at baseline, mortality was significantly associated with neither BMI nor WC, but there were trends towards non-significant J-curves across both BMI and WC quintiles. Disability (231 cases) tended to increase monotonically across both BMI and WC quintiles and was significantly associated with BMI quintile 5 (HR=2.44, 95% CI [1.65-3.63]), and WC quintiles 4 (HR=1.81 [1.15-2.85]) and 5 (HR=2.58, [1.67-4.00]). CONCLUSION Almost half of the study population had a substantially increased HR of disability, as compared to the reference BMI/WC categories. This observation emphasizes the need for life-long strategies aimed at preventing excess weight, muscle loss and functional decline through adequate nutrition and regular physical activity, starting at early age and extending throughout life.
Collapse
Affiliation(s)
- N Danon-Hersch
- Nadia Danon-Hersch, Institute of Social and Preventive Medicine (IUMSP), University and University Hospital Center, Biopole 2, Route de la Corniche 10, 1010 Lausanne, Switzerland, Tel : +41 21 314 91 09; Fax: +41 21 314 97 67; ;
| | | | | | | | | |
Collapse
|
20
|
Su P, Ding H, Zhang W, Duan G, Yang Y, Long J, Du L, Xie C, Jin C, Hu C, Sun Z, Duan Z, Gong L, Tian W. Joint Association of Obesity and Hypertension with Disability in the Elderly-- A Community-Based Study of Residents in Shanghai, China. J Nutr Health Aging 2017; 21:362-369. [PMID: 28346562 DOI: 10.1007/s12603-016-0777-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although both obesity and hypertension are known risk factors for disability, the joint association of obesity and hypertension with risk of disability is unknown. This paper is aim to examine the joint association of obesity and hypertension with risk of disability. METHODS Cross-sectional study with 8060 elderly community-dwelling individuals participating in the survey initiated by Shanghai Health and Family Planning Commission from March to September 2013. Obesity was measured using the body mass index (BMI) in World Health Organization (WHO) Asia criteria. Hypertension, based on the doctor's diagnosis, was obtained through face-to-face interview. Disability was measured using the self-reported physical self-maintenance scale (PSMS) and the instrumental activities of daily living (IADL) scale developed by Lawton and Brody. RESULTS A total of 8.97% of participants reported ADL disability, and 15.18% for IADL disability. After adjusting social demographics and chronic conditions, the risk of ADL disability was progressively greater in obese persons with hypertension (OR=1.40, 95% CI=1.05-1.89), underweight persons without hypertension (OR=2.05, 95% CI=1.29-3.25), and underweight persons with hypertension (OR=2.14, 95% CI=1.36-3.36). For IADL disability, only underweight persons with hypertension were significantly associated (OR=1.65, 95% CI=1.23-2.21). CONCLUSIONS Low or extremely high BMI, independent of its metabolic consequences, is a risk factor for disability among the elderly. Simple hypertension wasn't significantly associated with disability. In addition, having hypertension significantly increased the risk of ADL disability in obese individuals and IADL disability in underweight individuals.
Collapse
Affiliation(s)
- P Su
- Wenhua Tian, PhD, Department of Health Services Management, the Second Military Medical University, No.800 Xiangyin Rd, Shanghai, 200433, China; Tel: +86-21-8187-1428; Fax: +86-21-8187-1428; Email address:
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Lebon J, Barsalani R, Payette H, Brochu M, Dionne IJ. Inflammation and Fat Mass as Determinants of Changes in Physical Capacity and Mobility in Older Adults Displaying A Large Variability in Body Composition: The NuAge Study. Exp Aging Res 2016; 42:403-417. [DOI: 10.1080/0361073x.2016.1224649] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
22
|
Moreira PL, Correa CR, Corrente JE, Martin LC, Boas PJFV, Ferreira ALA. Anthropometric, functional capacity, and oxidative stress changes in Brazilian community-living elderly subjects. A longitudinal study. Arch Gerontol Geriatr 2016; 66:140-6. [PMID: 27323308 DOI: 10.1016/j.archger.2016.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 05/10/2016] [Accepted: 05/29/2016] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To examine the changes and relationships among anthropometric, functional and plasma oxidative stress markers in elderly. DESIGN longitudinal study. SETTING measurements in 2008 and 2010. PARTICIPANTS 103 community-dwelling men and women aged 67-92. MEASUREMENTS Anthropometric parameters [waist, hip, arm and calf circumferences; waist-hip ratio, triceps skinfold thickness and others], basic (ADL) and instrumental activities of daily living (IADL)] and plasma oxidative stress markers (α-tocopherol, β-carotene and malondialdehyde) were assessed in 2008 and 2010. RESULTS ADL, IADL, body weight, skinfold thickness and circumferences of calf and arm decreased and waist and waist-hip ratio increased from 2008 to 2010. α-Tocopherol decreased and malondialdehyde plasma levels increased during the study period. In multiple logistic regression analyses, increased age (OR=1.12; IC: 1.02-1.23; p=0.02), female gender (OR=8.43; IC: 1.23-57.58; p=0.03), hypertension (OR=0.22; IC: 0.06-0.79; p=0.02), arthritis/arthrosis (OR=0.09; IC: 0.009-0.87; p=0.04) and depression (OR=0.20; IC: 0.04-1.03; p=0.05) were independent risk factors for functional decline. CONCLUSION Fat reduction, muscle loss, central obesity increase, functional decline and worsening of plasma oxidative stress were observed during 2-year follow-up. Some of the risk factors that were identified could be modified to help prevent functional decline in elderly. The factors deserving attention include hypertension, arthritis/arthrosis and depression.
Collapse
Affiliation(s)
- Priscila Lucelia Moreira
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, SP, Brazil.
| | - Camila Renata Correa
- Post-Graduation Program in Pathology, Botucatu Medical School at São Paulo State University (UNESP), Botucatu, SP, Brazil.
| | - José Eduardo Corrente
- Department of Biostatistics, Botucatu, Institute of Biosciences at Sao Paulo State University (UNESP), Botucatu, SP, Brazil.
| | - Luis Cuadrado Martin
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, SP, Brazil.
| | | | - Ana Lucia Anjos Ferreira
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, SP, Brazil.
