Frailty, Body Mass Index, and Abdominal Obesity in Older People (original) (raw)

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1Geriatric Medicine Research Unit, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Canada

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2Epidemiology and Public Health Group, Peninsula Medical School, Royal Devon and Exeter Hospital Site, Exeter, UK

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2Epidemiology and Public Health Group, Peninsula Medical School, Royal Devon and Exeter Hospital Site, Exeter, UK

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1Geriatric Medicine Research Unit, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Canada

3Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, Canada

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Accepted:

31 October 2009

Published:

25 November 2009

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Ruth E. Hubbard, Iain A. Lang, David J. Llewellyn, Kenneth Rockwood, Frailty, Body Mass Index, and Abdominal Obesity in Older People, The Journals of Gerontology: Series A, Volume 65A, Issue 4, April 2010, Pages 377–381, https://doi.org/10.1093/gerona/glp186
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Abstract

Background

Frailty has been conceptualized as a wasting disorder with weight loss as a key component. However, obesity is associated with disability and with physiological markers also recently linked with frailty, for example, increased inflammation and low antioxidant capacity. We aimed to explore the relationship between frailty and body mass index (BMI) in older people.

Methods

Data were from 3,055 community-dwelling adults aged 65 years and older who participated in the English Longitudinal Study of Ageing. Frailty was defined both by an index of accumulated deficits and by the Fried phenotype. BMI was divided into five categories, and waist circumference 88 cm or more (for women) and 102 cm or more (for men) was defined as high. Analyses were adjusted for sex, age, wealth, level of education, and smoking status.

Results

The association between BMI and frailty showed a U-shaped curve. This relationship was consistent across different frailty measures. The lowest frailty index (FI) scores and lowest prevalence of Fried frailty were in those with BMI 25–29.9. At each BMI category, and using either measure of frailty, those with a high waist circumference were significantly more frail.

Conclusions

Both the phenotypic definition of frailty and the FI show increased levels of frailty among those with low and very high BMIs. In view of the rise in obesity in older populations, the benefits and feasibility of diet and exercise for obese older adults should be a focus of urgent inquiries. The association of frailty with a high waist circumference, even among underweight older people, suggests that truncal obesity may be an additional target for intervention.

© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Topic:

• aging
• obesity
• phenotype
• body mass index procedure
• weight reduction
• frailty
• older adult
• waist circumference
• fried foods
• obesity, abdominal

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