Longitudinal associations between body composition, sarcopenic obesity and outcomes of frailty, disability, institutionalisation and mortality in community-dwelling older men: The Concord Health and Ageing in Men Project
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Background: to explore the longitudinal associations between body composition measures, sarcopenic obesity and outcomes of frailty, activities of daily living (ADL) and instrumental ADL (IADL) disability, institutionalisation and mortality. Methods: men aged ≥ 70 years (2005-07) from the Concord Health and Ageing in Men Project were assessed at baseline (n = 1,705), 2 (n = 1,366) and 5 years (n = 954). The main outcome measures were frailty (adapted Fried criteria), ADL, including personal care and mobility and IADL disability (ability to perform tasks for independent living), institutionalisation and mortality. The Foundation for the National Institutes of Health cut-points were used for low muscle mass: appendicular lean mass (ALM):Body Mass Index (BMI) ratio (ALMBMI) <0.789 and obesity was defined as >30% fat. Generalised estimating equations were used to examine the longitudinal associations between the independent variables (obesity alone, low muscle mass and sarcopenic obesity) and frailty, ADL and IADL disability. Results: in unadjusted, age adjusted and fully adjusted analysis, men with low muscle mass showed increased risk of frailty and IADL disability. In fully adjusted analysis, men with sarcopenic obesity had an increased risk of frailty (odds ratio (OR): 2.00 (95% confidence of interval (CI): 1.42, 2.82)) ADL disability (OR: 1.58 (95% CI: 1.12, 2.24)) and IADL disability (OR: 1.36 (95% CI: 1.05, 1.76)). Obesity alone was protective for institutionalisation (OR: 0.51 (95% CI: 0.31, 0.84)) but was not associated with any other outcomes. Conclusions: low muscle mass and sarcopenic obesity were associated with poor functional outcomes, independent of confounders. This would suggest that future trials on frailty and disability prevention should be designed to intervene on both muscle mass and fat mass.
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Sarcopenic obesity defined by FNIH criteria with elevated body fat is associated with increased risk of instrumental activity of daily living disability (OR 1.36, 95% CI 1.05-1.76).
“instrumental activity of daily living disability (OR 1.36, 95% CI 1.05–1.76)”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [204]
Sarcopenic obesity defined by FNIH criteria with elevated body fat is associated with increased risk of frailty (OR 2.00, 95% CI 1.42-2.82).
“sarcopenic obesity resulted in an increased risk of frailty (OR 2.00, 95% CI 1.42–2.82)”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [204]
Sarcopenic obesity defined by FNIH criteria with elevated body fat is associated with increased risk of activity of daily living disability (OR 1.58, 95% CI 1.12-2.24).
“activity of daily living disability (OR 1.58, 95% CI 1.12–2.24)”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [204]
The Concord Health and Aging Project reported that elderly men with sarcopenic obesity had a 2-fold higher risk of frailty and an approximately 1.5-fold increased risk of disability during 7 years of follow-up.
“The Concord Health and Aging Project reported that elderly men with sarcopenic obesity (defined based on ALM/BMI and % body fat according to the FNIH criteria) had a 2-fold higher risk of frailty and an ~1.5-fold increased risk of disability during the 7 years of follow-up (35).”
From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [35]
In the Concord Health and Aging Project, sarcopenia was associated with poor functional outcomes while obesity alone was not associated with any adverse outcomes.
“Sarcopenia was associated with poor functional outcomes while obesity alone was not associated with any adverse outcomes.”
From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [35]
Among elderly men in the Concord Health and Aging Project, low muscle mass and sarcopenic obesity were not associated with institutionalization.
“Among elderly men in the Concord Health and Aging Project, low muscle mass and sarcopenic obesity (defined based on ALM/BMI and % body fat according to FNIH criteria) were not associated with institutionalization (35).”
From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [35]
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Frailty and sarcopenia in combination are more predictive of mortality than either condition alone
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“Another important consequence of sarcopenic obesity is a higher risk of disability than that of healthy subjects [84].”
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SAÚDE PÚBLICA: EPIDEMIOLOGIA, CLÍNICA E ESTRATÉGIAS DE TRATAMENTO
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Obesity and Metabolic Health in CKD
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“Indeed, in the general population, sarcopenic obesity has been consistently associated with higher risk of disability and decreased functional status, 42 a higher risk of falls, 43 and a higher risk of hospitalization 44 and institutionalization.”
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“However, the association was not always consistently observed for a) all muscle mass parameters used in a single study [35, 51], b) men and women [54, 74], and c) the different physical function outcomes used in a single study [57].”
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Addressing Obesity to Promote Healthy Aging
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Mortality, sarcopenic obesity, and sarcopenia: Frailty in Brazilian Older People Study – FIBRA – RJ
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“Similarly, no association was found in a cohort study using criteria combining low muscle mass and body fat percentage for SO among men aged ≥70 years [32].”
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Sarcopenic Obesity in Facioscapulohumeral Muscular Dystrophy
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“According to the Concord Health and Aging Project, sarcopenic obesity is linked to an increased risk of frailty and instrumental activity of daily living disability (IADL), a measure that is characterized by an inability to perform tasks for independent living (21).”
MethodThe Impact of Smoking and Obesity on Disability-Free Life Expectancy in Older Australians
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“23].”
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“Sarcopenic obesity has a stronger impact on negative health outcomes than obesity alone in older adults; it has a higher risk for IADL decline, frailty, falls, hip fractures, gait disturbance, cardiovascular disease, and death than obesity alone (22), ((23)).”
Background
- Authors
- Hirani, V., Naganathan, V., Blyth, F., Le Couteur, D. G., Seibel, M. J., Waite, L. M., Handelsman, D. J., & Cumming, R. G.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Hirani, Vasant
- ORCID
- Venue
- Age and Ageing
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-12-08
- Volume
- 46
- Issue
- 3
- Pages
- 413-420
- ISSN
- 0002-0729 (ISSN-L)
- 1468-2834
- OpenAlex
- W2585605586
- Cited by
- 246
- References
- 39
- Citations by year
- 2026: 22 · 2025: 23 · 2024: 28 · 2023: 52 · 2022: 27 · 2021: 27 · 2020: 28 · 2019: 17 · 2018: 17 · 2017: 5
- FWCI
- 10.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Age and Ageing (publishedVersion)
- PubMed (publishedVersion)
- The Sydney eScholarship Repository (The University of Sydney) (submittedVersion)
- Funders
- Medical Research Council
- National Health and Medical Research Council (301916)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- sarcopenic obesity, body composition, frailty, disability, activities of daily living, instrumental activities of daily living, institutionalization, mortality, low muscle mass, appendicular lean mass, obesity, older men, community-dwelling older adults, functional outcome
- MeSH terms
- Frailty, Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Aging, Body Composition, Cause of Death, Disability Evaluation, Humans, Institutionalization, Longitudinal Studies, Male, New South Wales, Obesity, Prognosis, Risk Factors, Sex Factors, Time Factors, Geriatric Assessment, Multivariate Analysis, Proportional Hazards Models, Odds Ratio, Frail Elderly, Muscle, Skeletal, Adiposity, Men's Health, Sarcopenia, Independent Living
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