The impact of waist circumference on function and physical activity in older adults: longitudinal observational data from the osteoarthritis initiative

Nutrition Journal

Stephen J Bartels¹  Todd A Mackenzie¹  Laura K Barre²  Alicia J Zbehlik¹  John A Batsis³ 

[1] The Dartmouth Institute, Dartmouth College, 30 Lafayette St, Lebanon NH 03766, USA;Currently address at Division of Nutritional Sciences, School of Human Ecology, Cornell University, Ithaca, NY 14850, USA;Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH 03755, USA

关键词: Quality of life;    Physical activity;    Disability;    Osteoarthritis;    Waist circumference;    Obesity;   

Others  :  1132519
DOI  :  10.1186/1475-2891-13-81

 received in 2014-02-27, accepted in 2014-07-29,  发布年份 2014

【 摘 要 】

Background

We previously demonstrated that BMI is associated with functional decline and reduced quality of life. While BMI in older adults is fraught with challenges, waist circumference (WC) is a marker of visceral adiposity that can also predict mortality. However, its association with function and quality of life in older adults is not well understood and hence we sought to examine the impact of WC on six-year outcomes.

Methods

We identified adults aged ≥60 years from the longitudinal Osteoarthritis Initiative and stratified the cohort into quartiles based on WC. Our primary outcome measures of function at six year follow-up included: self-reported quality of life [Short Form-12 (SF-12)], physical function [Physical Activity Scale for the Elderly (PASE)] and disability [Late-life Disability Index (LLDI)]. Linear regression analyses predicted 6-year outcomes based on WC quartile category (lowest = referent), adjusted for age, sex, race, education, knee pain, smoking status, a modified Charlson co-morbidity index and baseline scores, where available.

Results

We identified 2,182 subjects meeting our inclusion criteria and stratified the study cohort by quartiles of WC. Mean age ranged from 67.5-68.7 years, 60-71% were female and 80-86% were white. The highest WC quartile compared to 50-75th, 25-50th or lowest quartile, was associated with a greater number of medications (4.3, 4.0, 3.6 and 3.4 [p < 0.001]), lower gait speeds (1.23, 1.27, 1.32, and 1.34 m/s[p < 0.001]), higher rates of knee osteoarthritis (70.2, 62.2, 60.2, 48.6;p < 0.001), higher Charlson co-morbidity scores and greater knee pain (WOMAC scores) (all p < 0.001). At follow-up, adjusted SF-12 physical function subscale and PASE scores, were lowest in the highest WC quartile as compared to the 50-75%, 25-50%, and lowest quartiles [(SF-12 scores: 45.5, 46.7, 47.6, and 47.9), and (PASE scores: 109.6, 128.7, 126.6, and 131.0). The LLDI limitation subscale for disability demonstrated lower scores in the high WC quartile as opposed to the referent group.

Conclusions

Elevated WC is associated with lower quality of life, a decline in physical function, and a slightly higher risk of disability over time. Intervention studies are needed to prevent functional decline in this high-risk population.

【 授权许可】

   
2014 Batsis et al.; licensee BioMed Central Ltd.

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