| |
Collapse
|
23
|
Kamel A, Abuhegazy H, Ismaila A, Sherra K, Ramadan M, Mekky A, Al Nabawy A. The prevalence of obesity in a sample of Egyptian psychiatric patients. ACTA ACUST UNITED AC 2016. [DOI: 10.4103/1110-1105.195546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
24
|
Sabia S, Cogranne P, van Hees VT, Bell JA, Elbaz A, Kivimaki M, Singh-Manoux A. Physical activity and adiposity markers at older ages: accelerometer vs questionnaire data. J Am Med Dir Assoc 2015; 16:438.e7-13. [PMID: 25752539 PMCID: PMC4417049 DOI: 10.1016/j.jamda.2015.01.086] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/19/2015] [Accepted: 01/19/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Physical activity is critically important for successful aging, but its effect on adiposity markers at older ages is unclear as much of the evidence comes from self-reported data on physical activity. We assessed the associations of questionnaire-assessed and accelerometer-assessed physical activity with adiposity markers in older adults. DESIGN/SETTING/PARTICIPANTS This was a cross-sectional study on 3940 participants (age range 60-83 years) of the Whitehall II study who completed a 20-item physical activity questionnaire and wore a wrist-mounted accelerometer for 9 days in 2012 and 2013. MEASUREMENTS Total physical activity was estimated using metabolic equivalent hours/week for the questionnaire and mean acceleration for the accelerometer. Time spent in moderate-and-vigorous physical activity (MVPA) was also assessed by questionnaire and accelerometer. Adiposity assessment included body mass index, waist circumference, and fat mass index. Fat mass index was calculated as fat mass/height² (kg/m²), with fat mass estimated using bioimpedance. RESULTS Greater total physical activity was associated with lower adiposity for all adiposity markers in a dose-response manner. In men, the strength of this association was 2.4 to 2.8 times stronger with the accelerometer than with questionnaire data. In women, it was 1.9 to 2.3 times stronger. For MVPA, questionnaire data in men suggested no further benefit for adiposity markers past 1 hour/week of activity. This was not the case for accelerometer-assessed MVPA where, for example, compared with men undertaking <1 hour/week of accelerometer-assessed MVPA, waist circumference was 3.06 (95% confidence interval 2.06-4.06) cm lower in those performing MVPA 1-2.5 hours/week, 4.69 (3.47-5.91) cm lower in those undertaking 2.5-4 hours/week, and 7.11 (5.93-8.29) cm lower in those performing ≥4 hours/week. CONCLUSIONS The association of physical activity with adiposity markers in older adults was stronger when physical activity was assessed by accelerometer compared with questionnaire, suggesting that physical activity might be more important for adiposity than previously estimated.
Collapse
Affiliation(s)
- Séverine Sabia
- Department of Epidemiology and Public Health, University College London, London, United Kingdom; University Versailles St-Quentin, Boulogne-Billancourt, France.
| | - Pol Cogranne
- INSERM, U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
| | - Vincent T van Hees
- MoveLab-Physical Activity and Exercise Research, Institute of Cellular Medicine, Newcastle University, United Kingdom
| | - Joshua A Bell
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Alexis Elbaz
- INSERM, U1018, Center for Research in Epidemiology and Population Health, Villejuif, France; University Paris 11, Villejuif, France
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, University College London, London, United Kingdom; University Versailles St-Quentin, Boulogne-Billancourt, France; INSERM, U1018, Center for Research in Epidemiology and Population Health, Villejuif, France; University Paris 11, Villejuif, France; Centre de Gérontologie, Hôpital Ste Périne, AP-HP, France
| |
Collapse
|
25
|
Stephan Y, Sutin AR, Terracciano A. How old do you feel? The role of age discrimination and biological aging in subjective age. PLoS One 2015; 10:e0119293. [PMID: 25738579 PMCID: PMC4349738 DOI: 10.1371/journal.pone.0119293] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 01/29/2015] [Indexed: 11/18/2022] Open
Abstract
Subjective age, or how young or old individuals experience themselves to be relative to their chronological age, is a crucial construct in gerontology. Subjective age is a significant predictor of important health outcomes, but little is known about the criteria by which individuals' subjectively evaluate their age. To identify psychosocial and biomedical factors linked to the subjective evaluation of age, this study examined whether perceived age discrimination and markers of biological aging are associated with subjective age. Participants were 4776 adults (Mage = 68) from the 2008 and 2010 waves of the Health and Retirement Study (HRS) who completed measures of subjective age, age discrimination, demographic variables, self-rated health and depression, and had physical health measures, including peak expiratory flow, grip strength, waist circumference, systolic and diastolic blood pressure. Telomere length was available for a subset of participants in the 2008 wave (n = 2214). Regression analysis indicated that perceived age discrimination, lower peak expiratory flow, lower grip strength, and higher waist circumference were associated with an older subjective age, controlling for sociodemographic factors, self-rated health, and depression. In contrast, blood pressure and telomere length were not related to subjective age. These findings are consistent with the hypothesis that how old a person feels depends in part on psychosocial and biomedical factors, including the experiences of ageism and perceptible indices of fitness and biological age.
Collapse
Affiliation(s)
- Yannick Stephan
- University of Montpellier, Montpellier, France
- * E-mail: (AT); (YS)
| | - Angelina R. Sutin
- College of Medicine, Florida State University, Tallahassee, Florida, United States of America
| | - Antonio Terracciano
- College of Medicine, Florida State University, Tallahassee, Florida, United States of America
- * E-mail: (AT); (YS)
| |
Collapse
|
26
|
Rossi AP, Harris TB, Fantin F, Armellini F, Zamboni M. The multidomain mobility lab in older persons: from bench to bedside. The assessment of body composition in older persons at risk of mobility limitations. Curr Pharm Des 2015; 20:3245-55. [PMID: 24050162 DOI: 10.2174/13816128113196660694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 08/27/2013] [Indexed: 12/25/2022]
Abstract
With body composition it is possible to divide human body in compartments on the basis of different physical properties. The two level body composition model subdividing the whole body in fat mass and fat free mass is the most used in epidemiological and clinical studies in the elderly. Body composition techniques may be used to study ageing process. Changes in body composition occur as part of the normal ageing process and are associated with important effects on health and function. It has been shown that body composition changes with aging, with an increase in fat mass and a decrease in muscle mass, have important consequences on health and physical disability. Moreover body fat distribution changes with adverse metabolic profiles and increased cardiovascular risk. The purpose of this review is to describe the basic principles and techniques for fat free mass and fat mass evaluation, highlighting the advantages and limitations of different available body composition methods.
