title: Relative contributions of adiposity and muscularity to physical function in community-dwelling older adults.
abstract: OBJECTIVE
  To determine the relative contributions of adiposity and muscularity to multi-dimensional performance-based and perceived physical function in older adults living independently.
  
  
  METHODS
  Data from 109 women and men, aged 60 or older, with low serum dehydroepiandrosterone (DHEA) sulfate levels were included in this cross-sectional analysis of baseline measures from a single-site, randomized, controlled trial of DHEA replacement therapy. Physical function was determined by means of performance on the 100-point Continuous Scale-Physical Functional Performance (CS-PFP) test and by self-reporting using the physical function subscale of the Medical Outcomes Short Form-36 (SF36PF). Body composition was measured by dual-energy X-ray absorptiometry (DXA). Linear regression analyses were used to determine the contributions of body mass index (BMI; kg body mass/m2), fat index (FI; kg fat/m2), and appendicular skeletal muscle index (ASMI; kg muscle/m2) to the CS-PFP and SF36PF scores, adjusted for age and sex.
  
  
  RESULTS
  Age-adjusted regression analyses indicated that FI, but not ASMI, was a significant (P<0.001) determinant of CS-PFP (R2=0.54) and SF36PF (R2=0.37). When adjusted for age and sex, BMI was nearly as good a predictor of CS-PFP (R2=0.50) and SF36PF (R2=0.34) as FI.
  
  
  CONCLUSIONS
  Adiposity was a stronger predictor of measured and self-reported physical function than was muscularity in older adults living independently. BMI, adjusted for sex, is a reasonable substitute for adiposity in the prediction of physical function.
authors.affiliation: Department of Medicine, Division of Geriatric Medicine, University of Colorado Denver, Aurora, Colorado, USA. catherine.jankowski@uchsc.edu
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Jankowski
authors.forename: Wendolyn S
authors.initials: WS
authors.lastname: Gozansky
authors.forename: Rachael E
authors.initials: RE
authors.lastname: Van Pelt
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Schenkman
authors.forename: Pamela
authors.initials: P
authors.lastname: Wolfe
authors.forename: Robert S
authors.initials: RS
authors.lastname: Schwartz
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Kohrt
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology; D011237:Predictive Value of Tests; D012044:Regression Analysis