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The journal of nutrition, health & aging
Published in: The journal of nutrition, health & aging 2/2019

01-02-2019

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

Authors: Rebecca S. Crow, M. C. Lohman, A. J. Titus, S. B. Cook, M. L. Bruce, T. A. Mackenzie, S. J. Bartels, J. A. Batsis

Published in: The journal of nutrition, health & aging | Issue 2/2019

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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).

Literature
  1. Ancoli–Israel S, Roth T. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep. 1999 May 1;22 Suppl 2:S347–53.
  2. Foley D, Ancoli–Israel S, Britz P, Walsh J. Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. J Psychosom Res. 2004;56(5):497–502.View ArticlePubMed
  3. Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep. 1995;18(6):425–32.View ArticlePubMed
  4. Newman AB, Enright PL, Manolio TA, Haponik EF, Wahl PW, Cardiovascular Health Study Research Group. Sleep disturbance, psychosocial correlates, and cardiovascular disease in 5201 older adults: the Cardiovascular Health Study. J Am Geriatr Soc. 1997;45(1):1–7.View ArticlePubMed
  5. Neikrug AB, Ancoli–Israel S. Sleep disorders in the older adult–a mini–review. Gerontology. 2010;56(2):181–9.View ArticlePubMed
  6. Vaz Fragoso CA, Gahbauer EA, Van Ness PH, Gill TM. Sleep–wake disturbances and frailty in community–living older persons. J Am Geriatr Soc. 2009;57(11):2094–100.View ArticlePubMedPubMed Central
  7. Ensrud KE, Blackwell TL, Redline S, Ancoli–Israel S, Paudel ML, Cawthon PM, et al. Sleep disturbances and frailty status in older community–dwelling men. J Am Geriatr Soc. 2009;57(11):2085–93.View ArticlePubMedPubMed Central
  8. Del Brutto OH, Mera RM, Sedler MJ, Zambrano M, Nieves JL, Cagino K, et al. The effect of age in the association between frailty and poor sleep quality: a populationbased study in community–dwellers (The Atahualpa Project). Journal of the American Medical Directors Association. 2016;17(3):269–71.View ArticlePubMed
  9. Moreno–Tamayo K, Manrique–Espinoza B, Rosas–Carrasco O, Pérez–Moreno A, Salinas–Rodríguez A. Sleep complaints are associated with frailty in Mexican older adults in a rural setting. Geriatrics & gerontology international. 2017;17(12):2573–8.View Article
  10. Goldman SE, Stone KL, Ancoli–Israel S, Blackwell T, Ewing SK, Boudreau R, et al. Poor sleep is associated with poorer physical performance and greater functional limitations in older women. Sleep. 2007;30(10):1317–24.View ArticlePubMedPubMed Central
  11. Lan T, Lan T, Wen C, Lin Y, Chuang Y. Nighttime sleep, Chinese afternoon nap, and mortality in the elderly. Sleep. 2007;30(9):1105–10.View ArticlePubMedPubMed Central
  12. Smyth C. The Pittsburgh Sleep Quality Index (PSQI). J Gerontol Nurs. 1999;25(12):10–.View ArticlePubMed
  13. Lee W, Peng L, Liang C, Chiou S, Chen L. Long sleep duration, independent of frailty and chronic Inflammation, was associated with higher mortality: A national population–based study. Geriatrics & gerontology international. 2017;17(10):1481–7.
  14. Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. J Psychosom Res. 2004;57(3):297–305.View ArticlePubMed
  15. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2001;56(3):M146–57.
  16. Chen L, Liu L, Woo J, Assantachai P, Auyeung T, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. Journal of the American Medical Directors Association. 2014;15(2):95–101.View ArticlePubMed
  17. Orme JG, Reis J, Herz EJ. Factorial and discriminant validity of the Center for Epidemiological Studies Depression (CES–D) scale. J Clin Psychol. 1986;42(1):28–33.View ArticlePubMed
  18. Son J, Kim S, Won C, Choi H, Kim B, Park M. Physical frailty predicts medical expenses in community–dwelling, elderly patients: three–year prospective findings from living profiles of older people surveys in Korea. European Geriatric Medicine. 2015;6(5):412–6.View Article
  19. Van Cauter E, Leproult R, Plat L. Age–related changes in slow wave sleep and REM sleep and relationship with growth hormone and cortisol levels in healthy men. JAMA. 2000;284(7):861–8.View ArticlePubMed
