title: Abdominal obesity as a risk factor for disability in Brazilian older adults.
abstract: OBJECTIVE
  To assess the role of abdominal obesity in the incidence of disability in older adults living in São Paulo, Brazil, in a 5-year period.
  
  
  METHODS
  Longitudinal study, part of the SABE Study (Health, Wellbeing and Aging). We assessed the disability incidence in the period (reported difficulty in at least one activity of daily living (ADL) in 2010) in relation to abdominal obesity in 2006 (waist circumference ≥102 cm in men and ≥88 cm in women). We used Poisson regression to evaluate the association between obesity and disability incidence, adjusting for sociodemographic and clinical factors including BMI.
  
  
  METHODS
  São Paulo, Brazil.
  
  
  METHODS
  Older adults (n 1109) who were independent in ADL in 2006. In 2010, 789 of these were located and re-interviewed.
  
  
  RESULTS
  The crude disability incidence (at least one ADL) was 27·1/1000 person-years in the period. The incidence rate was two times higher in participants with abdominal obesity compared with those without (39·1/1000 and 19·4/1000 person-years, respectively; P<0·001). This pattern was observed in all BMI levels. In regression models, abdominal obesity remained associated with disability incidence (incidence rate ratio=1·90; P<0·03), even after controlling for BMI, gender, age, low grip strength, cognitive impairment, physical inactivity and chronic diseases.
  
  
  CONCLUSIONS
  Abdominal obesity was strong risk factor for disability, showing a more significant effect than BMI, and thus should be an intervention target for older adults. Waist measure is simple, cost-effective and easily interpreted, and therefore can be used in several settings to identify individuals at higher risk of disability.
authors.affiliation: 1School of Applied Sciences,University of Campinas,R. Pedro Zaccaria 1300,Limeira - SP,Brazil,13484-350.
authors.forename: Ligiana Pires
authors.initials: LP
authors.lastname: Corona
authors.affiliation: 2Department of Gerontology,Universidade Federal de São Carlos,São Carlos - SP,Brazil.
authors.forename: Tiago da Silva
authors.initials: TD
authors.lastname: Alexandre
authors.affiliation: 3Department of Medical Surgical Nursing,School of Nursing,University of São Paulo,São Paulo - SP,Brazil.
authors.forename: Yeda Aparecida de Oliveira
authors.initials: YA
authors.lastname: Duarte
authors.affiliation: 4Department of Epidemiology,School of Public Health,University of São Paulo,São Paulo - SP,Brazil.
authors.forename: Maria Lúcia
authors.initials: ML
authors.lastname: Lebrão
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D006233:Persons with Disabilities; D015444:Exercise; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D056128:Obesity, Abdominal / Q000453:epidemiology*; D012307:Risk Factors; D057185:Sedentary Behavior; D012959:Socioeconomic Factors; D055105:Waist Circumference
keywords: Abdominal obesity; Disability; Obesity; Older adults; SABE Study