title: Association of Dynamics in Lean and Fat Mass Measures with Mortality in Frail Older Women.
abstract: The relationship between body composition and mortality in frail older people is unclear. We used dual-x-ray absorptiometry (DXA) data to examine the association between dynamics in whole-body composition and appendicular (4 limbs) and central (trunk) compartments and all-cause mortality in frail older women.
  
  
  
  Prospective study with up to 19 years of follow up.
  
  
  
  Community dwelling older (≥65) women.
  
  
  
  876 frail older participants of the Women's Health Initiative Observational Study with a single measure of body composition and 581 participants with two measures.
  
  
  
  Frailty was determined using modified Fried's criteria. All-cause mortality hazard was modeled as a function of static (single-occasion) or dynamic changes (difference between two time points) in body composition using Cox regression.
  
  
  
  Analyses adjusted for age, ethnicity, income, smoking, cardiovascular disease, diabetes, stroke, number of frailty criteria and whole-body lean mass showed progressively decreased rates of mortality in women with higher appendicular fat mass (FM) (P for trend=0.01), higher trunk FM (P for trend=0.03) and higher whole-body FM (P for trend=0.01). The hazard rate ratio for participants with more than a 5% decline in FM between two time points was 1.91; 1.67 and 1.71 for appendicular, trunk and whole-body compartment respectively as compared to women with relatively stable adiposity (p<0.05 for all). Dynamics of more than 5% in lean mass were not associated with mortality.
  
  
  
  Low body fat or a pronounced decline in adiposity is associated with increased risks of mortality in frail older women. These results indicate a need to re-evaluate healthy weight in persons with frailty. .
authors.affiliation: Oleg Zaslavsky, PhD, Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA, Email: oleg.zaslavsky@fulbrightmail.org, Phone number: 206-849-3301.
authors.forename: O
authors.initials: O
authors.lastname: Zaslavsky
authors.forename: E
authors.initials: E
authors.lastname: Rillamas-Sun
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.forename: S
authors.initials: S
authors.lastname: Going
authors.forename: M
authors.initials: M
authors.lastname: Datta
authors.forename: L
authors.initials: L
authors.lastname: Snetselaar
authors.forename: S
authors.initials: S
authors.lastname: Zelber-Sagi
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006801:Humans; D008875:Middle Aged; D064887:Observational Studies as Topic; D016016:Proportional Hazards Models; D011446:Prospective Studies