title: Body mass index, muscle strength and physical performance in older adults from eight cohort studies: the HALCyon programme.
abstract: OBJECTIVE
  To investigate the associations of body mass index (BMI) and grip strength with objective measures of physical performance (chair rise time, walking speed and balance) including an assessment of sex differences and non-linearity.
  
  
  METHODS
  Cross-sectional data from eight UK cohort studies (total N = 16,444) participating in the Healthy Ageing across the Life Course (HALCyon) research programme, ranging in age from 50 to 90+ years at the time of physical capability assessment, were used. Regression models were fitted within each study and meta-analysis methods used to pool regression coefficients across studies and to assess the extent of heterogeneity between studies.
  
  
  RESULTS
  Higher BMI was associated with poorer performance on chair rise (N = 10,773), walking speed (N = 9,761) and standing balance (N = 13,921) tests. Higher BMI was associated with stronger grip strength in men only. Stronger grip strength was associated with better performance on all tests with a tendency for the associations to be stronger in women than men; for example, walking speed was higher by 0.43 cm/s (0.14, 0.71) more per kg in women than men. Both BMI and grip strength remained independently related with performance after mutual adjustment, but there was no evidence of effect modification. Both BMI and grip strength exhibited non-linear relations with performance; those in the lowest fifth of grip strength and highest fifth of BMI having particularly poor performance. Findings were similar when waist circumference was examined in place of BMI.
  
  
  CONCLUSIONS
  Older men and women with weak muscle strength and high BMI have considerably poorer performance than others and associations were observed even in the youngest cohort (age 53). Although causality cannot be inferred from observational cross-sectional studies, our findings suggest the likely benefit of early assessment and interventions to reduce fat mass and improve muscle strength in the prevention of future functional limitations.
authors: Medical Research Council Unit for Lifelong Health and Ageing and Institute of Epidemiology and Health Care, University College London, London, United Kingdom. r.hardy@nshd.mrc.ac.uk
authors: Rebecca
authors: R
authors: Hardy
authors: Rachel
authors: R
authors: Cooper
authors: Avan
authors: A
authors: Aihie Sayer
authors: Yoav
authors: Y
authors: Ben-Shlomo
authors: Cyrus
authors: C
authors: Cooper
authors: Ian J
authors: IJ
authors: Deary
authors: Panayotes
authors: P
authors: Demakakos
authors: John
authors: J
authors: Gallacher
authors: Richard M
authors: RM
authors: Martin
authors: Geraldine
authors: G
authors: McNeill
authors: John M
authors: JM
authors: Starr
authors: Andrew
authors: A
authors: Steptoe
authors: Holly
authors: H
authors: Syddall
authors: Diana
authors: D
authors: Kuh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015992:Body Mass Index; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D010809:Physical Fitness