Sex Differences in Association Between Body Composition and Frailty or Physical Performance in Community-Dwelling Older Adults

Abstract

BackgroundFrailty is a common geriatric condition due to aging, defined as a decrease in the functional reserve to maintain the homeostasis. As part of the aging process, body composition changes occur. This study investigated the relationship between body composition and frailty in a community-dwelling elderly Korean population.MethodsThis cross-sectional cohort study analyzed data of 2,385 elderly participants (aged 70–84 years, 1131 males and 1254 females) of the Korean Frailty and Aging Cohort Study from 2016 to 2017. Body composition, including total and trunk fat masses and fat-free mass, were measured with dual-energy X-ray absorptiometry. Fat mass index (FMI), trunk fat mass index (TFMI), and fat-free mass index (FFMI) represented total fat mass, trunk fat mass, and fat-free mass according to height. Based on the frailty index developed by Fried, we compared the frail and non-frail groups. Poor physical performance assessed with the short physical performance battery score of <9 is considered frailty. To evaluate the relationship between the variables, simple and fully adjusted multivariable logistic regression analyses were performed according to sex.ResultsAmong the participants, 462 (19.3%) were defined as the frail group, with a significantly high mean age of 77.9±4.0 years. In the logistic regression analysis of frailty based on body mass index (BMI) categories, underweight (BMI<18 kg/m2) participants showed a high incidence of frailty in both sexes. BMI showed an association with frailty only in males. In both sexes, FFMI was associated with a lower incidence of frailty, which was statistically significant in the fully adjusted models. In the female, fat-related indexes including body fat percentage, FMI, and TFMI showed a significant association with poor physical performance. In contrast, males with low FFMI only showed a significant association with poor physical performance.ConclusionsFrailty closely correlated with FFMI in both sexes. The poor physical performance associated with frailty correlated with fat-related body composition in females and fat-free mass in males owing to the difference in body composition between the sexes. In the assessment of frailty, body composition and sex-related differences should be analyzed.

Comparison of appendicular lean mass indices for predicting physical performance in Korean hemodialysis patients

“…Kim et al [33] reported a positive association between muscle mass indices and physical performance status in only weak populations. Muscle mass is positively associated and intramuscular or intermuscular fat is inversely associated with strength or physical performance [34–36] . Muscle dysfunction, such as strength and performance, can be determined earlier compared with decreased in muscle mass; this may be associated with the increased inter- and intra-muscular fat infiltration [37–39] .…”

“…Muscle mass is positively associated and intramuscular or intermuscular fat is inversely associated with strength or physical performance. [34][35][36] Muscle dysfunction, such as strength and performance, can be determined earlier compared with decreased in muscle mass; this may be associated with the increased inter-and intra-muscular fat infiltration. [37][38][39] In our cohort, the female participants had less muscle mass and greater muscular fat compared with men.…”

Sex differences in association between body composition and frailty or physical performance in community-dwelling older adults: Erratum

“…In the article, “Sex differences in association between body composition and frailty or physical performance in community-dwelling older adults”, [ 1 ] which appeared in Volume 100, Issue 4 of Medicine , the rows in Tables 4 and 5 were not correctly aligned. The correct tables are below.…”