title: Longitudinal associations between body composition, sarcopenic obesity and outcomes of frailty, disability, institutionalisation and mortality in community-dwelling older men: The Concord Health and Ageing in Men Project.
abstract: to explore the longitudinal associations between body composition measures, sarcopenic obesity and outcomes of frailty, activities of daily living (ADL) and instrumental ADL (IADL) disability, institutionalisation and mortality.
  
  
  
  men aged ≥ 70 years (2005-07) from the Concord Health and Ageing in Men Project were assessed at baseline (n = 1,705), 2 (n = 1,366) and 5 years (n = 954). The main outcome measures were frailty (adapted Fried criteria), ADL, including personal care and mobility and IADL disability (ability to perform tasks for independent living), institutionalisation and mortality. The Foundation for the National Institutes of Health cut-points were used for low muscle mass: appendicular lean mass (ALM):Body Mass Index (BMI) ratio (ALMBMI) <0.789 and obesity was defined as >30% fat. Generalised estimating equations were used to examine the longitudinal associations between the independent variables (obesity alone, low muscle mass and sarcopenic obesity) and frailty, ADL and IADL disability.
  
  
  
  in unadjusted, age adjusted and fully adjusted analysis, men with low muscle mass showed increased risk of frailty and IADL disability. In fully adjusted analysis, men with sarcopenic obesity had an increased risk of frailty (odds ratio (OR): 2.00 (95% confidence of interval (CI): 1.42, 2.82)) ADL disability (OR: 1.58 (95% CI: 1.12, 2.24)) and IADL disability (OR: 1.36 (95% CI: 1.05, 1.76)). Obesity alone was protective for institutionalisation (OR: 0.51 (95% CI: 0.31, 0.84)) but was not associated with any other outcomes.
  
  
  
  low muscle mass and sarcopenic obesity were associated with poor functional outcomes, independent of confounders. This would suggest that future trials on frailty and disability prevention should be designed to intervene on both muscle mass and fat mass.
authors.affiliation: School of Life and Environmental Sciences Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia.|Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Sydney, Australia.|The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia.
authors.forename: Vasant
authors.initials: V
authors.lastname: Hirani
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Sydney, Australia.
authors.forename: Vasi
authors.initials: V
authors.lastname: Naganathan
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Sydney, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Blyth
authors.affiliation: ANZAC Research Institute & Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.affiliation: Bone Research Program, ANZAC Research Institute, and Department of Endocrinology & Metabolism, Concord Hospital, The University of Sydney, New South Wales, Sydney, Australia.
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Seibel
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Sydney, Australia.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Waite
authors.affiliation: Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Sydney, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Handelsman
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Sydney, Australia.|The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia.|School of Public Health, University of Sydney, New South Wales, Sydney, Australia.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
mesh_terms: D000203:Activities of Daily Living; D050154:Adiposity; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001823:Body Composition; D002423:Cause of Death; D004185:Disability Evaluation; D016330:Frail Elderly; D000073496:Frailty / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living; D007326:Institutionalization; D008137:Longitudinal Studies; D008297:Male; D054526:Men's Health; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000503:physiopathology; D009517:New South Wales / Q000453:epidemiology; D009765:Obesity / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D055948:Sarcopenia / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D012737:Sex Factors; D013997:Time Factors
keywords: ADL and IADL disability; body composition; frailty; institutionalisation; mortality; older men