Dynapenic Abdominal Obesity as a Predictor of Worsening Disability, Hospitalization, and Mortality in Older Adults: Results From the InCHIANTI Study.
BACKGROUND
There are relatively few prospective studies evaluating the combined effect of abdominal obesity and low muscle strength on mortality, hospitalization, and incident disability. The aim of this study was to prospectively evaluate the prognostic value of dynapenic abdominal obesity on incident disability, hospitalization, and mortality in the population of the InCHIANTI study.


METHODS
In 370 men and 476 women aged between 65 and 95 years, handgrip strength, waist circumference (WC), body mass index, interleukin-6, C-reactive protein, education, medications, smoking status, and comorbidities were evaluated at the baseline. Difficulties in performing basic activities of daily living were assessed at baseline and at 3-, 6-, and 9-year follow-ups, using a standardized questionnaire. Hospitalization and mortality rates were evaluated during an 11-year follow-up. The study population was categorized as nondynapenic nonabdominal obese (ND/NAO, reference group), dynapenic nonabdominal obese (D/NAO), nondynapenic abdominal obese (ND/AO), and dynapenic abdominal obese (D/AO), according to handgrip strength/WC tertiles.


RESULTS
D/AO participants presented more than a twofold increase in risk of worsening disability (odds ratio = 2.10; 95% confidence interval [CI]: 1.14-3.88) and significantly higher risk of hospitalization (1.36; 95% CI: 1.04-1.78) compared with ND/NAO participants. After adjustment for potential confounders, the relative risk of death was 1.47 (95% CI: 1.09-1.97) for D/NAO compared with the ND/NAO group.


CONCLUSIONS
Dynapenic abdominal obese participants are at higher risk of worsening disability and hospitalization than ND/NAO participants. Mortality risk was higher in participants with dynapenia without central fat distribution compared with the reference group.
Department of Medicine, Geriatrics Division, University of Verona, Italy.
Andrea P
AP
Rossi
Department of Medicinal Sciences, University of Ferrara, Italy.
Lara
L
Bianchi
Department of Medicinal Sciences, University of Ferrara, Italy.
Stefano
S
Volpato
Geriatric Unit, Local Health Authority-Tuscany Centre, Florence, Italy.
Stefania
S
Bandinelli
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore.
Jack
J
Guralnik
Department of Medicine, Geriatrics Division, University of Verona, Italy.
Mauro
M
Zamboni
Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.
Luigi
L
Ferrucci
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D018737:Hand Strength; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D007558:Italy / Q000453:epidemiology; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D011379:Prognosis; D012307:Risk Factors; D055105:Waist Circumference
D015850:Interleukin-6; D002097:C-Reactive Protein
Disability; Dynapenia; Mortality; Muscle strength; Sarcopenic obesity