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Abdominal Obesity and Mobility Disability in Older Adults: A 4-Year Follow-Up of the International Mobility in Aging Study

Fernandes de Souza Barbosa, Juliana, dos Santos Gomes, C., Vilton Costa, J., Ahmed, T., Zunzunegui, M. V., Curcio, C.-L., Gomez, F., Oliveira Guerra, R.
The journal of nutrition, health & aging 2018 v.22 no.10 pp. 1228-1237
accounting, education, elderly, equations, gait, men, mental depression, mortality, obesity, observational studies, waist circumference, walking, women
BACKGROUND: Abdominal obesity is related to the disability process in older adults, however, little is known about this relationship when adjusted for important confounders such as depression and physical performance measures in a diverse international aged population. OBJECTIVES: To explore the longitudinal relationship between abdominal obesity and mobility disability controlling for physical performance and depression. DESIGN AND SETTING: Longitudinal observational study using data from the International Mobility in Aging Study (IMIAS) Study. PARTICIPANTS: 1104 out of 2002 older adults aged 64–74 years old free of mobility disability at baseline (2012) and then reassessed in 2016. MEASUREMENTS: Mobility disability was defined as reporting difficulty in walking 400 m or climbing stairs. Activities of daily living (ADL) disability was based on any self-reported difficulty in five mobility-related ADLs. Abdominal obesity was defined as waist circumference ≥ 88cm for women or ≥ 102 cm for men. Four meters gait speed, handgrip strength and depressive symptoms (CES-D) were assessed. Generalized Estimating Equations (GEE) and multinomial regressions were used to estimate associations between disability and abdominal obesity. RESULTS: 1104 free of disability participants were followed over 4 years, the mean age was 68.9 (±2.9) years among men and 68.7 (±2.6) years among women. Prevalence and incidence rates of mobility disability varied widely across research site and sex. The longitudinal associations between mobility disability and abdominal obesity remained significant even when adjusted by depressive symptoms, handgrip strength, gait speed, age, sex, education and research site. Participants with abdominal obesity had higher mobility disability (OR=1.68, 95% CI 1.23-1.76, p-value=0.01) and also increased risk for ADL disability (OR: 1.47, 95% CI 1.23-1.76, p-value=0.01). Abdominal obesity in baseline was also predictor of mobility disability in 2016 (OR: 1.93, 95% CI 1.17-3.17, p-value <0.01) but not for ADL disability (OR: 1.59, 95% CI 0.93-2.71, p-value =0.09) with accounting mortality. CONCLUSION: Abdominal obesity is associated longitudinally and predicts mobility disability, even over a short period (4 years) in community-dwelling older adults from different epidemiological contexts.