Response to The Letter “Overadjustment in Regression Analyses: Considerations When Evaluating Relationships Between Body Mass Index, Muscle Strength, and Body Size”

Obesity History as a Predictor of Walking Limitation at Old Age*

Objective: To study whether walking limitation at old age is determined by obesity history. Research Methods and Procedures: In a retrospective longitudinal study based on a representative sample of the Finnish population of 55 years and older (2055 women and 1337 men), maximal walking speed, body mass, and body height were measured in a health examination. Walking limitation was defined as walking speed <1.2 m/s or difficulty in walking 0.5 km. Recalled height at 20 years of age and recalled weight at 20, 30, 40, and 50 years of age were recorded. Results: Subjects who had been obese at the age of 30, 40, or 50 years had almost a 4-fold higher risk of walking limitation compared to non-obe…

Sleep-Related Factors and Mobility in Older Men and Women

SHORT and long sleep duration, sleep-related disturbances, and their daytime consequences are common in older adults, and they are associated with decreased health and increased mortality (1–4). Because aging is associated with decline in physical performance often leading to physical disability and loss of independence, concomitant sleep problems may exacerbate the age-related decline in physical function. Previous studies suggest that self-reported and measured insomnia and sleep-related problems are associated with decline in psychomotor performance (5) as well as with poor balance and increased risk of falls (6–8). In addition, Goldman and coworkers (2007) (9) reported that short (<6 ho…

Perceived stress symptoms in midlife predict disability in old age: a 28-year prospective cohort study.

Background Stress has damaging effects on individual's health. However, information about the long-term consequences of mental stress is scarce. Methods This 28-year prospective cohort study examined on the associations between midlife stress and old age disability among 2,994 Finnish municipal professionals aged 44-58 years at baseline. Self-reported stress symptoms were assessed at baseline in 1981 and 4 years later in 1985 and perceived disability in 2009. For the baseline data, principal component analysis was used for differentiation into stress symptom profiles. The regression coefficient estimates for self-care disability (activities of daily living) and instrumental activities of da…

The effect of obesity combined with low muscle strength on decline in mobility in older persons: results from the InCHIANTI study.

Both obesity and muscle impairment are increasingly prevalent among older persons and negatively affect health and physical functioning. However, the combined effect of coexisting obesity and muscle impairment on physical function decline has been little studied. We examined whether obese persons with low muscle strength experience significantly greater declines in walking speed and mobility than persons with only obesity or low muscle strength.Community-dwelling adults agedor = 65 years (n = 930) living in the Chianti geographic area (Tuscany, Italy) were followed for 6 years in the population-based InCHIANTI study.On the basis of baseline measurements (1998-2000), obesity was defined as b…

Sarcopenic obesity: definition, cause and consequences.

PURPOSE OF REVIEW: Older obese persons with decreased muscle mass or strength are at special risk for adverse outcomes. We discuss potential pathways to muscle impairment in obese individuals and the consequences that joint obesity and muscle impairment may have on health and disability. Tantamount to this discussion is whether low muscle mass or, rather, muscle weakness should be used for the definition. RECENT FINDINGS: Excess energy intake, physical inactivity, low-grade inflammation, insulin resistance and changes in hormonal milieu may lead to the development of so-called 'sarcopenic obesity'. It was originally believed that the culprit of age-related muscle weakness was a reduction in…

Effect of co-morbidity on the association of high body mass index with walking limitation among men and women aged 55 years and older.

Background and aims: Obesity among older persons is rapidly increasing, thus affecting their mobility negatively. The aim of this study was to examine the association of high body mass index (BMI) with walking limitation, and the effect of obesity-related diseases on this association. Methods: In a representative sample of the Finnish population of 55 years and older (2055 women and 1337 men), maximal walking speed, chronic diseases, and BMI were ascertained in a health examination. Walking limitation was defined as maximal walking speed of less than 1.2 m/s or difficulty in walking 500 meters. To analyze the effects of chronic conditions, smoking, marital status, and education on BMI class…

Ammattikeittiötyön fyysisten kuormitustekijöiden arviointimenetelmän luotettavuuden tarkastelu

The effect of obesity combined with low muscle strengthon decline in mobility in older persons - Results from the InCHIANTI Study

Objective: Both obesity and muscle impairment are increasingly prevalent among older persons and negatively affect health and physical functioning. However, the combined effect of coexisting obesity and muscle impairment on physical function decline has been little studied. We examined whether obese persons with low muscle strength experience significantly greater declines in walking speed and mobility than persons with only obesity or low muscle strength. Design: Community-dwelling adults aged ⩾65 years (n=930) living in the Chianti geographic area (Tuscany, Italy) were followed for 6 years in the population-based InCHIANTI study. Measurements: On the basis of baseline measurements (1998–2…

Association of Body Mass Index and Waist Circumference With Physical Functioning: The Vitality 90+ Study

BACKGROUND Both obesity and underweight are associated with impaired physical functioning, but related information on the oldest old population is scarce. Our purpose was to examine whether body mass index, waist circumference (WC), and their combination are associated with physical performance and activities of daily living (ADL) disability in 90-year-old women and men. METHODS Data are from the Vitality 90+ Study, which is a population-based study of persons with age ≥90 years living in the area of Tampere, Finland. Altogether 416 women and 153 men, aged 90-91 years, provided data on body mass index, WC, chair stand, and Barthel Index. Comorbidity, physical exercise, smoking history, livi…

Are body mass index, waist circumference and waist-to-hip ratio associated with leptin in 90-year-old people?

