Physical frailty and body composition in obese elderly men and women
Open accessAbstract
Objective: To evaluate the prevalence of frailty and interrelationships among body composition, physical function, and quality of life in community‐dwelling obese elderly (OE) persons. Research Methods and Procedures: Fifty‐two OE, 52 nonobese frail, and 52 nonobese nonfrail subjects, matched for age and sex, were studied. Subjective and objective measures of functional status were evaluated by using the physical performance test, exercise stress test, lower extremity (LE) strength, gait speed, static and dynamic balance, functional status questionnaires, and health‐related quality‐of‐life questionnaire (Medical Outcomes Short Form). Body composition was evaluated by using DXA, and muscle quality was evaluated by determining the ratio of LE strength to LE lean mass. Results: Among OE subjects, 96% met our standard criteria for mild to moderate frailty. Compared with the nonobese nonfrail group, the OE and nonobese frail groups had lower and similar scores in physical performance test, peak aerobic power, and functional status questionnaire, and exhibited similar impairments in strength, walking speed, balance, and health‐related quality of life. Although absolute fat‐free mass (FFM) was greater, the percentage body weight as FFM and muscle quality was lower in the OE group than in the other two groups. Discussion: Physical frailty, which predisposes to loss of independence, is common in community‐living OE men and women. Physical frailty in OE subjects was associated with low percentage FFM, poor muscle quality, and decreased quality of life. These findings suggest that weight loss therapy may be particularly important in OE persons to improve physical function, in addition to improving the medical complications associated with obesity.
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Obesity may increase fracture risk through bone quality or frailty independently of bone mineral density.
“Obesity is inversely related to BMD and fractures313 but might increase the fracture risk through bone quality314,315 or frailty132,316 independent of BMD.”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [132]
The Results report that 96% of the obese elderly subjects met the study’s frailty criteria, and the Discussion associates obesity with physical frailty despite greater bone mass than in the nonobese groups. The paper does not establish that frailty increases fracture risk independently of BMD; it says the implications of the greater bone mass for fracture risk are unknown. Bone quality is not the part of the citing sentence attributed to this source. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIndividuals with obesity may have comparable or even higher absolute skeletal muscle mass relative to non-obese counterparts, due to higher overall body mass and potentially higher related muscle workload in daily physical activity.
“Individuals with obesity may conversely have comparable or even higher absolute skeletal muscle mass relative to non-obese counterparts, due to higher overall body mass and potentially higher related muscle workload in daily physical activity [80,81].”
From Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement (2022) · cites this paper as [81]
The Results (page not provided) report greater absolute lower-extremity lean mass in the obese elderly group than in either non-obese group, supporting the muscle-mass comparison. The paper does not attribute that difference to greater muscle workload during daily activity, and its findings concern elderly participants rather than individuals with obesity generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPeak oxygen consumption is potentially inversely related to frailty, suggesting that improvements in VO2 max after aerobic training counteract frailty.
“Peak oxygen consumption is potentially inversely related to frailty129,130, suggesting that improvements in VO2 max following aerobic training counteract frailty131,132.”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [132]
Various studies suggest the necessity to adjust hand-grip strength to body mass.
“Moreover, as discussed below, various studies suggest the necessity to adjust HGS to body mass [76, 77].”
From Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement (2022) · cites this paper as [77]
The BMI may not be an accurate predictor of the degree of adiposity in some older adults due to changes in body composition with aging.
“The BMI may not be an accurate predictor of the degree of adiposity in some older adults due to changes in body composition with aging85.”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [85]
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Effect of lifestyle intervention on the hormonal profile of frail, obese older men
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Long-term maintenance of weight loss after lifestyle intervention in frail, obese older adults
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Obesity in Older Adults – A Growing Problem
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- Authors
- Villareal, D. T., Banks, M., Siener, C., Sinacore, D. R., & Klein, S.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Villareal, Dennis T.
- Venue
- Obesity Research
- Publisher
- Wiley
- Published
- 2004-06
- Volume
- 12
- Issue
- 6
- Pages
- 913-920
- ISSN
- 1071-7323 (ISSN-L)
- 1550-8528
- OpenAlex
- W1998049880
- Semantic Scholar
- 9c15bed2236536c46f941161d4039c74bc116311
- Cited by
- 459
- References
- 42
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 18 · 2023: 15 · 2022: 17 · 2021: 16 · 2020: 18 · 2019: 21 · 2018: 17 · 2017: 18 · 2016: 26 · 2015: 34 · 2014: 38 · 2013: 32 · 2012: 35
- FWCI
- 6.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (P60AG013629, AG-13629)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK37948, DK56341, R01DK037948, P30DK056341)
- National Center for Research Resources (K23RR016191, RR16191, RR.00036)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- physical frailty, obesity, older adults, body composition, fat-free mass, muscle quality, physical function, health-related quality of life, balance, walking speed, lower limb strength, weight loss treatment, community-dwelling older adults
- MeSH terms
- Aged, Blood Pressure, Body Composition, Postural Balance, Female, Gait, Humans, Male, Obesity, Quality of Life, Exercise, Bone Density, Body Mass Index, Muscle Weakness
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