Obesity in midlife linked to higher frailty risk in older people

Credit: Towfiqu barbhuiya / Unsplash

In a study from the University of Oslo and elsewhere, scientists found that carrying too much weight—including a midriff bulge—from midlife onwards is linked to a heightened risk of physical frailty in older age.

Frailty is often wrongly perceived as a purely wasting disorder, say the researchers, who emphasize the importance of keeping trim throughout adulthood to help minimize the risk.

Frailty is characterized by at least 3 of the following 5 criteria, and pre-frailty by 1-2 of the criteria: unintentional weight loss; exhaustion; weak grip strength; slow walking speed; and low physical activity levels.

Frailty is linked to vulnerability to falls, disability, hospital admission, reduced quality of life and death.

Previous research suggests that obese older adults may be at increased risk because obesity aggravates the age-related decline in muscle strength, aerobic capacity, and physical function.

But few studies have tracked weight changes and frailty risk over the long term.

In the study, the team used data from 4,509 people aged 45 or older. The average age at baseline was 51, with the average monitoring period lasting 21 years.

A BMI of less than 18.5 was categorized as underweight, normal as 18.5-24.9, overweight as 25-29.9, and obesity as 30 and above.

Waist circumference was categorized as normal (94 cm or less for men and 80 cm or less for women); moderately high (95-102 cm for men and 81-88 cm for women); and high (above 102 cm for men and above 88 cm for women).

In all, nearly 51% of those who were strong and 55% of those categorized as pre-frail were women.

The team found alcohol intake and smoking, educational attainment, marital status, social support, and physical activity levels differed strongly between the strong and pre-frail/frail groups and were accounted for in the analysis.

Those who were obese in 1994, assessed by BMI alone, were nearly 2.5 times more likely to be pre-frail/frail at the end of the monitoring period than those with a normal BMI.

Similarly, those with a moderately high or high waist circumference, to start off with, were respectively 57% and twice as likely to be pre-frail or frail than those with a normal waistline.

Those who started off with a normal BMI but moderately-high waist circumference, or who were overweight but had a normal waistline, weren’t much more likely to be pre-frail/frail at the end of the monitoring period.

But those who were both obese and who had a moderately-high waist circumference at the start of the monitoring period were.

Higher odds of pre-frailty/frailty were also found among those who put on weight and among those whose waistlines expanded than in those whose weight and waistlines remained the same throughout.

The team says the increased inflammatory capacity of fat cells and their infiltration into muscle cells, both of which likely boost naturally occurring age-related decline in muscle mass and strength, so heightening the risk of frailty.

If you care about weight loss, please read studies that hop extract could reduce belly fat in overweight people, and early time-restricted eating could help lose weight.

For more information about wellness, please see recent studies about vitamin K deficiency linked to hip fractures in old people, and results showing these vitamins could help reduce bone fracture risk.

The study was conducted by Shreeshti Uchai et al and published in the journal BMJ Open.

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