ASSOCIATION OF OBESITY AND FRAILTY IN OLDER ADULTS: NHANES 1999–2004

摘要

Body composition changes with aging can impact function in older adults leading to frailty. Measuring adiposity using body fat or central adiposity using waist circumference (WC) have greater diagnostic accuracy than traditional measures such as body mass index (BMI).We identified individuals ≥60 years old using the 1999–2004 cross-sectional National Health and Nutrition Survey (NHANES). Body fat percent was assessed using dual energy x-ray absorptiometry and WC was objectively measured. Frailty was defined using an adapted version of Fried’s criteria: (low BMI<18.5kg/m2; slow walking speed [<0.8m/s]; weakness [unable to lift 10lbs]; exhaustion [difficulty walking between rooms on same floor] and low physical activity [compared to others]). Robust, pre-frailty and frailty persons met zero, 1 or 2, and ≥3 criteria, respectively. The primary outcome evaluated the association between frailty and body fat or WC. Frailty was the primary predictor (robust=referent) and body fat and WC were considered continuous outcomes. Multiple imputation analyses accounted for missing characteristics.Of the 4,984 participants, mean age was 71.1 ± 0.2 (SE) years (56.5% females). We classified 2,246 (50.4%), 2,195 (40.3%), and 541 (9.2%) individuals as robust, pre-frail and frail, respectively. Mean body fat and WC was 35.9% and 99.5cm in the robust, 38.3% and 100.1cm in pre-frail, and 40.0% and 104.7cm in frail individuals. After adjustment, pre-frailty and frailty were associated with a β=0.37 ± 0.27,p=0.18, and β=0.97 ± 0.43,p=0.03 for body fat and β=2.18 ± 0.64,p=0.002, and β=4.80 ± 1.1,p<0.001 for WC.Geriatric obesity defined by higher body fat and high WC are associated with increasing rates of frailty when compared to robust patients.