Collapse
Affiliation(s)
| | | | | | | | - Mauro Zamboni
- Cattedra di Geriatria, Università di Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126 Verona, Italy.
| |
Collapse
|
27
|
Vascular risk factor burden, atherosclerosis, and functional dependence in old age: a population-based study. Int J Behav Med 2014; 21:597-604. [PMID: 24057410 DOI: 10.1007/s12529-013-9352-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Vascular risk factors such as hypertension and obesity have been associated with physical limitations among older adults. PURPOSE The purpose of this study is to examine whether individual and aggregated vascular risk factors (VRFs) are associated with functional dependence and to what extent carotid atherosclerosis (CAS) or peripheral artery disease (PAD) may mediate the possible associations of aggregated VRFs with functional dependence. METHOD This cross-sectional study included 1,451 community-living participants aged ≥60 years in the Confucius Hometown Aging Project of China. Data on demographic features, hypertension, high total cholesterol, obesity, smoking, physical inactivity, diabetes, CAS, PAD, and cardiovascular diseases (CVDs) were collected through an interview, a clinical examination, and laboratory tests. Functional dependence was defined as being dependent in at least one activity in the personal or instrumental activities of daily living. Data were analyzed using multiple logistic models controlling for potential confounders. We used the mediation model to explore the potential mediating effect of CAS and PAD on the associations of aggregated VRFs with functional dependence. RESULTS Of the 1,451 participants, 222 (15.3%) had functional dependence. The likelihood of functional dependence increased linearly with increasing number of VRFs (hypertension, high total cholesterol, abdominal obesity, and physical inactivity) (p for trend <0.002). Mediation analysis showed that controlling for demographics and CVDs up to 11% of the total association of functional dependence with clustering VRFs was mediated by CAS and PAD. CONCLUSION Aggregation of multiple VRFs is associated with an increased likelihood of functional dependence among Chinese older adults; the association is partially mediated by carotid and peripheral artery atherosclerosis independently of CVDs.
Collapse
|
28
|
Araújo F, Lucas R, Alegrete N, Azevedo A, Barros H. Individual and contextual characteristics as determinants of sagittal standing posture: a population-based study of adults. Spine J 2014; 14:2373-83. [PMID: 24486474 DOI: 10.1016/j.spinee.2014.01.040] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 10/29/2013] [Accepted: 01/17/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Sagittal standing posture is associated with musculoskeletal symptoms and quality of life. However, the frequency and determinants of suboptimal sagittal alignment outside the clinical context remain to be clarified. PURPOSE To estimate the association of sociodemographic, anthropometric, and behavioral characteristics with sagittal standing posture among adults from the general population. STUDY DESIGN Cross-sectional evaluation of a population-based sample. PATIENT SAMPLE As part of the EPIPorto study, 489 adults were assessed during 2005 to 2008. OUTCOME MEASURES Individual spinopelvic parameters were measured. Additionally, participants were classified into one of four types of sagittal postural patterns (Roussouly classification: Types 1, 2, and 4 corresponding to nonneutral postures and Type 3 to a neutral posture). METHODS Spinopelvic parameters were recorded from 36-inch sagittal radiographs obtained in free-standing posture. Age, sex, education, occupation, body mass index (BMI), waist circumference, total physical activity, leisure time physical activity, time spent in sitting position, smoking status, and tobacco cumulative exposure were collected. Individual parameters and patterns of sagittal posture were compared across categories of participants' characteristics. RESULTS Older age, lower educational level, blue collar occupation, and overall and central obesity were associated with increased sagittal vertical axis and pelvic tilt/pelvic incidence ratio. Taking the neutral postural pattern (Type 3) as reference for the outcome in a multinomial regression model, independently of age, sex, education, total physical activity, and smoking status, overweight adults had higher odds of Type 2 (odds ratio [OR]=1.92; 95% confidence interval [CI]: 1.13-3.27) and Type 4 (OR=2.13; 95% CI: 1.16-3.91) postural patterns in comparison with normal weight subjects. Overall and central obesity were positively related with Type 1 postural pattern (OR=6.10, 95% CI: 1.52-24.57 and OR=3.54, 95% CI: 1.13-11.11, respectively). There was also a weak direct association between female sex and Type 1 postural pattern. Regarding behavioral factors, subjects with total physical activity above the first third exhibited all nonneutral postural patterns less frequently, and current smokers were more likely to present a Type 4 postural pattern. CONCLUSIONS Higher BMI and central obesity were important potential determinants of nonneutral posture among adults from the general population. Future research should investigate the potential effectiveness of overweight prevention and management in avoiding sagittal misalignment conditions.
Collapse
Affiliation(s)
- Fábio Araújo
- Institute of Public Health - University of Porto (ISPUP), Rua das Taipas, 135-139, 4050-600 Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - Raquel Lucas
- Institute of Public Health - University of Porto (ISPUP), Rua das Taipas, 135-139, 4050-600 Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Nuno Alegrete
- Centro Hospitalar São João, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Department of Surgery, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Ana Azevedo
- Institute of Public Health - University of Porto (ISPUP), Rua das Taipas, 135-139, 4050-600 Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Centro Hospitalar São João, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Henrique Barros
- Institute of Public Health - University of Porto (ISPUP), Rua das Taipas, 135-139, 4050-600 Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| |
Collapse
|
29
|
Yin Z, Shi X, Kraus VB, Brasher MS, Chen H, Liu Y, Lv Y, Zeng Y. Gender-dependent association of body mass index and waist circumference with disability in the Chinese oldest old. Obesity (Silver Spring) 2014; 22:1918-1925. [PMID: 24777985 PMCID: PMC4114995 DOI: 10.1002/oby.20775] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 03/23/2014] [Accepted: 04/13/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To explore associations of BMI and waist circumference (WC) with disability among the Chinese oldest old. METHODS The 5,495 oldest old in the sixth wave of Chinese Longitudinal Healthy Longevity Study conducted in 2011 were included in this study. Disability was assessed by activities of daily living (ADL); height and weight for BMI and WC were measured; information including socio-demographics, lifestyles, and health status was collected. RESULTS Generalized additive models analysis showed that the association of BMI/WC with ADL disability was nonlinear. Among the males, logistic regression results supported a "J" shape association between ADL disability with BMI/WC-the highest tertile group in BMI or WC was significantly associated with an increased risk of ADL disability: odds ratio 1.78 (95% confidence interval (CI): 1.26-2.52) for BMI and 2.01 (95% CI: 1.44-2.82) for WC. Among females, an inverse "J" shape association was found, only the lowest tertile group before the cutoff point had an increased risk of ADL disability: odds ratio 1.42 (95%CI: 1.02-1.97) for BMI and 1.47 (95% CI:1.06-2.04) for WC. CONCLUSIONS Associations of BMI and WC with ADL disability are significant even in the oldest old, but differ between the genders.
