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Clustering of Strength, Physical Function, Muscle, and Adiposity Characteristics and Risk of Disability in Older Adults

Authors

  • Peggy M. Cawthon PhD, MPH,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Kathleen M. Fox MHS, PhD,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Shravanthi R. Gandra PhD,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Matthew J. Delmonico PhD, MPH,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Chiun-Fang Chiou PhD,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Mary S. Anthony PhD,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Paolo Caserotti PhD,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Stephen B. Kritchevsky PhD,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Anne B. Newman MD, MPH,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Bret H. Goodpaster PhD,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Suzanne Satterfield MD, DrPH,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Steven R. Cummings MD,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • Tamara B. Harris MD, MS,

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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  • for the Health, Aging and Body Composition Study

    1. From the *Research Institute, California Pacific Medical Center, San Francisco, California; Strategic Healthcare Solutions, LLC, Monkton, Maryland; Amgen, Thousand Oaks, California; §University of Rhode Island, Kingston, Rhode Island; Intramural Research Program, National Institute on Aging, Bethesda, Maryland; #Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina; **University of Pittsburgh, Pittsburgh, Pennsylvania; and ††University of Tennessee, Memphis, Tennessee.
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Address correspondence to Peggy M. Cawthon, California Pacific Medical Center Research Institute, 185 Berry Street, Lobby 4, Suite 5700, San Francisco, CA 94107. E-mail: pcawthon@sfcc-cpmc.net

Abstract

OBJECTIVES: To empirically identify groupings of strength, physical performance, adiposity, and lean mass and test how such groupings of these interrelated measures may relate to disability risk.

DESIGN: Prospective Health, Aging and Body Composition Study.

SETTING: Two U.S. clinical centers.

PARTICIPANTS: One thousand two hundred sixty-three women and 1,221 men.

MEASUREMENTS: Weight, strength (knee extension, grip); walking speed, chair stands, dual X-ray absorptiometry (fat and lean mass for total body, arm, and leg; percent fat), and thigh computed tomography scans (muscle area, muscle density). Analyses were stratified according to sex. Factor analysis reduced these variables into a smaller number of components, and proportional hazards models assessed risk of major disability for the components identified.

RESULTS: In both sexes, factor analysis reduced the 14 individual variables into three components that explained 76% to 77% of the data variance: Factor 1, an adiposity component, with strong loading by fat mass, weight, and muscle density; Factor 2, a strength and lean body size component with strong loading by lean mass, weight, and strength; Factor 3, a physical performance component with positive loading by walking speed and chair stand performance. Factor 1 (adiposity) and Factor 3 (performance) but not Factor 2 (strength and lean body size) were associated with disability over 6.1±2.6 years.

CONCLUSION: The adiposity and physical performance constructs but not the strength and lean body size construct were associated with disability risk, suggesting that adiposity and performance should be considered as risk factors for disability.

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