The Association Between Obesity and the Frailty Syndrome in Older Women: The Women's Health and Aging Studies

Authors

  • Caroline S. Blaum MD, MS,

    1. From the *University of MichiganAnn Arbor Veterans Affairs Healthcare System Geriatric Rehabilitation, Education and Clinical Center, Ann Arbor, MichiganJohns Hopkins Medical Institutions, Baltimore, Maryland§Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
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  • Qian Li Xue PhD,

    1. From the *University of MichiganAnn Arbor Veterans Affairs Healthcare System Geriatric Rehabilitation, Education and Clinical Center, Ann Arbor, MichiganJohns Hopkins Medical Institutions, Baltimore, Maryland§Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
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  • Elisabete Michelon MD,

    1. From the *University of MichiganAnn Arbor Veterans Affairs Healthcare System Geriatric Rehabilitation, Education and Clinical Center, Ann Arbor, MichiganJohns Hopkins Medical Institutions, Baltimore, Maryland§Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
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  • Richard D. Semba MD, MPH,

    1. From the *University of MichiganAnn Arbor Veterans Affairs Healthcare System Geriatric Rehabilitation, Education and Clinical Center, Ann Arbor, MichiganJohns Hopkins Medical Institutions, Baltimore, Maryland§Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
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  • Linda P. Fried MD, MPH

    1. From the *University of MichiganAnn Arbor Veterans Affairs Healthcare System Geriatric Rehabilitation, Education and Clinical Center, Ann Arbor, MichiganJohns Hopkins Medical Institutions, Baltimore, Maryland§Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
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  • This work was supported by National Institute on Aging Grant RO1 AG11703–01A1, National Institutes of Health, National Center for Research Resources, General Clinical Research Center Grants RR00722 and RO1 AI41956, and National Institute on Aging Contract NO1-AG12112. Dr. Blaum was supported by NIA-K08 AG00749-02 and the Ann Arbor Veterans Affairs Geriatric Research, Education and Clinical Center. Dr. Michelon was supported by a postdoctoral scholarship from CNPq-Brazil.

Address correspondence to Caroline S. Blaum, MD, MS, Associate Professor, The University of Michigan Medical School, CCGCB Room 1111, 1500 East Medical Center Drive, Ann Arbor, MI 48109. E-mail: cblaum@umich.edu

Abstract

Objectives: To determine whether obesity is associated with the frailty phenotype and, if so, whether comorbid conditions or inflammatory markers explain this association.

Design: Cross-sectional analysis of baseline data from the Women's Health and Aging Studies I (1992) and II (1994), complementary population-based studies.

Setting: Twelve contiguous ZIP code areas in Baltimore, Maryland.

Participants: Five hundred ninety-nine community-dwelling women aged 70 to 79 with a body mass index (BMI) greater than 18.5 kg/m2.

Measurements: The dependent variables were the frailty syndrome, including prefrailty, defined as presence of one or two of five frailty indicators (weakness, slowness, weight loss, low physical activity, exhaustion), and frailty, defined as three or more indicators. Independent variables included BMI, categorized using World Health Organization criteria as normal (18.5 to <25 kg/m2), overweight (25 to <30 kg/m2), and obese (≥30 kg/m2); chronic diseases; C-reactive protein; and serum carotenoids.

Results: Being overweight was significantly associated with prefrailty, and obesity was associated with prefrailty and frailty. In all frail women, regardless of BMI group, a similar pattern of three defining frailty indicators was found: slowness, weakness, and low activity (with the addition of weight loss in the normal weight group.) In multinomial regression models, obesity was significantly associated with prefrailty (odds ratio (OR)=2.23, 95% confidence interval (CI)=1.29–3.84) and frailty (OR=3.52, 95% CI=1.34–9.13), even when controlling for covariates.

Conclusion: Obesity is associated with the frailty syndrome in older women in cross-sectional data. This association remains significant even when multiple conditions associated with frailty are considered. Prospective studies are needed to confirm this finding.

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