title: Fitness but not weight status is associated with projected physical independence in older adults.
abstract: Obesity and fitness have been associated with older adults' physical independence. We aimed to investigate the independent and combined associations of physical fitness and adiposity, assessed by body mass index (BMI) and waist circumference (WC) with the projected ability for physical independence. A total of 3496 non-institutionalized older adults aged 65 and older (1167 male) were included in the analysis. BMI and WC were assessed and categorized according to established criteria. Physical fitness was evaluated with the Senior Fitness Test and individual test results were expressed as Z-scores. Projected ability for physical independence was assessed with the 12-item composite physical function scale. Logistic regression was used to estimate the odds ratio (OR) for being physically dependent. A total of 30.1 % of participants were classified as at risk for losing physical independence at age 90 years. Combined fitness and fatness analysis demonstrated that unfit older adults had increased odds ratio for being physically dependent in all BMI categories (normal: OR = 9.5, 95 %CI = 6.5-13.8; overweight: OR = 6.0, 95 %CI = 4.3-8.3; obese: OR = 6.7, 95 %CI = 4.6-10.0) and all WC categories (normal: OR = 10.4, 95%CI = 6.5-16.8; middle: OR = 6.2, 95 %CI = 4.1-9.3; upper: OR = 7.0, 95 %CI = 4.8-10.0) compared to fit participants that were of normal weight and fit participants with normal WC, respectively. No increased odds ratio was observed for fit participants that had increased BMI or WC. In conclusion, projected physical independence may be enhanced by a normal weight, a normal WC, or an increased physical fitness. Adiposity measures were not associated with physical independence, whereas fitness is independently related to physical independence. Independent of their weight and WC status, unfit older adults are at increased risk for losing physical independence.
authors.affiliation: Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Lisboa, Portugal. lsardinha@fmh.ulisboa.pt.
authors.forename: Luis B
authors.initials: LB
authors.lastname: Sardinha
authors.affiliation: Study and Research Group in Metabolism, Nutrition, and Exercise GEPEMENE, State University of Londrina - UEL, Londrina, Brazil.
authors.forename: Edilson S
authors.initials: ES
authors.lastname: Cyrino
authors.affiliation: Study and Research Group in Metabolism, Nutrition, and Exercise GEPEMENE, State University of Londrina - UEL, Londrina, Brazil.
authors.forename: Leandro Dos
authors.initials: LD
authors.lastname: Santos
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.|Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Ulf
authors.initials: U
authors.lastname: Ekelund
authors.affiliation: Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Lisboa, Portugal.
authors.forename: Diana A
authors.initials: DA
authors.lastname: Santos
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001835:Body Weight / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D016017:Odds Ratio; D010809:Physical Fitness / Q000502:physiology*; D011174:Portugal / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Adiposity; BMI; Physical fitness; Waist circumference