Collapse
Affiliation(s)
- Zhaoxue Yin
- Division of Non-communicable Diseases Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoming Shi
- Division of Non-communicable Diseases Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Corresponding Authors: Xiaoming Shi, NO.155 Changbai Road, Changping District, Beijing 102206, China, Tel. +86-10-58900215, Fax. +86-10-58900247, Yi Zeng, Box 3003, Room 1506, BUSSE Building, Durham, NC27710, USA, Tel. 919-660-7554, Fax: 919-668-0453,
| | - Virginia B. Kraus
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Huashuai Chen
- Center for the study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC, USA
| | - Yuzhi Liu
- Center for Study of Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
| | - Yuebin Lv
- Division of Non-communicable Diseases Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zeng
- Center for the study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC, USA
- Center for Study of Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
- Corresponding Authors: Xiaoming Shi, NO.155 Changbai Road, Changping District, Beijing 102206, China, Tel. +86-10-58900215, Fax. +86-10-58900247, Yi Zeng, Box 3003, Room 1506, BUSSE Building, Durham, NC27710, USA, Tel. 919-660-7554, Fax: 919-668-0453,
| |
Collapse
|
30
|
Williams ED, Eastwood SV, Tillin T, Hughes AD, Chaturvedi N. The effects of weight and physical activity change over 20 years on later-life objective and self-reported disability. Int J Epidemiol 2014; 43:856-65. [PMID: 24562419 PMCID: PMC4052138 DOI: 10.1093/ije/dyu013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Weight and health behaviours are known to affect physical disability; however the evidence exploring the impact of changes to these lifestyle factors over the life course on disability is inconsistent. We aimed to explore the roles of weight and activity change between mid and later life on physical disability. Methods: Baseline and 20-year clinical follow-up data were collected from1418 men and women, aged 58–88 years at follow-up, as part of a population-based observational study based in north-west London. At clinic, behavioural data were collected by questionnaire and anthropometry measured. Disability was assessed using a performance-based locomotor function test and self-reported questionnaires on functional limitation and basic activities of daily living (ADLs). Results: At follow-up, 39% experienced a locomotor dysfunction, 24% a functional limitation and 17% an impairment of ADLs. Weight gain of 10–20% or >20% of baseline, but not weight loss, were associated with increased odds of a functional limitation [odds ratio (OR) 1.69, 95% confidence interval (CI) 1.14-2.49 and OR 2.74, 1.55-4.83, respectively], after full adjustment for covariates. The same patterns were seen for the other disability outcomes. Increased physical activity reduced, and decreased physical activity enhanced the likelihood of disability, independent of baseline behaviours and adiposity. The adverse effects of weight gain appeared to be lessened in the presence of increased later-life physical activity. Conclusion: Weight and activity changes between mid and later life have strong implications for physical functioning in older groups. These findings reinforce the importance of the maintenance of healthy weight and behaviour throughout the life course, and the need to promote healthy lifestyles across population groups.
Collapse
Affiliation(s)
- Emily D Williams
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Sophie V Eastwood
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Therese Tillin
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Alun D Hughes
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Nishi Chaturvedi
- International Centre for Circulatory Health, Imperial College London, London, UK
| |
Collapse
|
31
|
Shin H, Liu PY, Panton LB, Ilich JZ. Physical Performance in Relation to Body Composition and Bone Mineral Density in Healthy, Overweight, and Obese Postmenopausal Women. J Geriatr Phys Ther 2014; 37:7-16. [DOI: 10.1519/jpt.0b013e31828af203] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
32
|
Yang M, Hao Q, Luo L, Ding X, Wu H, Zhang Y, Dong B. Body mass index and disability in Chinese nonagenarians and centenarians. J Am Med Dir Assoc 2013; 15:303.e1-6. [PMID: 24287207 DOI: 10.1016/j.jamda.2013.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 10/10/2013] [Accepted: 10/15/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To examine the potential association between body mass index (BMI) and activities of daily living (ADLs) and instrumental activities of daily living (IADLs) disabilities in a population-based sample of Chinese nonagenarians and centenarians. METHODS This study analyzed data obtained from a survey conducted in 870 elderly Chinese adults aged 90 years or older in Dujiangyan. The participants were divided into 4 groups according to the World Health Organization (WHO) Asia criteria of underweight, normal weight, overweight, and obesity in BMI (<18.5, 18.5-23.0, 23.0-25.0, ≥25.0 kg/m(2), respectively) and to BMI quartile (<16.8, 16.8-18.9, 18.9-21.1, ≥21.1 kg/m(2), respectively). The ADL and IADL disabilities were measured using the physical self-maintenance scale (PSMS) and IADL scale developed by Lawton and Brody, respectively. RESULTS The participants included in the current statistical analyses were 233 men and 505 women. The mean age was 93.5 ± 3.2 years (ranging from 90 to 108 years). Using the WHO Asia criteria, the prevalence of underweight and obesity were 43.9% and 6.6%, respectively. In long-lived women, the prevalence of ADL and IADL disabilities was significantly higher in either the underweight group (39.4% and 72.9%, respectively) or the obesity group (38.1% and 77.7%, respectively) compared with the normal weight group (31.4% and 60.8%, respectively). After adjusting for relevant covariates, the underweight group and obesity group showed significantly increased odds ratios (ORs) for either ADL (1.5 and 1.8, respectively) or IADL disability (1.9 and 1.4, respectively). Similar results were found when using the BMI quartile. However, in long-lived men, no significant difference was found with respect to the prevalence of ADL or IADL disability and adjusted ORs among the different BMI groups. CONCLUSIONS Among Chinese long-lived adults, the risk of ADL and IADL disability was higher for women with both extremely low and high BMIs, but this pattern was not found in men.
Collapse
Affiliation(s)
- Ming Yang
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiukui Hao
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Luo
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiang Ding
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hongmei Wu
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanling Zhang
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Birong Dong
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
33
|
Matsushita K, Williams EK, Mongraw-Chaffin ML, Coresh J, Schmidt MI, Brancati FL, Hoogeveen RC, Ballantyne CM, Young JH. The association of plasma lactate with incident cardiovascular outcomes: the ARIC Study. Am J Epidemiol 2013; 178:401-9. [PMID: 23817916 DOI: 10.1093/aje/kwt002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
We examined the association of plasma lactate at rest, a marker of oxidative capacity, with incident cardiovascular outcomes in 10,006 participants in the Atherosclerosis Risk in Communities (ARIC) Study visit 4 (1996-1998). We used Cox proportional-hazards models to estimate hazard ratios of incident coronary heart disease, stroke, heart failure, and all-cause mortality by quartiles of plasma lactate (Q1, ≤5.3 mg/dL; Q2, 5.4-6.6; Q3, 6.7-8.6; and Q4 ≥8.7). During a median follow-up time of 10.7 years, there were 1,105 coronary heart disease cases, 379 stroke cases, 820 heart failure cases, and 1,408 deaths. A significant graded relation between lactate level and cardiovascular events was observed in the demographically adjusted model (all P for trend < 0.001). After further adjustment for traditional and other potential confounders, the association remained significant for heart failure (Q4 vs. Q1: hazard ratio (HR) = 1.35, 95% confidence interval (CI): 1.07, 1.71) and all-cause mortality (HR = 1.27, 95% CI: 1.07, 1.51) (P for trend < 0.02 for these outcomes) but not for coronary heart disease (HR = 1.02, 95% CI: 0.84, 1.24) and stroke (HR = 1.26, 95% CI: 0.91, 1.75). The results for heart failure were robust across multiple subgroups, after further adjustment for N-terminal pro-B-type natriuretic peptide and after exclusion of participants with incident heart failure within 3 years. The independent associations of plasma lactate with heart failure and all-cause mortality suggest an important role for low resting oxidative capacity.
