Frailty status is related to general and abdominal obesity in older adults

Afonso, Cláudia; Sousa‐Santos, Ana Rita; Santos, Alejandro; Borges, Nuno; Padrão, Patrícia; Moreira, Pedro; Amaral, Teresa

doi:10.1016/j.nutres.2020.10.009

Cited by 21 publications

(19 citation statements)

References 33 publications

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“…Many studies, including a recent study by Alfonso et al ., showed that frailty is highly associated with 'general and abdominal obesity' where general obesity was defined as BMI ≥ 30.0 kg/m 2 ( 36 ). The same group also had low HGS ( 37 ). Our study also revealed similar findings where the normal BMI with CO group had the highest frailty prevalence and the high BMI without CO group had the highest HGS.…”

Section: Discussionmentioning

confidence: 83%

“…WC may be a better measure of obesity and is associated with many negative consequences including cognitive and functional impairment, and cardiometabolic diseases. BMI alone in older adults may not be a good reflection of obesity as losing height may over-estimate the BMI, although 85% of our population with high BMI had CO. High WC and BMI in combination may be a better prediction of obesity‐related morbidity and mortality ( 37 ). WC is currently not routinely measured due to technical difficulties, but findings from our study and previous studies have highlighted that WC should be included as one of the vital signs measured in primary care, with necessary interventions put in place to screen for chronic diseases, function, frailty, and cognitive outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Association of central obesity and high body mass index with function and cognition in older adults

Merchant

Kit

Lim

et al. 2021

Endocrine Connections

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Objective: To investigate the association of normal body mass index (BMI) with central obesity (CO), high BMI with CO, high BMI without CO, and normal BMI without CO, with function and cognition in older adults. Methods: Cross-sectional study involving 754 participants ≥ 65 years. Data collected include demographics, cognition and physical measurements. Results: Females had higher prevalence of high BMI with CO and lower prevalence of high BMI without CO than males (61.0% vs. 44.6% and 4.6% vs. 15.0% respectively). Within gender, CO groups, regardless of BMI, had lower mini-mental state examination (MMSE), handgrip strength (HGS) and Timed-Up-and-Go (TUG) scores. Overall, the high BMI without CO group had highest MMSE scores, HGS, and shortest TUG. Amongst males, HGS was significantly lower in the normal BMI with CO group (B -3.28, 95% CI -6.32 - -0.23, p=0.04). CO, regardless of normal/high BMI, had significantly longer TUG time (B 2.65, 95% CI 0.45 - 4.84, p = 0.02; B 1.07, 95% CI 0.25 - 1.88, p=0.01 respectively) than normal BMI without CO group. CO was associated with lower MMSE scores in both genders but significant only in males with normal BMI and CO (B -1.60, 95% CI -3.15 - -0.06, p=0.04). Conclusion: CO may be a better predictor of obesity and adverse outcomes in older adults. High BMI without CO was associated with better outcomes especially in males but require further validation. Prospective longitudinal studies are needed to ascertain the impact of BMI and/or CO on function, cognition, mortality and gender differences.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Association of central obesity and high body mass index with function and cognition in older adults

Merchant

Kit

Lim

et al. 2021

Endocrine Connections

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“…The proportion of Firmicutes decreased slightly, although there was no significant difference between groups, and the Firmicutes/Bacteroidetes (F/B) ratio was significantly lower in the TMAO group than in the control group ( p < 0.05, Figure 3F ). A decreased F/B ratio has previously been correlated with frailty ( Kim and Jazwinski, 2018 ; Grigor’eva, 2020 ; Afonso et al., 2021 ). The major significantly altered genera are listed in Figures 3G, I, J .…”

Section: Resultsmentioning

confidence: 92%

“…The F/B ratio can indicate the state of the human body. For example, the F/B ratio is commonly used as a biomarker of obesity, and there is a positive association between frailty and obesity ( Grigor’eva, 2020 ; Afonso et al., 2021 ). Moreover, the F/B ratio has recently been shown to be a biomarker of gut dysbiosis ( Grigor’eva, 2020 ); thus, the F/B is a sign of gut health.…”

Section: Discussionmentioning

confidence: 99%

A Novel Trimethylamine Oxide-Induced Model Implicates Gut Microbiota-Related Mechanisms in Frailty

Chen

Rong

Sun

et al. 2022

Front. Cell. Infect. Microbiol.

