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Association of Obesity and Frailty in Older Adults: NHANES 1999–2004

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The journal of nutrition, health & aging

Abstract

Objectives

Body composition changes with aging can increase rates of obesity, frailty and impact function. Measuring adiposity using body fat (%BF) or central adiposity using waist circumference (WC) have greater diagnostic accuracy than traditional measures such as body mass index (BMI).

Design

This is an observational study.

Setting

This study focused on older community-dwelling participants.

Participants

We identified individuals age ≥ 60 years old using the 1999–2004 cross-sectional National Health and Nutrition Survey (NHANES).

Intervention

The primary analysis evaluated the association between frailty and %BF or WC. Frailty was the primary predictor (robust=referent) and %BF and WC were considered continuous outcomes. Multiple imputation analyses accounted for missing characteristics.

Measurement

Dual energy x-ray absorptiometry was used to assess %BF and WC was objectively measured. Frailty was defined using an adapted version of Fried’s criteria that was self-reported: (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-frail and frail persons met zero, 1 or 2, and ≥3 criteria, respectively.

Results

Of the 4,984 participants, the mean age was 71.1±0.2 (SE) years and 56.5% were females. We classified 2,246 (50.4%), 2,195 (40.3%), and 541 (9.2%) individuals as robust, pre-frail and frail, respectively. Percent BF was 35.9±0.13, 38.3±0.20 and 40.0±0.46 in the robust, pre-frail and frail individuals, respectively. WC was 99.5±0.32 in the robust, 100.1±0.43 in pre-frail, 104.7±1.17 in frail individuals. Compared to robust individuals, only frail individuals had greater %BF on average (β=0.97±0.43,p=0.03); however, pre-frail and frail individuals had 2.18 and 4.80 greater WC, respectively (β=2.18±0.64,p=0.002, and β=4.80±1.1,p<0.001).

Conclusion

Our results demonstrate that in older adults, frailty and pre-frailty are associated with a greater likelihood of high WC (as dichotomized) and a greater average WC (continuous).

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Author information

Authors and Affiliations

  1. Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA

    Rebecca S. Crow & J. A. Batsis

  2. Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Rebecca S. Crow, A. J. Titus, M. L. Bruce, T. A. Mackenzie, S. J. Bartels & J. A. Batsis

  3. Dartmouth Centers for Health and Aging, Dartmouth College, Hanover, NH, USA

    Rebecca S. Crow, M. L. Bruce, S. J. Bartels & J. A. Batsis

  4. Health Promotion Research Center at Dartmouth, Lebanon, NH, USA

    M. L. Bruce, S. J. Bartels & J. A. Batsis

  5. Dartmouth Weight & Wellness Center, Lebanon, NH, USA

    J. A. Batsis

  6. Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth Practice, Lebanon, NH, USA

    A. J. Titus & T. A. Mackenzie

  7. The Dartmouth Institute for Health Policy & Clinical Research, Lebanon, NH, USA

    S. J. Bartels & J. A. Batsis

  8. Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia, SC, USA

    M. C. Lohman

  9. Department of Kinesiology, University of New Hampshire, Durham, NH, USA

    S. B. Cook

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  1. Rebecca S. Crow
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Correspondence to Rebecca S. Crow.

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Crow, R.S., Lohman, M.C., Titus, A.J. et al. Association of Obesity and Frailty in Older Adults: NHANES 1999–2004. J Nutr Health Aging 23, 138–144 (2019). https://doi.org/10.1007/s12603-018-1138-x

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  • DOI: https://doi.org/10.1007/s12603-018-1138-x

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