Collapse
Affiliation(s)
- Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Precilios H, Brunani A, Cimolin V, Tacchini E, Donini LM, Fabris De Souza S, Capodaglio P. Measuring changes after multidisciplinary rehabilitation of obese individuals. J Endocrinol Invest 2013; 36:72-7. [PMID: 22306619 DOI: 10.3275/8240] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND In 2009, the Italian Society of Obesity developed the short-form questionnaire for Obesity-related Disabilities (TSD-OC). AIMS To stage the degree of disability in obese patients using TSD-OC; to verify its sensitivity to change after rehabilitation. SUBJECTS Three hundred and fifty-five adult obese individuals [body mass index (BMI) >30 kg/m2] undergoing rehabilitation. Exclusion criteria were severe cardiovascular or respiratory diseases, neurological and psychological conditions. Sensitivity to change of TSD-OC was evaluated in 194 patients out of the initial sample. METHODS To define the disability levels according to TSD-OC, the method of interquartile range was applied to the initial sample. The 194 in-patients were assessed with Roland-Morris Disability Questionnaire, Functional Independence Measure (FIM), Functional Visual Analogue Scale, and TSD-OC before (S0) and after 4 weeks (S1) of intensive (3 h daily) rehabilitation multidisciplinary program. Individuals were grouped according to age (1: age 30-59 yr; 2: age over 60 yr) and degree of obesity (BMI: A, 30-40 kg/m2; B, 40-50 kg/m2). RESULTS At S1, BMI and all the clinical scores improved significantly in the whole study sample. The younger individuals with higher level of obesity showed a higher functional improvement (-51.3%). In the older subjects, improvement was not statistically different when varying BMI (A2 -13.7% vs B2 -14.6%). In the whole group, the TSD-OC improvement was statistically greater than the physical FIM gain (-25.9% vs +5.4%, p<0.05). CONCLUSIONS Our data evidenced that the TSD-OC is a sensitive measure of short-term changes in disability status of obese individuals after rehabilitation.
Collapse
Affiliation(s)
- H Precilios
- Rehabilitation Unit and Laboratory of Research in Biomechanics and Rehabilitation, S. Giuseppe Hospital, Istituto Auxologico Italiano IRCCS, Verbania-Piancavallo, Italy
| | | | | | | | | | | | | |
Collapse
|
35
|
Wong E, Stevenson C, Backholer K, Mannan H, Pasupathi K, Hodge A, Freak-Poli R, Peeters A. Adiposity measures as predictors of long-term physical disability. Ann Epidemiol 2012; 22:710-6. [DOI: 10.1016/j.annepidem.2012.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 07/24/2012] [Accepted: 07/24/2012] [Indexed: 10/27/2022]
|
36
|
Abstract
OBJECTIVES To analyse the relationship between body mass index (BMI) in middle-age and disability status in old-age using data from the Melbourne Collaborative Cohort Study (MCCS). METHODS A total of 41 514 participants enroled in the MCCS between 1990-1994. Height and weight were measured at baseline and disability, defined as limitations to self-care activities of daily living (ADLs) and self-care plus mobility activities, was identified at follow-up (2003-2007). In all, 6300 participants were <65 years at baseline, 70 years at follow-up and not missing BMI at baseline or ADLs at follow-up. The association between BMI in six categories (BMI 18.5-22.5; 22.5-25; 25-27.5; 27.5-30; 30-35; 35+) and disability status was analysed using logistic regression. Models were stratified by sex, and sequentially adjusted for age, education, country of birth, then smoking, alcohol, fruit and vegetable intake, and physical activity. RESULTS Adjusted odds ratios for composite self-care ADL and mobility limitations compared with BMI 18.5-22.5 kg m(-2) were 1.73 (95%CI 1.14-2.64) for BMI 30-35 kg m(-2) and 3.46 (1.78-6.73) for BMI 35+ kg m(-2) in males. In females, adjusted odds ratios were 1.29 (1.00-1.68) for BMI 22.5-25 kg m(-2), 1.74 (1.35-2.24) for BMI 25-27.5 kg m(-2), 2.58 (1.98-3.36) for BMI 27.5-30 kg m(-2), 2.74 (2.10-3.58) for BMI 30-35 kg m(-2) and 4.21 (3.12-5.88) for BMI 35+ kg m(-2). CONCLUSION A graded relationship was observed between BMI and disability in males and females, across the continuum of BMI. These results highlight the importance of a healthy body weight at middle age in order to reduce the risk of disability in old age.
Collapse
|
37
|
Lee JSW, Auyeung TW, Leung J, Kwok T, Leung PC, Woo J. Physical frailty in older adults is associated with metabolic and atherosclerotic risk factors and cognitive impairment independent of muscle mass. J Nutr Health Aging 2011; 15:857-62. [PMID: 22159773 DOI: 10.1007/s12603-011-0134-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Metabolic and atherosclerotic diseases are known risk factors for disability in old age, and can result in sarcopenia as well as cognitive impairment, which are both components of frailty syndrome. As muscle loss increases with ageing, it is unclear whether muscle loss per se, or the diseases themselves, are the underlying cause of physical frailty in those suffering from these diseases. We tested the hypothesis that metabolic and atherosclerotic diseases and cognitive impairment are associated with physical frailty independent of muscle loss in old age, and further examined their impact on the relationship between physical frailty and mortality. DESIGN Prospective. SETTING Community. PARTICIPANTS 4000 community dwelling Chinese elderly ≥65 years. MEASUREMENTS Diabetes, hypertension, stroke, heart disease, cognitive impairment, smoking, physical activity, waist hip ratio (WHR) and ankle-brachial index (ABI)) were recorded. Physical frailty measurements (grip-strength, chair-stands, stride length and 6-metre walks) were summarized into a composite frailty score (0-20), 0 being the most frail) according to quartiles of performance. Appendicular muscle mass (ASM) was measured using dual X-ray absorptiometry. Relationships between the score and covariates were analyzed. Cox regression was used to study the impact of metabolic and atnerosclerotic risk factors on the relationship between physical frailty and 6-year mortality. RESULTS After adjustment for ASM, all metabolic diseases and indexes, and cognitive impairment were significantly associated with the composite physical frailty score in univariate analysis. In multivariate analysis, cognitive impairment, high WHR, diabetes, stroke and heart disease were all independently associated with higher physical frailty with adjustment for age, physical activity level and ASM. Hypertension was associated with physical frailty in men but not in women. In Cox regression, increased physical frailty was associated with higher 6-year mortality. The impact of metabolic and atherosclerotic risk factors was however only modest after adjustment for age and cognitive function. CONCLUSION Metabolic and atherosclerotic diseases and high WHR, was associated with physical frailty, independent of their adverse effect on cognitive function and muscle mass.
