Physical Frailty and Body Composition in Obese Elderly Men and Women

Authors

  • Dennis T. Villareal,

    Corresponding author
    1. Division of Geriatrics and Nutritional Science, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
    Search for more papers by this author
  • Marian Banks,

    1. Division of Geriatrics and Nutritional Science, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
    Search for more papers by this author
  • Catherine Siener,

    1. Division of Geriatrics and Nutritional Science, Department of Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri
    Search for more papers by this author
  • David R. Sinacore,

    1. Division of Geriatrics and Nutritional Science, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
    2. Division of Geriatrics and Nutritional Science, Department of Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri
    Search for more papers by this author
  • Samuel Klein

    1. Division of Geriatrics and Nutritional Science, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
    Search for more papers by this author

  • The costs of publication of this article were defrayed, in part, by the payment of page charges. This article must, therefore, be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Washington University Older Adult Health Center, 4488 Forest Park Boulevard, St. Louis, MO 63108. E-mail: dvillare@im.wustl.edu

Abstract

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.

Ancillary