The Association Between Obesity and the Frailty Syndrome in Older Women

The Women's Health and Aging Studies

Blaum, Caroline S. MD, MS
Li Xue, Qian PhD
Michelon, Elisabete MD
Semba, Richard D. MD, MPH
Fried, Linda P. MD, MPH

^*University of Michigan, Michigan
^†Ann Arbor Veterans Affairs Healthcare System Geriatric Rehabilitation, Education and Clinical Center, Ann Arbor, Michigan
^‡Johns Hopkins Medical Institutions, Baltimore, Maryland
^§Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Rio Grande do Sul, Brazil

Address correspondence to Caroline S. Blaum, MD, MS, Associate Professor, The University of Michigan Medical School, CCGCB Room 1111, 1500 East Medical Center Drive, Ann Arbor, MI 48109. E-mail: [email protected]

This work was supported by National Institute on Aging Grant RO1 AG11703–01A1, National Institutes of Health, National Center for Research Resources, General Clinical Research Center Grants RR00722 and RO1 AI41956, and National Institute on Aging Contract NO1-AG12112. Dr. Blaum was supported by NIA-K08 AG00749-02 and the Ann Arbor Veterans Affairs Geriatric Research, Education and Clinical Center. Dr. Michelon was supported by a postdoctoral scholarship from CNPq-Brazil.

(See editorial comments by Dr. Kenneth Rockwood on pp 1069–1070)

Journal of the American Geriatrics Society 53(6):p 927-934, June 2005.

OBJECTIVES

To determine whether obesity is associated with the frailty phenotype and, if so, whether comorbid conditions or inflammatory markers explain this association.

DESIGN

Cross-sectional analysis of baseline data from the Women's Health and Aging Studies I (1992) and II (1994), complementary population-based studies.

SETTING

Twelve contiguous ZIP code areas in Baltimore, Maryland.

PARTICIPANTS

Five hundred ninety-nine community-dwelling women aged 70 to 79 with a body mass index (BMI) greater than 18.5 kg/m².

MEASUREMENTS

The dependent variables were the frailty syndrome, including prefrailty, defined as presence of one or two of five frailty indicators (weakness, slowness, weight loss, low physical activity, exhaustion), and frailty, defined as three or more indicators. Independent variables included BMI, categorized using World Health Organization criteria as normal (18.5 to <25 kg/m²), overweight (25 to <30 kg/m²), and obese (≥30 kg/m²); chronic diseases; C-reactive protein; and serum carotenoids.

RESULTS

Being overweight was significantly associated with prefrailty, and obesity was associated with prefrailty and frailty. In all frail women, regardless of BMI group, a similar pattern of three defining frailty indicators was found: slowness, weakness, and low activity (with the addition of weight loss in the normal weight group.) In multinomial regression models, obesity was significantly associated with prefrailty (odds ratio (OR) = 2.23, 95% confidence interval (CI) = 1.29–3.84) and frailty (OR = 3.52, 95% CI = 1.34–9.13), even when controlling for covariates.

CONCLUSION

Obesity is associated with the frailty syndrome in older women in cross-sectional data. This association remains significant even when multiple conditions associated with frailty are considered. Prospective studies are needed to confirm this finding.