Obesity, fat distribution, and risk of frailty in two population‐based cohorts of older adults in Spain

Abstract

Objective: To evaluate for the first time the longitudinal relationship between abdominal obesity and the onset of frailty. Methods: Study based on results from two population-based cohorts, the Seniors-ENRICA, with 1801 individuals aged 60, and the Toledo Study for Healthy Ageing (TSHA), with 1289 participants 65 years. Incident frailty was assessed with the Fried criteria. Results: During 3.5 years of follow-up, 125 individuals with incident frailty in Seniors-ENRICA and 162 in TSHA were identified. After adjustment for the main confounders, the pooled odds ratio (pooled OR) for general obesity and risk of frailty was 1.

Incidence and Risk Factors for Frailty in the Community-Dwelling Elderly Population. A Two-Year Follow-Up Cohort Study

“…Abdominal obesity was maintained as a significant risk factor for frailty in the multivariate analysis -a result that agrees with the relationship between obesity and poor physical activity and weakness reported by other studies [24]. Growing evidence suggests that obesity, and especially abdominal obesity, may contribute to frailty by promoting pro-inflammatory processes, insulin resistance, fat infiltration of the skeletal muscle and hormonal changes (such as increased leptin or decreased adiponectin levels) with catabolic and satiation effects [24][25][26]. These changes may lead to a loss of muscle mass and the development of sarcopenic obesity and frailty.…”

Frailty and reduced physical function go hand in hand in adults with rheumatoid arthritis: a US observational cohort study

“…In addition, frail individuals in the present RA cohort were more likely to be obese. This observation corroborates mounting data in which obesity is strongly associated with an increased risk of frailty in both elderly and chronic disease cohorts [30–33]. Moreover, sarcopenic obesity, the combination of low lean mass and high fat mass, is also associated with frailty in older adults [34,35].…”

Contribution of health behaviours and clinical factors to socioeconomic differences in frailty among older adults

“…Sedentary behaviour was assessed with the Nurses’ Health Study questionnaire validated in Spain 34. Weight, height, and waist circumference were measured with standardised procedures 7 32. General obesity was defined as BMI≥30 kg/m 2 , and abdominal obesity as waist circumference >102 cm in men and >88 cm in women.…”

“…Frailty is associated with several behavioural and clinical factors (BCF) such as reduced physical activity,6 poor diet,6 obesity,7 smoking,8 inflammatory markers9 10 and many chronic conditions, particularly cardiovascular disease,11 diabetes mellitus,12 and depression or use of antidepressants 9. Most of these BCF, in turn, vary by socioeconomic status (SES) 13–19…”