Collapse
Affiliation(s)
- J S W Lee
- Division of Geriatrics, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
| | | | | | | | | | | |
Collapse
|
38
|
Bouchard DR, Choquette S, Dionne IJ, Brochu M. Is fat mass distribution related to impaired mobility in older men and women? Nutrition as a determinant of successful aging: the Quebec longitudinal study. Exp Aging Res 2011; 37:346-57. [PMID: 21534033 DOI: 10.1080/0361073x.2011.568848] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
It is established that a high level of fat mass (FM) is related to mobility impairment in older adults. However, FM distribution has received very little attention. In this study, 904 well-functioning older adults aged between 68 and 82 years old were recruited to examine the association between waist circumference, trunk FM, leg FM, and mobility. The results show that waist circumference was the only measure of body fat distribution independently associated with mobility (p ≤ .001). Therefore, the use of objective measures of FM distribution may not be necessary to examine the impact of FM distribution on mobility.
Collapse
Affiliation(s)
- Danielle R Bouchard
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, Quebec, Canada.
| | | | | | | |
Collapse
|
39
|
Gomez-Cabello A, Pedrero-Chamizo R, Olivares PR, Luzardo L, Juez-Bengoechea A, Mata E, Albers U, Aznar S, Villa G, Espino L, Gusi N, Gonzalez-Gross M, Casajus JA, Ara I. Prevalence of overweight and obesity in non-institutionalized people aged 65 or over from Spain: the elderly EXERNET multi-centre study. Obes Rev 2011; 12:583-92. [PMID: 21535360 DOI: 10.1111/j.1467-789x.2011.00878.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Coupled with the growth of the older population, an increase in the prevalence of overweight and obesity in this age group has occurred in the last decades. The main aims of the present study were (i) to provide an updated prevalence of overweight and obesity in a representative sample of the Spanish elderly population; (ii) to calculate the prevalence of sarcopenic obesity (SO) and (iii) to analyse the relationships between adiposity measurements and lifestyle. A cross-sectional study was carried out in a sample of 3136 persons representative of the non-institutionalized population ≥65 years of age. Anthropometric measurements were obtained using standardized techniques and equipment. Overall, 84% of the population can be categorized as overweight and/or obese. The present study indicates that 67% of the Spanish elderly population has an increased percentage of fat mass and more than 56% suffer from central obesity. Moreover, SO is present in 15% of the Spanish elderly population. Finally, a strong relationship between both physically active and sedentary lifestyles and the level of adiposity was found. Prevalence of overweight and obesity among elderly people in Spain is very high and is still increasing. Lifestyle seems to be a determinant factor in the development of obesity among elderly people.
Collapse
Affiliation(s)
- A Gomez-Cabello
- GENUD Research Group, University of Zaragoza, Zaragoza, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Body composition changes over 9 years in healthy elderly subjects and impact of physical activity. Clin Nutr 2011; 30:436-42. [DOI: 10.1016/j.clnu.2011.01.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 01/05/2011] [Accepted: 01/13/2011] [Indexed: 12/25/2022]
|
41
|
Donini LM, Brunani A, Sirtori A, Savina C, Tempera S, Cuzzolaro M, Spera G, Cimolin V, Precilios H, Raggi A, Capodaglio P. Assessing disability in morbidly obese individuals: the Italian Society of Obesity test for obesity-related disabilities. Disabil Rehabil 2011; 33:2509-18. [PMID: 21542694 DOI: 10.3109/09638288.2011.575529] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE To validate a new obesity-specific disability assessment test: the Obesity-related Disability test (Test SIO Disabilità Obesità Correlata, TSD-OC). METHODS Adult obese individuals were assessed with the TSD-OC, 36-Item Short-Form Health Survey (SF-36), 6-min walking test (6MWT) and grip strength. The TSD-OC is composed of 36 items divided into seven sections (pain, stiffness, activities of daily living and indoor mobility, housework, outdoor activities, occupational activities and social life). Statistical correlations between the TSD-OC, functional assessment (6MWT and grip strength) and quality of life parameters (SF-36) were analysed. Internal consistency was assessed with Cronbach's α test. Test-retest reliability was evaluated in a subgroup of 30 individuals. A linking exercise between TSD-OC items and categories of the International Classification of Functioning, Disability and Health was performed. RESULTS Test-retest showed excellent stability (r = 0.90) and excellent internal consistency was reported (Cronbach's α > 0.90). Significant low to moderate correlations between TSD-OC, SF-36 scores, 6MWT and grip strength were observed. A total of 26 ICF categories were linked, mostly related to the area of mobility. CONCLUSIONS The TSD-OC is a reliable and valid instrument for measuring self-reported disability in obese subjects. It may represent an important tool for establishing rehabilitation needs in individuals with obesity-related disability, for planning appropriate rehabilitation programmes and for evaluating their effectiveness.
Collapse
Affiliation(s)
- Lorenzo M Donini
- Department of Medical Physiopathology (Food Science Section)-Sapienza University of Rome, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Zitkus BS. The relationship among registered nurses' weight status, weight loss regimens, and successful or unsuccessful weight loss. ACTA ACUST UNITED AC 2011; 23:110-6. [PMID: 21281377 DOI: 10.1111/j.1745-7599.2010.00583.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate relationships between body mass index (BMI), personality type, weight loss regimens, and successful or unsuccessful weight loss. DATA SOURCES Seven hundred and twenty-one registered nurses (RNs) were recruited from the American Academy of Nurse Practitioners, the membership of a nursing honor society, and RNs at a large state university. Participants completed the Myers-Briggs Type Indicator (MBTI), a demographic survey (age, gender, height, weight, ethnicity, education status, disability, shift work hours, and prescription medication use), and questions related to their weight status, weight loss attempts, and motivation. CONCLUSIONS RNs who had a lower BMI were more successful in losing weight than RNs who had a higher BMI. They were also more successful in their weight loss attempts if they did not use a diet regimen. IMPLICATIONS FOR PRACTICE RNs who were successful in losing weight did not use a specified dietary regimen.