Data on how body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) are associated with body fat in the oldest-old people are scarce. The purpose of this study was to examine if BMI, WC or WHR are associated with leptin, a biological surrogate measure of body fat in 90-year-old people. The data comes from the Vitality 90+ Study, a prospective population-based study of people living in Tampere, Finland. BMI, WC, WHR and plasma concentration of leptin were available for 160 women and 54 men aged 90 years. BMI and WC had a strong significant positive association with leptin both in women and in men, but WHR was associated with leptin only in men. In conclusion, based on th…

Long-Term Determinants of Muscle Strength Decline: Prospective Evidence from the 22-Year Mini-Finland Follow-Up Survey

Objectives: To examine long-term changes in handgrip strength and the factors predicting handgrip strength decline. Design: Longitudinal cohort study with 22 years of follow-up. Setting: Population-based Mini-Finland Health Examination Survey in Finland. Participants: Nine hundred sixty-three men and women aged 30 to 73 at baseline. Measurements: Handgrip strength was measured using a handheld dynamometer at baseline and follow-up. Information on potential risk factors, namely lifestyle and chronic conditions, and their changes throughout the follow-up were based on health interviews. Results: Based on linear mixed-effect models, midlife physically strenuous work, excess body weight, smokin…

The Mediating Role of C-Reactive Protein and Handgrip Strength Between Obesity and Walking Limitation

OBJECTIVES: To study the association between different obesity indicators and walking limitation and to examine the role of C-reactive protein (CRP) and handgrip strength in that association. DESIGN: A cross-sectional, population-based study. SETTING: The Health 2000 Survey with a representative sample of the Finnish population. PARTICIPANTS: Subjects aged 55 and older with complete data on body composition, CRP, handgrip strength, and walking limitation (N=2,208). MEASUREMENTS: Body composition, anthropometrics, CRP, medical conditions, handgrip strength, and maximal walking speed were measured in the health examination. Walking limitation was defined as maximal walking speed less than 1.2…

Body Mass Index and Waist Circumference as Predictors of Disability in Nonagenarians : The Vitality 90+ Study

Background Only scarce data exist on the association between obesity and disability in the oldest old. The purpose of this prospective study is to examine if body mass index and waist circumference (WC) are associated with incident mobility and activities of daily living (ADL) disability in nonagenarians. Methods We used longitudinal data from the Vitality 90+ Study, which is a population-based study conducted at the area of Tampere, Finland. Altogether 291 women and 134 men, aged 90–91 years, had measured data on body mass index and/or WC and did not have self-reported mobility or ADL disability at baseline. Incident mobility and ADL disability was followed-up on median 3.6 years (range 0.…

Association between Obesity History and Hand Grip Strength in Older Adults-Exploring the Roles of Inflammation and Insulin Resistance as Mediating Factors

Background: To examine the association between obesity history and hand grip strength, and whether the association is partly explained by subclinical inflammation and insulin resistance. Methods:Data are from 2,021 men and women aged 55 years and older participating in the representative population-based Health 2000 Survey in Finland. Body mass and body height, maximal hand grip strength, C-reactive protein, and insulin resistance based on homeostasis model assessment (HOMA-IR) were measured in a health examination. Recalled weight at 20, 30, 40, and 50 years of age were recorded to obtain a hierarchical classification of obesity history. Obesity was defined as body mass index ≥ 30 kg/m2. R…

Hand-Grip Strength Cut Points to Screen Older Persons at Risk for Mobility Limitation

Objectives To determine optimal hand-grip strength cut points for likelihood of mobility limitation in older people and to study whether these cut points differ according to body mass index (BMI). Design Cross-sectional analysis of data. Setting Data collected in the Finnish population-based Health 2000 Survey. Participants One thousand eighty-four men and 1,562 women aged 55 and older with complete data on anthropometry, hand-grip strength and self-reported mobility. Measurements Mobility limitation was defined as difficulty walking 0.5 km or climbing stairs. Receiver operating characteristic analysis was used to estimate hand-grip strength cut points for likelihood of mobility limitation.…

Midlife Cardiovascular Status and Old Age Physical Functioning Trajectories in Older Businessmen

Objectives The associations between cardiovascular disease (CVD) risk and later physical functioning have been observed, but only a few studies with follow-up into old age are available. We investigated the association between cardiovascular status in midlife and physical functioning trajectories in old age. Design Prospective cohort study. Setting Helsinki Businessmen Study. Participants We studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3490). Measurements Three CVD status groups were formed based on clinical measurements carried out in 1974: signs of CVD (diagnosed clinically or with changes in ECG, chronic disease present or used medicati…

Body Mass Index and Waist Circumference as Predictors of Disability in Nonagenarians: The Vitality 90+ Study.

Background Only scarce data exist on the association between obesity and disability in the oldest old. The purpose of this prospective study is to examine if body mass index and waist circumference (WC) are associated with incident mobility and activities of daily living (ADL) disability in nonagenarians. Methods We used longitudinal data from the Vitality 90+ Study, which is a population-based study conducted at the area of Tampere, Finland. Altogether 291 women and 134 men, aged 90-91 years, had measured data on body mass index and/or WC and did not have self-reported mobility or ADL disability at baseline. Incident mobility and ADL disability was followed-up on median 3.6 years (range 0.…