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Frailty is a complicated syndrome that occurs at various ages, with highest incidence in aged populations, suggesting associations between the pathogenesis of frailty and age-related changes. Gut microbiota (GM) diversity and abundance change with age, accompanied by increased levels of trimethylamine oxide (TMAO), a systemic inflammation-inducing GM metabolite. Thus, we hypothesized that TMAO may be involved in the development of frailty. We successfully established and verified a novel model of frailty in adult mice based on a 4-week intraperitoneal injection regime of TMAO followed by LPS challenge. The frailty index significantly increased in TMAO-treated mice after LPS challenge. TMAO also decreased claudin-1 immunofluorescent staining intensity in the jejunum, ileum, and colon, indicating that the destruction of intestinal wall integrity may increase vulnerability to exogenous pathogens and invoke frailty. 16S sequencing showed that TMAO significantly reduced the GM Firmicutes/Bacteroidetes (F/B) ratio, but not α-diversity. Interestingly, after LPS challenge, more genera of bacterial taxa were differently altered in the control mice than in the TMAO-treated mice. We infer that a variety of GM participate in the maintenance of homeostasis, whereas TMAO could blunt the GM and impair the ability to recover from pathogens, which may explain the continuous increase in the frailty index in TMAO-treated mice after LPS challenge. TMAO also significantly increased serum imidazole metabolites, and led to different patterns of change in serum peptide and phenylpropanoid metabolites after LPS stimulation. These changes indicate that glucose metabolism may be one mechanism by which GM inactivation causes frailty. In conclusion, TMAO leads to frailty by destroying intestinal barrier integrity and blunting the GM response.

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“…The fact that there is an over expression of obesity over weight loss deserved our attention. Several studies [ 23 , 24 ] show that weight loss but also obesity can be a frailty indicator. This aspect may be dependent on the cultural context and deserves further reflection.…”

Section: Discussionmentioning

confidence: 99%

Validation and Screening Capacity of the European Portuguese Version of the SUNFRAIL Tool for Community-Dwelling Older Adults

Cardoso

Bobrowicz-Campos

Teixeira-Santos

et al. 2021

IJERPH

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Early detection of frailty may prevent or delay adverse health outcomes in community-dwelling older adults. In Portugal, there are currently no valid multidimensional frailty screening tools. SUNFRAIL is a user-friendly multidimensional tool for frailty screening that can be used in primary care. Aims: (i) to determine the validity and reliability of the European Portuguese version of the SUNFRAIL tool for use in community-dwelling older adults; (ii) to assess the screening capacity of this version of SUNFRAIL using Fried’s phenotypic model criteria for frailty as a reference test. Methods: Cross-sectional pilot study in a convenience sample of 128 community-dwelling older adults. Objective and subjective data were collected. Internal consistency, concurrent validity, sensitivity, and specificity (ROC curve analysis) were examined. Results: Internal consistency was low. Significant moderate to strong correlations were found between different domains and the total score. The differences between robust, pre-frail, and frail older adults were significant. SUNFRAIL was also correlated with multimorbidity. Sensitivity and specificity were satisfactory. Conclusions: The European Portuguese version of the SUNFRAIL tool is a promising frailty screening tool for community-dwelling older adults to be routinely used in clinical practice. However, more consistent results on its validity and reliability are needed to be used nationwide.

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Frailty status is related to general and abdominal obesity in older adults

Cited by 21 publications

References 33 publications

Association of central obesity and high body mass index with function and cognition in older adults

Association of central obesity and high body mass index with function and cognition in older adults

A Novel Trimethylamine Oxide-Induced Model Implicates Gut Microbiota-Related Mechanisms in Frailty

Validation and Screening Capacity of the European Portuguese Version of the SUNFRAIL Tool for Community-Dwelling Older Adults

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