Collapse
Affiliation(s)
- Bruce S Zitkus
- School of Nursing, Health Sciences Center, Stony Brook University, Stony Brook, New York, USA.
| |
Collapse
|
43
|
Kyrou I, Osei-Assibey G, Williams N, Thomas R, Halder L, Taheri S, Saravanan P, Kumar S. Self-reported disability in adults with severe obesity. J Obes 2011; 2011:918402. [PMID: 22132319 PMCID: PMC3205777 DOI: 10.1155/2011/918402] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Accepted: 08/18/2011] [Indexed: 01/22/2023] Open
Abstract
Self-reported disability in performing daily life activities was assessed in adults with severe obesity (BMI ≥ 35 kg/m(2)) using the Health Assessment Questionnaire (HAQ). 262 participants were recruited into three BMI groups: Group I: 35-39.99 kg/m(2); Group II: 40-44.99 kg/m(2); Group III: ≥45.0 kg/m(2). Progressively increasing HAQ scores were documented with higher BMI; Group I HAQ score: 0.125 (median) (range: 0-1.75); Group II HAQ score: 0.375 (0-2.5); Group III HAQ score: 0.75 (0-2.65) (Group III versus II P < 0.001; Group III versus I P < 0.001; Group II versus I P = 0.004). HAQ score strongly correlated with BMI and age. Nearly three-fourths of the study participants reported some degree of disability (HAQ score > 0). The prevalence of this degree of disability increased with increasing BMI and age. It also correlated to type 2 diabetes, metabolic syndrome, and clinical depression, but not to gender. Our data suggest that severe obesity is associated with self-reported disability in performing common daily life activities, with increasing degree of disability as BMI increases over 35 kg/m(2). Functional assessment is crucial in obesity management, and establishing the disability profiles of obese patients is integral to both meet the specific healthcare needs of individuals and develop evidence-based public health programs, interventions, and priorities.
Collapse
Affiliation(s)
- I. Kyrou
- WISDEM, University Hospital Coventry and Warwickshire, Clinical Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- *I. Kyrou:
| | - G. Osei-Assibey
- WISDEM, University Hospital Coventry and Warwickshire, Clinical Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
| | - N. Williams
- Health, Work and Wellbeing Directorate, Department for Work and Pensions, London SW1H 9NA, UK
| | - R. Thomas
- Health, Work and Wellbeing Directorate, Department for Work and Pensions, London SW1H 9NA, UK
| | - L. Halder
- WISDEM, University Hospital Coventry and Warwickshire, Clinical Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
| | - S. Taheri
- Birmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK
| | - P. Saravanan
- WISDEM, University Hospital Coventry and Warwickshire, Clinical Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
| | - S. Kumar
- WISDEM, University Hospital Coventry and Warwickshire, Clinical Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
| |
Collapse
|
44
|
Abstract
We examine obesity, intentional weight loss and physical disability in older adults. Based on prospective epidemiological studies, body mass index exhibits a curvilinear relationship with physical disability; there appears to be some protective effect associated with older adults being overweight. Whereas the greatest risk for physical disability occurs in older adults who are ≥class II obesity, the effects of obesity on physical disability appears to be moderated by both sex and race. Obesity at age 30 years constitutes a greater risk for disability later in life than when obesity develops at age 50 years or later; however, physical activity may buffer the adverse effects obesity has on late life physical disability. Data from a limited number of randomized clinical trials reinforce the important role that physical activity plays in weight loss programmes for older adults. Furthermore, short-term studies have found that resistance training may be particularly beneficial in these programmes as this mode of exercise attenuates the loss of fat-free mass during caloric restriction. Multi-year randomized clinical trials are needed to examine whether weight loss can alter the course of physical disablement in aging and to determine the long-term feasibility and effects of combining resistance exercise with weight loss in older adults.
Collapse
Affiliation(s)
- W J Rejeski
- Departments of Health and Exercise Science and Geriatric Medicine, Wake Forest University School of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | | | | | | |
Collapse
|
45
|
Abstract
Mobility disability is becoming prevalent in the obese older population (> or = 60 years of age). We included a total of 13 cross-sectional and 15 longitudinal studies based on actual physical assessments of mobility in the obese older population in this review. We systematically examined existing evidence of which adiposity estimate best predicted mobility disability. Cross-sectional studies (82-4000 participants) showed poorer lower extremity mobility with increasing obesity severity in both men and women. All longitudinal studies (1-22 years) except for one, reported relationships between adiposity and declining mobility. While different physical tests made interpretation challenging, a consistent finding was that walking, stair climbing and chair rise ability were compromised with obesity, especially if the body mass index (BMI) exceeded 35 kg m(-2). More studies found that obese women were at an increased risk for mobility impairment than men. Existing evidence suggests that BMI and waist circumference are emerging as the more consistent predictors of the onset or worsening of mobility disability. Limited interventional evidence shows that weight loss is related with increased mobility and lower extremity function. Additional longitudinal studies are warranted that address overall body composition fat and muscle mass or change on future disability.
Collapse
Affiliation(s)
- H K Vincent
- Department of Orthopaedics and Rehabilitation, Division of Research, University of Florida & Shands Orthopaedics and Sports Medicine Institute, Gainesville, FL 32611, USA.
| | | | | |
Collapse
|
46
|
Abstract
PURPOSE OF REVIEW The present review is intended to provide a critical overview of recent investigations of obesity among older persons with emphasis upon associated functional limitations, potential for intervention, and a future research agenda. RECENT FINDINGS Obesity is growing in prevalence among older persons. The association between obesity and functional decline is well documented. Recent findings suggest possible contributions of obesity-associated inflammatory milieu, sarcopenia, and impairment of muscle function/strength to adverse functional outcomes. A growing body of literature supports consideration of moderate weight reduction to secure improved metabolic and functional parameters for obese older persons. SUMMARY Obesity is associated with an unfortunate burden of chronic disease, functional limitation, and poor life quality. In view of the growing numbers of afflicted older individuals, there must be research priority to discern how obesity impacts function so that appropriate prevention and treatment strategies may be adopted.
