title: The effect of obesity combined with low muscle strength on decline in mobility in older persons: results from the InCHIANTI study.
abstract: 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.
  
  
  METHODS
  Community-dwelling adults aged > or = 65 years (n = 930) living in the Chianti geographic area (Tuscany, Italy) were followed for 6 years in the population-based InCHIANTI study.
  
  
  METHODS
  On the basis of baseline measurements (1998-2000), obesity was defined as body mass index (BMI) > or = 30 kg/m(2) and low muscle strength as lowest sex-specific tertile of knee extensor strength. Walking speed and self-reported mobility disability (ability to walk 400 m or climb one flight of stairs) were assessed at baseline and at 3- and 6-year follow-up.
  
  
  RESULTS
  At baseline, obese persons with low muscle strength had significantly lower walking speed compared with all other groups (P < or = 0.05). In longitudinal analyses, obese participants with low muscle strength had steeper decline in walking speed and high risk of developing new mobility disability over the 6-year follow-up compared with those without obesity or low muscle strength. After the age of 80, the differences between groups were substantially attenuated. The differences seen in walking speed across combination of low muscle strength and obesity groups were partly explained by 6-year changes in muscle strength, BMI and waist circumference.
  
  
  CONCLUSIONS
  Obesity combined with low muscle strength increases the risk of decline in walking speed and developing mobility disability, especially among persons < 80 years old.
authors.affiliation: Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, MD 21225, USA. stenholmsm@mail.nih.gov
authors.forename: S
authors.initials: S
authors.lastname: Stenholm
authors.forename: D
authors.initials: D
authors.lastname: Alley
authors.forename: S
authors.initials: S
authors.lastname: Bandinelli
authors.forename: M E
authors.initials: ME
authors.lastname: Griswold
authors.forename: S
authors.initials: S
authors.lastname: Koskinen
authors.forename: T
authors.initials: T
authors.lastname: Rantanen
authors.forename: J M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: L
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015992:Body Mass Index; D005260:Female; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008124:Locomotion / Q000502:physiology; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D012307:Risk Factors; D016138:Walking / Q000502:physiology*