Dynapenic obesity and the effect on long-term physical function and quality of life: data from the osteoarthritis initiative

BMC Geriatrics

Research Article

Stephen J. Bartels¹  Alicia J. Zbehlik²  Dawna Pidgeon³  John A. Batsis⁴ 

[1] Centers for Health and Aging, Dartmouth College, 03756, Lebanon, NH, USA;Geisel School of Medicine at Dartmouth, 03755, Hanover, NH, USA;Dartmouth Weight and Wellness Center, 03756, Lebanon, NH, USA;Health Promotion Research Center at Dartmouth, 03756, Lebanon, NH, USA;The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, 03756, Hanover, NH, USA;Department of Community and Family Medicine, 03756, Lebanon, NH, USA;Centers for Health and Aging, Dartmouth College, 03756, Lebanon, NH, USA;Geisel School of Medicine at Dartmouth, 03755, Hanover, NH, USA;The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, 03756, Hanover, NH, USA;Section of Rheumatology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, 03756, Lebanon, NH, USA;Department of Rehabilitation, 03756, Lebanon, NH, USA;Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, 03756, Lebanon, NH, USA;Centers for Health and Aging, Dartmouth College, 03756, Lebanon, NH, USA;Geisel School of Medicine at Dartmouth, 03755, Hanover, NH, USA;Dartmouth Weight and Wellness Center, 03756, Lebanon, NH, USA;Health Promotion Research Center at Dartmouth, 03756, Lebanon, NH, USA;The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, 03756, Hanover, NH, USA;

关键词: Dyanpenia;    Obesity;    Osteoarthritis;    Disability;    Muscle function;   

DOI  :  10.1186/s12877-015-0118-9

 received in 2015-05-26, accepted in 2015-10-05,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundObesity is associated with functional impairment, institutionalization, and increased mortality risk in elders. Dynapenia is defined as reduced muscle strength and is a known independent predictor of adverse events and disability. The synergy between dynapenia and obesity leads to worse outcomes than either independently. We identified the impact of dynapenic obesity in a cohort at risk for and with knee osteoarthritis on function.MethodsWe identified adults aged ≥ 60 years from the Osteoarthritis Initiative. Obesity was defined as a body mass index ≥ 30 kg/m2. Dynapenia was classified using the lowest sex-specific tertile of knee extensor strength. Participants were grouped according to obesity and knee strength: dynapenic obesity; dynapenia without obesity; obesity without dynapenia; and no dynapenia nor obesity. Four-year data was available. Self-reported activities of daily living (ADL) were assessed at follow-up. Outcomes of gait speed, 400 m walk distance, Late-life Disability and Function Index (LLFDI), and Short-Form (SF)-12 were analyzed using mixed effects and logistic regression models.ResultsOf 2025 subjects (56.3 % female), mean age was 68.2 years and 182 (24.1 %) had dynapenic obesity. Dynapenic obesity was associated with reduced gait speed, LLFDI-limitations, and SF-12 physical score in both sexes and in the 400 m walk in men only (all p < 0.001). A time*group interaction was significant for dynapenic obese men in the 400 m walk distance only. Odds of ADL limitations in dynapenic obesity was OR 2.23 [1.42:3.50], in dynapenia 0.98 [0.66:1.46], and in obesity 1.98 [1.39:2.80] in males. In females, odds were 2.45 [1.63:3.68], 1.60 [1.15:2.22], and 1.47 [1.06:2.04] respectively.ConclusionDynapenic obesity may be a risk factor for functional decline suggesting the need to target subjects with low knee strength and obesity.

【 授权许可】

CC BY   
© Batsis et al. 2015