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Comparison of methods to identify individuals with obesity at increased risk of functional impairment among a population of home-dwelling older adults

Published online by Cambridge University Press:  09 November 2021

Anne Lene Nordengen
Affiliation:
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
Linn Kristin Lie Øyri
Affiliation:
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
Stine Marie Ulven
Affiliation:
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway Department of Nursing and Health Promotion Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
Truls Raastad
Affiliation:
Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
Kirsten Bjørklund Holven
Affiliation:
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway Norwegian National Advisory Unit on Familiar Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
Inger Ottestad*
Affiliation:
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway Clinical Nutrition Outpatient Clinic, Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
*
*Corresponding author: Inger Ottestad, email inger.ottestad@medisin.uio.no

Abstract

Obesity is associated with increased muscle mass and muscle strength. Methods taking into account the total body mass to reveal obese older individuals at increased risk of functional impairment are needed. Therefore, we aimed to detect methods to identify obese older adults at increased risk of functional impairment. Home-dwelling older adults (n 417, ≥ 70 years of age) were included in this cross-sectional study. Sex-specific cut-off points for two obesity phenotypes (waist circumference (WC) and body fat mass (FM %)) were used to divide women and men into obese and non-obese groups, and within-sex comparisons were performed. Obese women and men, classified by both phenotypes, had similar absolute handgrip strength (HGS) but lower relative HGS (HGS/total body mass) (P < 0·001) than non-obese women and men, respectively. Women with increased WC and FM %, and men with increased WC had higher appendicular skeletal muscle mass (P < 0·001), lower muscle quality (HGS/upper appendicular muscle mass) (P < 0·001), and spent longer time on the stair climb test and the repeated sit-to-stand test (P < 0·05) than non-obese women and men, respectively. Absolute muscle strength was not able to discriminate between obese and non-obese older adults. However, relative muscle strength in particular, but also muscle quality and physical performance tests, where the total body mass was taken into account or served as an extra load, identified obese older adults at increased risk of functional impairment. Prospective studies are needed to determine clinically relevant cut-off points for relative HGS in particular.

Type
Full Papers
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society

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Comparison of methods to identify individuals with obesity at increased risk of functional impairment among a population of home-dwelling older adults
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