title: The relationship of body mass index and the functional status of community-dwelling female older people admitting to a geriatric outpatient clinic.
abstract: OBJECTIVE
  The relationship of body mass index (BMI) with functional status differs in diversified geriatric population and various settings. In this study, we aimed to investigate whether BMI is related to functional status independent of age, nutritional status, multimorbidity, and polypharmacy in a group of Turkish community-dwelling female elderly.
  
  
  METHODS
  This study was conducted using a cross-sectional study design.
  
  
  METHODS
  Geriatric outpatient clinic of a university hospital.
  
  
  METHODS
  There were 438 female patients aged 60 years or older included in the analysis.
  
  
  METHODS
  Body mass indexes were calculated from weight (kg) divided by the square of height (m). Functional status was assessed with the evaluation of activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Diseases and drugs were determined after the evaluation of the patients with comprehensive geriatric assessment, physical examination, first-line biochemical tests, and using the patients' self-report and current medication lists.
  
  
  RESULTS
  In total, 438 subjects comprised our study cohort. Mean age was 73.3 ± 6.9 years. Mean BMI was 27.8 ± 5.2 kg/m(2). Linear regression analysis revealed significant and independent association of lower BMI with higher ADL and IADL scores (p = 0.02, B = -0.10; p < 0.001, B = -0.17, respectively). ADL and IADL were significantly negatively correlated with BMI in subjects with normal nutrition (p = 0.03, r = -0.122; p = 0.001, r = -0.183) but not in subjects with malnutrition risk or malnutrition. We suggest that lower BMI is associated with better functional status in Turkish community-dwelling female older people. This association is prominent in the subjects with normal nutritional status.
  
  
  CONCLUSIONS
  Our study recommends the need for further studies accounting for the nutritional status on the relationship between BMI and functionality in different populations and in different settings. It represents an important example for diversity in BMI-functionality relationship.
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey, gbahatozturk@yahoo.com.
authors.forename: Gulistan
authors.initials: G
authors.lastname: Bahat
authors.forename: Asli
authors.initials: A
authors.lastname: Tufan
authors.forename: Yucel
authors.initials: Y
authors.lastname: Aydin
authors.forename: Fatih
authors.initials: F
authors.lastname: Tufan
authors.forename: Zumrut
authors.initials: Z
authors.lastname: Bahat
authors.forename: Timur Selcuk
authors.initials: TS
authors.lastname: Akpinar
authors.forename: Ozlem
authors.initials: O
authors.lastname: Soyluk
authors.forename: Nilgun
authors.initials: N
authors.lastname: Erten
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Karan
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D009752:Nutritional Status / Q000502:physiology*; D010808:Physical Examination / Q000379:methods; D019338:Polypharmacy; D012044:Regression Analysis; D014421:Turkey / Q000453:epidemiology