  20. Bauer ME, Jeckel CMM, Luz C. The role of stress factors during aging of the immune system. Ann N Y Acad Sci. 2009;1153(1):139–52.View ArticlePubMed
  21. Ensrud KE, Blackwell TL, Redline S, Ancoli–Israel S, Paudel ML, Cawthon PM, et al. Sleep disturbances and frailty status in older community–dwelling men. J Am Geriatr Soc. 2009;57(11):2085–93.View ArticlePubMedPubMed Central
  22. Song HJ, Choi J, Lee YJ, Youn NH, Oh JM, Lee YR. The Association of Objective Depression and Subjective Depression with Weight Change among Korean Adults Aged over 65 Years: Korean National Health and Nutrition Examination Survey, 2010–2012. Korean Journal of Family Practice. 2018;8(2):281–5.View Article
  23. Kwon Y, Jang S, Park E, Cho A, Shim J, Linton JA. Long sleep duration is associated with sarcopenia in Korean adults based on data from the 2008–2011 KNHANES. Journal of Clinical Sleep Medicine. 2017;13(09):1097–104.View ArticlePubMedPubMed Central
  24. Lee JS, Auyeung T, Leung J, Chan D, Kwok T, Woo J, et al. Long sleep duration is associated with higher mortality in older people independent of frailty: a 5–year cohort study. Journal of the American Medical Directors Association. 2014;15(9):649–54.View ArticlePubMed
  25. Self–reported sleep duration as a predictor of all–cause mortality: results from the JACC study, Japan. Sleep. 2004;27(1):51–4.
  26. Hublin C, Partinen M, Koskenvuo M, Kaprio J. Sleep and mortality: a populationbased 22–year follow–up study. Sleep. 2007;30(10):1245–53.View ArticlePubMedPubMed Central
  27. Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Sleep duration and all–cause mortality: a systematic review and meta–analysis of prospective studies. Sleep. 2010;33(5):585–92.View ArticlePubMedPubMed Central
  28. Stone KL, Ewing SK, Ancoli–Israel S, Ensrud KE, Redline S, Bauer DC, et al. Selfreported sleep and nap habits and risk of mortality in a large cohort of older women. J Am Geriatr Soc. 2009;57(4):604–11.View ArticlePubMedPubMed Central
  29. Kurina LM, McClintock MK, Chen J, Waite LJ, Thisted RA, Lauderdale DS. Sleep duration and all–cause mortality: a critical review of measurement and associations. Ann Epidemiol. 2013;23(6):361–70.View ArticlePubMedPubMed Central
  30. Mesas AE, López–García E, León–Muñoz LM, Guallar–Castillón P, Rodríguez–Artalejo F. Sleep duration and mortality according to health status in older adults. J Am Geriatr Soc. 2010;58(10):1870–7.View ArticlePubMed
  31. Li Y, Sato Y, Yamaguchi N. Potential biochemical pathways for the relationship between sleep duration and mortality. Sleep Med. 2013;14(1):98–104.View ArticlePubMed
  32. Irwin MR, Olmstead R, Carroll JE. Sleep disturbance, sleep duration, and inflammation: a systematic review and meta–analysis of cohort studies and experimental sleep deprivation. Biol Psychiatry. 2016;80(1):40–52.View ArticlePubMed
  33. Gale CR, Baylis D, Cooper C, Sayer AA. Inflammatory markers and incident frailty in men and women: the English Longitudinal Study of Ageing. Age. 2013;35(6):2493–501.View ArticlePubMedPubMed Central
  34. Khor Y, Tolson J, Churchward T, Rochford P, Worsnop C. Patients’ estimates of their sleep times: reliability and impact on diagnosis of obstructive sleep apnoea. Intern Med J. 2015;45(8):850–3.View ArticlePubMed
  35. Lee M, Choh A, Demerath E, Knutson K, Duren D, Sherwood R, et al. Sleep disturbance in relation to health–related quality of life in adults: the Fels Longitudinal Study. JNHA–The Journal of Nutrition, Health and Aging. 2009;13(6):576–83.View ArticlePubMed
  36. Cochen V, Arbus C, Soto M, Villars H, Tiberge M, Montemayor T, et al. Sleep disorders and their impacts on healthy, dependent, and frail older adults. JNHA–The Journal of Nutrition, Health and Aging. 2009;13(4):322–9.View ArticlePubMed
Metadata
Title
Association of Obesity and Frailty in Older Adults: NHANES 1999–2004
Authors
Rebecca S. Crow
M. C. Lohman
A. J. Titus
S. B. Cook
M. L. Bruce
T. A. Mackenzie
S. J. Bartels
J. A. Batsis
Publication date
01-02-2019
Publisher
Springer Paris
Published in
The journal of nutrition, health & aging / Issue 2/2019
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-018-1138-x

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