Obesity, Even in the Metabolically Healthy, Increases the Risk of Poor Physical Performance: A Cross-Sectional Study of Older People in a Chinese Community

Prevalence of ideal cardiovascular health and its relationship with relative handgrip strength in rural northeast China

Objectives

We aimed to investigate ideal cardiovascular health (CVH), its relationship with handgrip strength, and its components in rural China.

Methods

We conducted a cross-sectional study of 3,203 rural Chinese individuals aged ≥35 years in Liaoning Province, China. Of these, 2,088 participants completed the follow-up survey. Handgrip strength was estimated using a handheld dynamometer and was normalized to body mass. Ideal CVH was assessed using seven health indicators (smoking, body mass index, physical activity, diet, cholesterol, blood pressure, and glucose). Binary logistic regression analyses were performed to assess the correlation between handgrip strength and ideal CVH.

Results

Women had a higher rate of ideal cardiovascular health (CVH) than men (15.7% vs. 6.8%, P < 0.001). Higher handgrip strength correlated with a higher proportion of ideal CVH (P for trend <0.001). After adjusting for confounding factors, the odds ratios (95% confidence interval) of ideal CVH across increasing handgrip strength tripartite were 1.00 (reference), 2.368 (1.773, 3.164), and 3.642 (2.605, 5.093) in the cross-sectional study and 1.00 (reference), 2.088 (1.074, 4.060), and 3.804 (1.829, 7.913) in the follow-up study (all P < 0.05).

Conclusion

In rural China, the ideal CVH rate was low, and positively correlated with handgrip strength. Grip strength can be a rough predictor of ideal CVH and can be used to provide guidelines for improving CVH in rural China.

Combined Effect of Dynapenia and Abdominal Obesity on the Prevalence of Peripheral Artery Disease in Older Adults Over 75 Years Old in China

The objective is to examine the separate and joint effects of dynapenia and abdominal obesity on the prevalence of peripheral artery disease (PAD) in older adults of different ages (60-74 and over 75 years old). This study comprised 1293 community-dwelling Chinese participants recruited from Shanghai, China, who were aged at least 60 years (753 women; mean age: 72.0 ± 5.9 years). Dynapenia was defined as low-grip strength (<28.0 kg for males and <18.0 kg for females) but normal skeletal muscle index (≥7.0 kg/m² for males and ≥5.7 kg/m² for females). Abdominal obesity was determined according to waist circumference (≥90 cm for males and ≥85 cm for females), and PAD was diagnosed by an ankle-brachial index  ≤ 0.9. Binary logistic regression models were performed to determine associations between dynapenia, abdominal obesity, and the combination of dynapenia and abdominal obesity and PAD. According to dynapenia and abdominal obesity status stratified by age (60-74 or over 75), the patients were divided into 4 groups: normal, dynapenia alone, abdominal obesity alone, and co-occurring groups. A logistic regression showed that the co-occurring groups (odds ratio = 4.63, 95% confidence interval = 1.41-15.21) had a higher prevalence of PAD than the normal group after adjusting for the covariates in older adults over 75 years of age. The combination of dynapenia and abdominal obesity increase the prevalence of PAD in older adults over 75 years. The present findings have important implications for the early identification of older adults with PAD and appropriate interventions should be implemented.

Obesity in Caucasian Seniors on the Rise: Is It Truly Harmful? Results of the PolSenior2 Study

Obesity is associated with an increased risk of morbidity and mortality; however, data suggest that in old age, obesity is not detrimental. The study’s objective was to verify whether obesity frequency still increases in Polish Caucasian seniors and to verify the “obesity paradox”. Five thousand and fifty-seven community-dwelling individuals aged ≥ 65 years completed a detailed medical questionnaire, underwent measurements of the body mass index (BMI) and the waist circumference (WC), and an evaluation of physical and cognitive performances. Over a decade, general obesity increased by 2.1%, mostly due to a 3.9% increase in men. Abdominal obesity increased by 1.0%, mainly due to males, in whom it increased by 3.9%. Obesity increased the risk of several aging-related diseases, but this effect was less pronounced in the oldest-old. Obesity did not adversely affect the physical and cognitive functioning or mortality. Through a multivariable analysis, the BMI and WC remained the independent predictors of the Katz Activities of Daily Living score (p < 0.001 and p < 0.05, respectively) and Mini-Mental State Examination score (both p < 0.001). The Kaplan−Meier survival curves revealed that overweight and obesity classes 1 and 2 were associated with the lowest mortality. Through a multivariable analysis, overweight, class 1 obesity, and abdominal obesity remained the independent predictors of a decreased mortality (all p < 0.001). In conclusion, we found that overweight and obesity are not detrimental in seniors, including the oldest-old. We suggest that the anthropometric values defining obesity should be modified for age-advanced people.

Outcomes addressed in randomized controlled lifestyle intervention trials in community-dwelling older people with (sarcopenic) obesity-An evidence map

Obesity and sarcopenic obesity (SO) are characterized by excess body fat with or without low muscle mass affecting bio-psycho-social health, functioning, and subsequently quality of life in older adults. We mapped outcomes addressed in randomized controlled trials (RCTs) on lifestyle interventions in community-dwelling older people with (sarcopenic) obesity. Systematic searches in Medline, Embase, Cochrane Central, CINAHL, PsycInfo, Web of Science were conducted. Two reviewers independently performed screening and extracted data on outcomes, outcome domains, assessment methods, units, and measurement time. A bubble chart and heat maps were generated to visually display results. Fifty-four RCTs (7 in SO) reporting 464 outcomes in the outcome domains: physical function (n = 42), body composition/anthropometry (n = 120), biomarkers (n = 190), physiological (n = 30), psychological (n = 47), quality of life (n = 14), pain (n = 4), sleep (n = 2), medications (n = 3), and risk of adverse health events (n = 5) were included. Heterogeneity in terms of outcome definition, assessment methods, measurement units, and measurement times was found. Psychological and quality of life domains were investigated in a minority of studies. There is almost no information beyond 52 weeks. This evidence map is the first step of a harmonization process to improve comparability of RCTs in older people with (sarcopenic) obesity and facilitate the derivation of evidence-based clinical decisions.

Menopausal Symptoms, Postural Balance, and Functional Mobility in Middle-Aged Postmenopausal Women

The aim of the present study was to determine the associations between the severity of the menopausal symptoms and postural balance and functional mobility in middle-aged postmenopausal women. A cross-sectional study was performed (171 participants, 57.18 ± 4.68 years). Severity of the menopausal symptoms (on the Menopause Rating Scale), postural balance (stabilometric platform) with eyes open and closed, and functional mobility (timed up and go test) were determined. A multivariate linear regression was performed, with body mass index, waist to hip ratio, age and fall history as possible confounders. Our findings showed that a greater severity of the menopausal symptoms at a psychological level was associated, under both eyes open and closed conditions, with worse postural control assessed by the length of the stabilogram (adjusted R2 = 0.093 and 0.91, respectively), the anteroposterior center of pressure displacements (adjusted R2 = 0.051 and 0.031, respectively) and the center of pressure velocity (adjusted R2 = 0.065 for both conditions). Older age was related to greater mediolateral displacements of the center of pressure with eyes open and closed (adjusted R2 = 0.45 and 0.58, respectively). There were no associations between the menopausal symptoms' severity and functional mobility. We can conclude that a greater severity of psychological menopausal symptoms was independently associated with worse postural balance in middle-aged postmenopausal women.