The effect of obesity combined with low muscle strength on decline in mobility in older persons: results from the InCHIANTI Study

Stenholm, S; Alley, D; Bandinelli, S; Griswold, M E; Koskinen, S; Rantanen, T; Guralnik, J M; Ferrucci, L

doi:10.1038/ijo.2009.62

Cited by 248Nutrition and Health in AgingFrailty in Older AdultsBalance, Gait, and Falls Prevention

The effect of obesity combined with low muscle strength on decline in mobility in older persons: results from the InCHIANTI Study

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Stenholm, S, Alley, D, Bandinelli, S, Griswold, M E, Koskinen, S, Rantanen, T, Guralnik, J M, Ferrucci, L·2009·International Journal of Obesity

DOI 10.1038/ijo.2009.62PMC PMC2697265

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Abstract

Objective Both obesity and muscle impairment are increasingly prevalent among older persons and negatively affect health and physical functioning. However, the combined effect of coexisting obesity and muscle impairment on physical function decline has been little studied. We examined whether obese persons with low muscle strength experience significantly greater declines in walking speed and mobility than persons with only obesity or low muscle strength.Design Community-dwelling adults aged > or = 65 years (n = 930) living in the Chianti geographic area (Tuscany, Italy) were followed for 6 years in the population-based InCHIANTI study.Measurements On the basis of baseline measurements (1998-2000), obesity was defined as body mass index (BMI) > or = 30 kg/m(2) and low muscle strength as lowest sex-specific tertile of knee extensor strength. Walking speed and self-reported mobility disability (ability to walk 400 m or climb one flight of stairs) were assessed at baseline and at 3- and 6-year follow-up.Results At baseline, obese persons with low muscle strength had significantly lower walking speed compared with all other groups (P < or = 0.05). In longitudinal analyses, obese participants with low muscle strength had steeper decline in walking speed and high risk of developing new mobility disability over the 6-year follow-up compared with those without obesity or low muscle strength. After the age of 80, the differences between groups were substantially attenuated. The differences seen in walking speed across combination of low muscle strength and obesity groups were partly explained by 6-year changes in muscle strength, BMI and waist circumference.Conclusions Obesity combined with low muscle strength increases the risk of decline in walking speed and developing mobility disability, especially among persons < 80 years old.

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In the InCHIANTI study, mobility disability trajectories and gait speed over 6 years were steepest in individuals with obesity defined by BMI and low muscle strength.
“mobility disability trajectories and gait speed over 6 years were steepest in individuals with obesity as defined by BMI and low muscle strength200”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [200]
The Results (Change over time in walking speed) report the most prominent six-year decline in walking speed among participants aged 65–80 with obesity and low muscle strength. The Results (Risk of mobility disability) report a higher rate of new disability at six years, but do not describe disability trajectories as steepest; the walking-speed finding is also qualified by age. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Data from the InCHIANTI study noted rates of 3.2-8.7% using low knee extensor strength with either high BMI or waist circumference.
“Data from the InCHIANTI study noted rates of 3.2–8.7% using the low knee extensor strength with either high BMI or waist circumferrence200.”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [200]
The Methods (Measurement of muscle strength; page not provided) define low strength using knee extensor strength, and the Results (Risk of mobility disability; page not provided) describe analyses using BMI or waist circumference to define obesity. The passages in our copy do not report the claimed 3.2–8.7% rates, so the numerical range is unsupported. (LLM, conf=0.84)
Experimental — accuracy not yet measured
In the InCHIANTI study, community-dwelling older adults with dynapenic obesity showed a steeper decline in walking speed and an increased risk of developing new mobility disability over 6-year follow-up compared to those without obesity or dynapenia.
“In the Invecchiare in Chianti (InCHIANTI, aging in the Chianti area) study, community-dwelling older adults with dynapenic obesity showed a steeper decline in walking speed and an increased risk of developing new mobility disability over the 6-year follow-up compared to those without obesity or dynapenia (38).”
From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [38]
Sarcopenia and obesity can co-occur and are synergistically associated with worse functional decline and outcomes than either condition alone.
“Sarcopenia and obesity can co-occur, and synergistically are associated with worse functional decline and outcomes than is either condition alone.70”
From Age-related and disease-related muscle loss: The effect of diabetes, obesity, and other diseases (2014) · cites this paper as [70]