Collapse
Affiliation(s)
- Gordon L Jensen
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania 16802, USA.
| | | |
Collapse
|
47
|
Stenholm S, Koster A, Alley DE, Houston DK, Kanaya A, Lee JS, Newman AB, Satterfield S, Simonsick EM, Visser M, Harris TB, Ferrucci L. Joint association of obesity and metabolic syndrome with incident mobility limitation in older men and women--results from the Health, Aging, and Body Composition Study. J Gerontol A Biol Sci Med Sci 2009; 65:84-92. [PMID: 19822624 DOI: 10.1093/gerona/glp150] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Although both obesity and the metabolic syndrome (MetS) are known risk factors for decline in physical function, the joint association of obesity and metabolic alterations with risk of incident mobility limitation is unknown. METHODS Data are from 2,984 women and men aged 70-79 years participating in the Health, Aging, and Body Composition Study without mobility limitation at baseline. Obesity was defined as body mass index greater than or equal to 30 kg/m(2) and the MetS as meeting greater than or equal to 3 of the ATP III criteria. Mobility limitation was defined as any difficulty walking one-quarter mile or climbing 10 steps during two consecutive semiannual assessments for more than 6.5 years. RESULTS Incidence of mobility limitation was 55% in women and 44% in men. In women, adjusted risk of developing mobility limitation was progressively greater in nonobese participants with the MetS (hazard ratio [HR] = 1.49, 95% confidence interval [CI] = 1.24-1.80), obese participants without the MetS (HR = 1.95, 95% CI = 1.51-2.53), and obese participants with the MetS (HR = 2.16, 95% CI = 1.78-2.63) relative to the nonobese without the MetS. In men, the corresponding adjusted HRs (95% CI) were 1.07 (0.87-1.32), 1.64 (1.19-2.25), and 1.41 (1.12-1.78). Elevated inflammatory markers partly explained the association between obesity, the MetS, and mobility limitation, particularly in nonobese and obese participants with the MetS. CONCLUSIONS Obesity itself, independent of its metabolic consequences, is a risk factor for mobility limitation among obese older adults. In addition, having the MetS increases the risk of functional decline in older nonobese women but not in men.
Collapse
Affiliation(s)
- Sari Stenholm
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Tomey K, Sowers M, Zheng H, Jackson EA. Physical functioning related to C-reactive protein and fibrinogen levels in mid-life women. Exp Gerontol 2009; 44:799-804. [PMID: 19819323 DOI: 10.1016/j.exger.2009.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 09/23/2009] [Accepted: 10/02/2009] [Indexed: 11/25/2022]
Abstract
We investigated whether subclinical inflammatory markers high-sensitivity C-reactive protein (CRP) and fibrinogen are related to measures of physical functioning in mid-life women. Our sample included 543 participants in the Michigan site of Study of Women's Health Across the Nation (SWAN). Predictors included CRP from serum and fibrinogen from plasma. Performance-based outcomes included measures of gait, hand grip strength, flexibility, stair climb, 40-foot walk, and chair rise. Perception of physical functioning was assessed with the Medical Outcomes Study Short-Form 36 questionnaire. Regression analyses adjusted for relevant covariates. Cross-sectional associations were identified between higher CRP and more time spent in double support (with both feet on the floor while walking), shorter forward reach, slower 2-lb lift, and slower stair climb. Higher CRP and fibrinogen were associated with worse perceived functioning in cross-sectional analyses. Predictive associations across time were found between higher CRP and increased time spent in double support, diminishing forward reach distance and grip strength and worse perceived physical functioning. Predictive associations across time were also found between higher fibrinogen and greater time spent in double support, slower stair climb and worse perceived physical functioning. Our results suggest that inflammatory processes are associated with poor physical functioning in mid-life women.
Collapse
Affiliation(s)
- Kristin Tomey
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48104, United States.
| | | | | | | |
Collapse
|
49
|
Sun Q, Townsend MK, Okereke OI, Franco OH, Hu FB, Grodstein F. Adiposity and weight change in mid-life in relation to healthy survival after age 70 in women: prospective cohort study. BMJ 2009; 339:b3796. [PMID: 19789407 PMCID: PMC3230231 DOI: 10.1136/bmj.b3796] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the hypothesis that mid-life adiposity is associated with a reduced probability of maintaining an optimal health status among those who survive to older ages. DESIGN Prospective cohort study. SETTING The Nurses' Health Study, United States. PARTICIPANTS 17,065 women who survived until at least the age of 70, provided information on occurrence of chronic disease, cognitive function, physical function, and mental health at older ages, and were free from major chronic diseases at mid-life (mean age was 50 at baseline in 1976). MAIN OUTCOME MEASURES Healthy survival to age 70 and over was defined as having no history of 11 major chronic diseases and having no substantial cognitive, physical, or mental limitations. RESULTS Of the women who survived until at least age 70, 1686 (9.9%) met our criteria for healthy survival. Increased body mass index (BMI) at baseline was significantly associated with linearly reduced odds of healthy survival compared with usual survival, after adjustment for various lifestyle and dietary variables (P<0.001 for trend). Compared with lean women (BMI 18.5-22.9), obese women (BMI >or=30) had 79% lower odds of healthy survival (odds ratio 0.21, 95% confidence interval 0.15 to 0.29). In addition, the more weight gained from age 18 until mid-life, the less likely was healthy survival after the age of 70. The lowest odds of healthy survival were among women who were overweight (BMI >or=25) at age 18 and gained >or=10 kg weight (0.18, 0.09 to 0.36), relative to women who were lean (BMI 18.5-22.9) and maintained a stable weight. CONCLUSIONS These data provide evidence that adiposity in mid-life is strongly related to a reduced probability of healthy survival among women who live to older ages, and emphasise the importance of maintaining a healthy weight from early adulthood.
Collapse
Affiliation(s)
- Qi Sun
- Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States.
| | | | | | | | | | | |
Collapse
|
50
|
Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky SB, Ferrucci L. Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care 2008; 11:693-700. [PMID: 18827572 PMCID: PMC2633408 DOI: 10.1097/mco.0b013e328312c37d] [Citation(s) in RCA: 752] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Older obese persons with decreased muscle mass or strength are at special risk for adverse outcomes. We discuss potential pathways to muscle impairment in obese individuals and the consequences that joint obesity and muscle impairment may have on health and disability. Tantamount to this discussion is whether low muscle mass or, rather, muscle weakness should be used for the definition. RECENT FINDINGS Excess energy intake, physical inactivity, low-grade inflammation, insulin resistance and changes in hormonal milieu may lead to the development of so-called 'sarcopenic obesity'. It was originally believed that the culprit of age-related muscle weakness was a reduction in muscle mass, but it is now clear that changes in muscle composition and quality are predominant. We propose that the risk of adverse outcomes, such as functional limitation and mortality, is better estimated by considering jointly obesity and muscle strength rather than obesity and muscle mass and the term 'sarcopenic obesity' should be revisited. SUMMARY Recognition of obese patients who have associated muscle problems is an essential goal for clinicians. Further research is needed to identify new target for prevention and cure of this important geriatric syndrome.
Collapse
Affiliation(s)
- Sari Stenholm
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland
- National Public Health Institute, Department of Health and Functional Capacity, Turku, Finland
| | - Tamara B. Harris
- Geriatrics Interdisciplinary Studies Section, Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland
| | - Taina Rantanen
- The Finnish Center For Interdisciplinary Gerontology, Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marjolein Visser
- Institute of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, and EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Stephen B. Kritchevsky
- Section on Gerontology and Geriatric Medicine, J. Paul Sticht Center on Aging, Wake Forest University School of Medicine
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland
| |
Collapse
|