title: Body mass index trajectories and functional decline in older adults: Three-City Dijon cohort study.
abstract: Obesity, whose prevalence is increasing, is associated with poor functional status at older ages. However, much of this evidence is cross-sectional with little known about longitudinal associations. We examined associations of body mass index (BMI), and change in BMI, with change in objective [walking speed (WS)] and self-reported (disability) measures of motor decline. Analyses included participants (65-85 years) from the Dijon center of the Three-City study (France) with up to five WS (N = 4007) and six disability assessments (N = 4478) over 11 years. Data were analyzed using regression models for repeated measures. Mean baseline WS was 153 cm/s. Compared to normal weight persons, obese participants at baseline walked slower and reported more disability; they also experienced 45% faster WS decline (-18.63 vs. -12.85 cm/s/10 years, P = 0.002). Participants who lost or gained weight had 47% (-18.85 cm/s/10 years, P < 0.001) and 33% (-17.08 cm/s/10 years, P = 0.002) respectively greater WS decline than participants in the normal BMI change category. 24% of participants reported disability at least once during the follow-up, those who lost or gained weight had a 1.63 and 1.34 respectively higher odds of disability than participants in the normal BMI change category (P = 0.001). Associations remained after adjustment for covariates. In conclusion, obesity is associated with worse motor performances, a higher risk of disability, and faster motor decline. Our results underline the interest of repeated BMI and motor assessments to identify those at higher risk of disability.
authors: U1018, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Aging and Age Related Diseases, INSERM, 94807, Villejuif, France.|UMRS 1018, Univ de Versailles St-Quentin, 78035, Versailles, France.
authors: Fanny
authors: F
authors: Artaud
authors: U1018, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Aging and Age Related Diseases, INSERM, 94807, Villejuif, France.|UMRS 1018, Univ de Versailles St-Quentin, 78035, Versailles, France.|Department of Epidemiology and Public Health, University College London, London, UK.
authors: Archana
authors: A
authors: Singh-Manoux
authors: U1018, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Aging and Age Related Diseases, INSERM, 94807, Villejuif, France.|UMRS 1018, Univ de Versailles St-Quentin, 78035, Versailles, France.
authors: Aline
authors: A
authors: Dugravot
authors: Department of Geriatrics, CHU Dijon, Dijon, France.
authors: Béatrice
authors: B
authors: Tavernier
authors: U897, Neuroepidemiology Team, INSERM, Bordeaux, France.|University of Bordeaux, Bordeaux, France.
authors: Christophe
authors: C
authors: Tzourio
authors: U1018, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Aging and Age Related Diseases, INSERM, 94807, Villejuif, France. alexis.elbaz@inserm.fr.|UMRS 1018, Univ de Versailles St-Quentin, 78035, Versailles, France. alexis.elbaz@inserm.fr.
authors: Alexis
authors: A
authors: Elbaz
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D005602:France / Q000453:epidemiology; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009765:Obesity / Q000150:complications*; D011597:Psychomotor Performance; D012307:Risk Factors; D012959:Socioeconomic Factors; D016138:Walking; D015430:Weight Gain
keywords: Aged; Body mass index; Cohort study; Disability; Epidemiology; Motor decline