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Prevalence of Sarcopenic Obesity in Adults with Class II/III Obesity Using Different Diagnostic Criteria
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Recommendations for the conduct of clinical trials for drugs to treat or prevent sarcopenia
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Has the Prevalence of Disability Increased Over the Past Decade (2000–2007) in Elderly People? A Spanish Population-based Survey
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Abdominal obesity, dynapenia and dynapenic-abdominal obesity as factors associated with falls
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Joint Association of Obesity and Metabolic Syndrome With Incident Mobility Limitation in Older Men and Women--Results From the Health, Aging, and Body Composition Study
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Muscle capacity and physical function in older women: What are the impacts of resistance training?
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Complex Exercise Improves Anti-Inflammatory and Anabolic Effects in Osteoarthritis-Induced Sarcopenia in Elderly Women
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Does Dietary-Induced Obesity in Old Age Impair the Contractile Performance of Isolated Mouse Soleus, Extensor Digitorum Longus and Diaphragm Skeletal Muscles?
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Patterns and correlates of grip strength change with age in Afro-Caribbean men
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SAÚDE PÚBLICA: EPIDEMIOLOGIA, CLÍNICA E ESTRATÉGIAS DE TRATAMENTO
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The Role of Muscle Mass, Muscle Quality, and Body Composition in Risk for the Metabolic Syndrome and Functional Decline in Older Adults
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Obesity and muscle weakness as risk factors for mobility limitation in community-dwelling older Japanese women: A two-year follow-up investigation
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Muscle Strength and BMI as Predictors of Major Mobility Disability in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P)
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Muscle quality and muscle fat infiltration in relation to incident mobility disability and gait speed decline: the Age, Gene/Environment Susceptibility-Reykjavik Study
Reinders, I., Murphy, R. A., Koster, A., Brouwer, I. A., Visser, M., Garcia, M. E., Launer, L. J., Siggeirsdottir, K., Eiriksdottir, G., Jonsson, P. V., et al. (2015) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glv016 · Cited by 93 · see citing works
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Jung, S., Seino, S., Yabushita, N., Kim, M., Nemoto, M., Osuka, Y., Okubo, Y., & Tanaka, K. (2013) · 体力科學 · doi:10.7600/jspfsm.62.323 · Cited by 2 · see citing works
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Authors: Stenholm, S., Alley, D., Bandinelli, S., Griswold, M. E., Koskinen, S., Rantanen, T., Guralnik, J. M., & Ferrucci, L.
Affiliations: National Institute on Aging (US)
University of Maryland, Baltimore (US)
Azienda Sanitaria di Firenze (IT)
Johns Hopkins University (US)
Finnish Institute for Health and Welfare (FI)
University of Jyväskylä (FI)
National Institutes of Health (US)
Corresponding author: Stenholm, S
ORCID: Stenholm, S
Bandinelli, S
Rantanen, T
Guralnik, J M
Ferrucci, L
Venue: International Journal of Obesity
Publisher: Springer Science and Business Media LLC
Published: 2009-04-21
Volume: 33
Issue: 6
Pages: 635-644
ISSN: 0307-0565 (ISSN-L)
1476-5497
DOI: 10.1038/ijo.2009.62
PMC: PMC2697265
OpenAlex: W2123960494
Cited by: 248
References: 46
Citations by year: 2026: 10 · 2025: 6 · 2024: 8 · 2023: 35 · 2022: 7 · 2021: 6 · 2020: 13 · 2019: 13 · 2018: 18 · 2017: 19 · 2016: 20 · 2015: 22 · 2014: 13 · 2013: 17 · 2012: 13
FWCI: 9.06
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.springer.com/tdm (tdm)
Locations: International Journal of Obesity (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
Funders: National Institutes of Health
National Institute on Aging (N.1‐AG‐1‐2111, N.1-AG-1-1, N01 AG000005, N01 AG-5-0002)
National Institute on Minority Health and Health Disparities (263MD9164, 263MD 821336, R01MD009164)
Topics: Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
Keywords: obesity, muscle weakness, mobility decline, walking speed, mobility impairment, older adults, quadriceps strength, body mass index, waist circumference, physical function, InCHIANTI study
MeSH terms: Activities of Daily Living, Aged, Female, Health Surveys, Humans, Italy, Locomotion, Male, Obesity, Risk Factors, Geriatric Assessment, Body Mass Index, Walking, Muscle, Skeletal, Muscle Strength

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The effect of obesity combined with low muscle strength on decline in mobility in older persons: results from the InCHIANTI Study

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